Expression of the p53 protein and clinical and pathologic correlation in adenocarcinoma of the rectum

Abstract

BACKGROUND: p53 is a tumor suppressor gene that has been implicated in the pathogenesis of a wide range of tumors, including colorectal cancer. AIM: To evaluate the prognostic significance of p53 protein expression, and to correlate with clinical and pathologic variables as well as survival. PATIENTS AND METHODS: Immunohistochemical staining for p53 protein was performed in a series of 83 patients with rectal cancer with a follow-up of at least 5 years. RESULTS: Expression of nuclear protein was positive in 36 (43.4%) of the tumors. We found association between positive p53 and death, local recurrence, distant metastasis and overall recurrence and we also found association between p53 and death, local recurrence, metastasis and overall recurrence when analysis was adjusted to Astler-Coller stage and grade of differentiation. CONCLUSION: p53 immunoexpression has shown to be an independent prognostic factor in these series.

The Prognostic Value of the Apoptosis Pathway in Colorectal Cancer: A Review of the Literature on Biomarkers Identified by Immunohistochemistry

“…Four of these 30 papers confirmed the results of Munro et al and claimed p53 to be a significant, prognostic marker in colorectal cancer. 73–76 Table 3 provides an overview of their study characteristics. From this table, it can be concluded that although p53 has been widely studied, the studies reporting on statistically significant prognostic relevance show differences in population size, tumor type selection, and disease stage selection.…”

Analysis of AC3-33 gene expression in multiple organ cancer and adjacent normal tissue by RNA in situ hybridization

“…It has been proposed that genetic alterations acquired during tumor development may predict prognosis (14). For example, the expression of the p53 protein has been found to predict a worse prognosis in rectal adenocarcinoma (14). Similarly to SCC of the esophagus, the current study identified positive AC3-33 expression in rectal adenocarcinoma, but negative expression in cancer-adjacent normal rectal tissue.…”

“…Although the prognosis of rectal adenocarcinoma is associated with histopathological features, including invasion of the rectal wall or perirectal fat and lymph node involvement, a number of patients experience recurrence despite undergoing potentially curative procedures and early pathological staging (12)(13). It has been proposed that genetic alterations acquired during tumor development may predict prognosis (14). For example, the expression of the p53 protein has been found to predict a worse prognosis in rectal adenocarcinoma (14).…”

p53 na prática clínica: sim ou não?

“…Os autores não conseguiram demonstrar associação com risco aumentado de câncer e o polimorfismo estudado, entretanto os doentes em estádio mais avançado apresentaram genótipo homozigoto em maior prevalência. No segundo estudo, JURACH et al (6) , da Universidade Federal do Rio Grande do Sul, reportam dados de 83 pacientes com câncer do reto tratados em Porto Alegre e submetidos a análise imunoistoquímica do p53. A imunoexpressão do p53 associou-se com o estádio, histologia e recurrência.…”

“…Como demonstrado na pesquisa de JURACH et al (6) , a imunoexpressão de p53 pode ter valor prognóstico em pacientes com câncer retal, pois maior índice de detecção da proteína tem sido demonstrado em tumores com maior envolvimento linfonodal, como também a sobrevivência de 5 anos é menor nos casos com tumor positivo para p53, quando comparada aos casos negativos (10) . A detecção de mutação do p53 e a perda de alelo representam marcadores de prognóstico desfavorável (10,12,14) , todavia a utilidade da imunoistoquímica ainda é duvidosa e apresenta resultados conflitantes (2,9,11,13) .…”