Carlos de Vicente Juan, Junquera Gutiérrez Luis Manuel, Zapatero Agustín Herrero, Fresno Forcelledo Manuel Florentino, Hernández-Vallejo Gonzalo, López Arranz Juan Sebastián
Department of Oral and Maxillofacial Surgery, Hospital Central de Asturias, University of Oviedo, Catedrático José Serrano 33006, Oviedo, Spain.
Head Neck. 2004 Jan;26(1):22-30. doi: 10.1002/hed.10339.
Aberrations of the p53 gene and overexpression of its protein are widely recognized markers of malignancy including oral squamous cell carcinomas. This study was performed to evaluate the relationship of immunoexpression of p53 protein in series of 91 squamous cell carcinomas of the oral cavity with clinicopathologic parameters and to investigate whether p53 immunoexpression might influence the clinical outcome of the disease.
From a group of 287 consecutive patients, 91 surgically treated ones were randomly selected. P53 protein expression was investigated by means of immunohistochemistry. Clinical and histopathologic data were gathered, and the patient survival was analyzed.
Of the oral carcinomas, 52.7% (n = 48) overexpressed p53, using a threshold of 10% stained cell nuclei. There was a negative correlation of p53 immunoexpression with a histologic grade of differentiation (r = -0.236, p =.06) but not with clinical variables. Overall survival rate was 59% at 5 years. In univariate analysis, tumor size, node status, and advanced clinical stage were significantly associated with shortened overall survival. In patients without neck node metastases, p53 showed a strong correlation with survival (p =.01). In multivariate analysis performed only on N0 patients, tumor extension and p53 immunoexpression were found to be the only independent prognostic parameters with relative risks of 1.9 and 4.3, respectively.
A strong relationship was observed between p53 immunoexpression and poor prognosis in patients with oral squamous cell carcinomas without neck node metastases.
p53基因异常及其蛋白过表达是包括口腔鳞状细胞癌在内的恶性肿瘤广泛认可的标志物。本研究旨在评估91例口腔鳞状细胞癌中p53蛋白免疫表达与临床病理参数之间的关系，并探讨p53免疫表达是否可能影响该疾病的临床结局。
从连续的287例患者中随机选取91例接受手术治疗的患者。采用免疫组织化学方法研究p53蛋白表达。收集临床和组织病理学数据，并分析患者的生存率。
在口腔癌中，以10%染色细胞核为阈值，52.7%（n = 48）的患者p53过表达。p53免疫表达与组织学分化程度呈负相关（r = -0.236，p =.06），但与临床变量无关。5年总生存率为59%。单因素分析显示，肿瘤大小、淋巴结状态和临床晚期与总生存期缩短显著相关。在无颈部淋巴结转移的患者中，p53与生存率密切相关（p =.01）。在仅对N0患者进行的多因素分析中，发现肿瘤范围和p53免疫表达是仅有的独立预后参数，相对风险分别为1.9和4.3。
在无颈部淋巴结转移的口腔鳞状细胞癌患者中，观察到p53免疫表达与预后不良之间存在密切关系。
