Immunohistochemical detection of p53 expression in patients with preoperative chemoradiation for rectal cancer: association with prognosis

• Published in: Yonsei medical journal Vol. 56; no. 1; pp. 82 - 88
• Main Authors: Huh, Jung Wook, Lee, Woo Yong, Kim, Seok Hyung, Park, Yoon Ah, Cho, Yong Beom, Yun, Seong Hyeon, Kim, Hee Cheol, Park, Hee Chul, Choi, Doo Ho, Park, Joon Oh, Park, Young Suk, Chun, Ho-Kyung
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01-01-2015; 연세대학교의과대학
• Subjects: Adult; Aged; Chemoradiotherapy; Disease-Free Survival; Female; Humans; Immunohistochemistry; Male; Middle Aged; Multivariate Analysis; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Original; Preoperative Care; Prognosis; Rectal Neoplasms - diagnosis; Rectal Neoplasms - metabolism; Rectal Neoplasms - surgery; Rectal Neoplasms - therapy; Tumor Suppressor Protein p53 - analysis; Tumor Suppressor Protein p53 - immunology; Tumor Suppressor Protein p53 - metabolism; 의학일반; rectal cancer; immunohistochemistry; p53
• ISSN: 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2015.56.1.82

The expression of p53 in patients with rectal cancer who underwent preoperative chemoradiation and and its potential prognostic significance were evaluated.
p53 expression was examined using immunohistochemistry in pathologic specimens from 210 rectal cancer patients with preoperative chemoradiotherapy and radical surgery. All patients were classified into two groups according to the p53 expression: low p53 (<50% nuclear staining) and high p53 (≥50%) groups.
p53 expression was significantly associated with tumor location from the anal verge (p=0.036). In univariate analysis, p53 expression was not associated with disease-free survival (p=0.118) or local recurrence-free survival (p=0.089). Multivariate analysis showed that tumor distance from the anal verge (p=0.006), ypN category (p=0.011), and perineural invasion (p=0.048) were independent predictors of disease-free survival; tumor distance from the anal verge was the only independent predictor of local recurrence-free survival. When the p53 groups were subdivided according to ypTNM category, disease-free survival differed significantly in patients with ypN+ disease (p=0.027) only.
Expression of p53 in pathologic specimens as measured by immunohistochemical methods may have a significant prognostic impact on survival in patients with ypN+ rectal cancer with preoperative chemoradiotherapy. However, it was not an independent predictor of recurrence or survival.