Genetic alterations of the TP53 gene, p53 protein expression and HPV infection in primary cervical carcinomas.

Primary cervical carcinomas from 92 patients were investigated for genetic alterations in the tumour suppressor gene TP53. Studies of allelic imbalance (AI) were performed by Southern blot analysis and by using two PCR (polymerase chain reaction) polymorphisms within the TP53 gene. AI in the tumour was observed in 22 per cent (11 of 52 informative patients) and was significantly associated with recurrence both in a univariate (P = 0.013) and in a multivariate (P = 0.045) analysis. The DNA samples were subjected to mutation analysis of four of the conserved domains in the TP53 gene, using PCR followed by constant denaturant gel electrophoresis (CDGE). Mutations were observed in 2 of 92 tumours (2 per cent), of which one was a silent mutation and the other a frameshift. Overexpression of the p53 protein was found by immunostaining of sections from formalin-fixed, paraffin-embedded material in 55 per cent (51/92) of the tumours. In 88 per cent (45/51) of these, overexpression was present in less than 5 per cent of the tumour cells. Overexpression was significantly associated with relapse-free survival only in a univariate analysis (P = 0.045). AI of the TP53 locus did not correlate with p53 expression or mutation. The important gene on 17p, responsible for the shorter disease-free survival for patients with AI of TP53, may therefore be another gene closely linked to TP53. In addition, the 92 tumour samples were tested for the presence of human papillomavirus (HPV) types 16 and 18. Fifty-four per cent (50/92) of the samples were positive for HPV 16 using in situ hybridization, and 93 per cent (86/92) using the PCR technique. The numbers for HPV 18 were 15 per cent (14/92) and 23 per cent (21/92), respectively. Twenty-one per cent (19/92) were positive for both HPV 16 and HPV 18, while 4 per cent (4/92) were negative for both HPV 16 and 18. The tumour with the frameshift TP53 mutation was HPV 16-positive, and the four samples negative for HPV 16 and 18 did not contain TP53 mutations within the conserved domains but had elevated p53 protein expression.