P53 expression as a predictor of recurrence in cervical squamous cell carcinoma

Abstract

P53 protein function is frequently down-regulated in cervical cancer by complexing with human papillomavirus (HPV) E6 protein, leading to degradation of p53, genomic instability, and mutations. Results are controversial, however, on the prognostic value of p53 protein expression in cervical cancer. In this study, a cohort of 220 Brazilian women with FIGO stage IB-III cervical squamous cell carcinoma (SCC), followed for 5 years, was analyzed for p53 protein expression using immunohistochemistry. The disease-free survival (DFS) and relapse rate were analyzed using univariate (Kaplan-Meier) and multivariable (Cox's proportional hazards model) survival analyses. P53 protein expression was detected in 35% of the patients, including 21% in stage I, 28% in stage II and 51% in stage III of disease. Of 220 women, only 116 completed one of the treatment options standardized by FIGO within 120 days. There was a higher risk of relapse in stage II and III disease, that was not modified by p53 positivity; HR 3.0 (1.3-6.5) to stage II and HR 4.0 (1.9-8.5) to stage III. The multivariate analysis evidenced that p53 expression is not an independent factor exceeding the power of FIGO stage as the single most important determinant of the hazards for disease relapse.

Correlation of p53 and Ki‐67 (MIB‐1) expressions with clinicopathological features and prognosis of early stage cervical squamous cell carcinomas

“…Therefore, in this study using DO‐7 monoclonal antibody to p53, the 33.6% p53 expression may represent an accumulation of wild‐type p53 protein. A wide range (8.9–77.6%) of p53 expression in cervical cancer has been published 9–12,24–26 . The varied results may be due to differences between the immunohistochemical methods or antibodies used.…”

“…Overexpression of p53 has been reported to be associated with poor prognosis in many malignant tumors, notably gastric cancer, 5 endometrial cancer, 6 and breast cancer 7 . However, association studies involving cervical cancer have been conflicting, mostly showing no association 8–12 …”

Regulation of cell cycles is of key importance in human papillomavirus (HPV)-associated cervical carcinogenesis

“…3,5 The detection of p53 protein using immunohistochemistry has been studied as a prognostic factor in invasive cervical squamous cell carcinoma. 6 Polymorphisms of the p53 gene seem to be common and have been described in cervical cancer patients as well. People can carry one of two variations of the p53 gene in codon 72; p53 arg or p53 pro.…”

The prognostic values of the expression of Vimentin, TP53, and Podoplanin in patients with cervical cancer

“…However, the clinical prognostic values of TP53 mutations in cervical cancer remains controversial [ 15 ]. It has been suggested that TP53 overexpression is correlated with an unfavourable prognosis in cervical cancer patients [ 16 , 17 ]. Nevertheless, other groups have also reported that TP53 mutations do not display important prognostic values in the management of cervical cancer patients [ 18 , 19 ].…”