title: p53 Immunohistochemistry expression in Wilms tumor: a prognostic tool in the detection of tumor aggressiveness.
abstract: OBJECTIVE
  We studied whether immunohistochemical expression of p53 in Wilms tumors correlates with tumor aggressiveness. We also examined whether preoperative chemotherapy results in any alteration of p53 expression.
  
  
  METHODS
  A total of 18 patients underwent preoperative chemotherapy and 30 underwent immediate surgery for Wilms tumor. All children were younger than 10 years and had histologically confirmed disease. Patients with a bilateral tumor or a syndrome related to Wilms tumor were excluded. All pathology slides were uniformly stained for p53 protein, and p53 staining density and intensity were scored. The p53 scoring was then compared to the clinical behavior of the Wilms tumor, ie unfavorable tumor staging, and survival and recurrence rates.
  
  
  RESULTS
  In the direct surgery and the preoperatively treated groups p53 positivity correlated with unfavorable Wilms tumor staging (p = 0.007). In addition, a positive p53 correlation predicted poorer survival (p = 0.017). Interestingly patients who underwent preoperative chemotherapy had an increased intensity of p53 staining compared to the direct surgery group (p <0.001).
  
  
  CONCLUSIONS
  This study provides preliminary evidence that a higher score for immunohistochemical p53 expression correlates with unfavorable Wilms tumor staging and predicts poorer survival. This test could become a useful addition to the current histopathological analysis of Wilms tumor.
authors.affiliation: Department of Urology and Department of Pathology (EL), University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Franken
authors.forename: Evelyne
authors.initials: E
authors.lastname: Lerut
authors.forename: Hendrik
authors.initials: H
authors.lastname: Van Poppel
authors.forename: Guy
authors.initials: G
authors.lastname: Bogaert
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000737:chemistry* / Q000378:metabolism* / Q000473:pathology; D008297:Male; D011379:Prognosis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis* / Q000096:biosynthesis*; D009396:Wilms Tumor / Q000737:chemistry* / Q000378:metabolism* / Q000473:pathology
chemical_list: D016159:Tumor Suppressor Protein p53