Abstract
Introduction: Gastric cancer is one of the common cancers after lung cancer worldwide, especially in the developing countries. p53 immunohistochemical expression has been proposed as a potential tool to evaluate the biological behavior of gastric cancer. However, its practical implication in gastric cancer prognosis or treatment by restoration of mutated p53 function is yet to be fully exploited. Hence, this study with the aim of assessing the yield of p53 expression in gastric carcinoma and its relationship with various clinicopathological parameters was formulated.
Objectives: To assess immunohistochemical expression of p53 protein in different histological subtypes of gastric carcinoma cases and to study correlation between p53 protein expression and different clinicopathological parameters like age, gender, tumour location, gross pattern, histological types, degree of tumor differentiation and pathological staging in the above said cases.
Materials and Methods: This was a hospital based cross-sectional study done over a period of 18 months on 60 cases of gastrectomies with proven histological diagnosis of gastric carcinoma.
Observation and Results: Strong p53 expression was frequent among elderly male patients (>60 years) who had ulceroproliferative tumors, located at pyloric antrum belonging to pTNM stage IIIA. In 87% cases, it was expressed, predominantly in moderately differentiated intestinal type with serosal invasion. Also, cases even with no lymph node metastasis showed p53 expression.
Conclusion: Few findings were contradictory to other similar studies e.g. lymph node negative cases showing P53 expression does not support the hypothesis of predicting lymph node status by p53 expression. No significant correlation between p53 expression and different clinicopathological parameters in gastric carcinoma cases was seen.
Keywords: P53, immunohistochemical, clinicopathological, histological subtypes, metastasis.
References
- Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA: Cancer journal for clinicians. 2005 Mar 1;55(2):74-108.
- Srikumar C, Long A, Beh H, Thani P, Kandasamy P, Arni T. The expression of p53 as a reliable immunohistochemical marker for clinicopathological correlation of gastric adenocarcinomas. Research Journal of Medical Sciences. 2010;4(1):15-9.
- Starzynska T, Bromley M, Ghosh A, Stern PL. Prognostic significance of p53 overexpression in gastric and colorectal carcinoma. British journal of cancer. 1992 Sep 1;66(3):558-62.
- Hollstein M, Sidransky D, Vogelstein B, Harris CC. p53 mutations in human cancers. Science. 1991 Jul 5;253(5015):49-53.
- Joypaul BV, Hopwood D, Newman EL, Qureshi S, Grant A, Ogston SA, Lane DP, Cuschieri A. The prognostic significance of the accumulation of p53 tumour-suppressor gene protein in gastric adenocarcinoma. British journal of cancer. 1994 May 1;69(5):943-6.
- Ponnala D, and Madiredddi,S. Evaluation of risk factors for gastric cancer.International Journal of Applied Biology and Pharmaceutical Technology: 2010 May July; 1(1): 158-161.
- Mathew A, Gangadharan P, Varghese C, Nair MK. Diet and stomach cancer: a case-control study in South India. European Journal of Cancer Prevention. 2000 Apr 1;9(2):89-98.
- Siddiqi M, Kumar R, Fazili Z, Spiegelhalder B, Preussmann R. Increased exposure to dietary amines and nitrate in a population at high risk of oesophageal and gastric cancer in Kashmir (India). Carcinogenesis. 1992 Aug 1;13(8):1331-5.
- Gajalakshmi CK, Shanta V. Lifestyle and risk of stomach cancer: a hospital-based case-control study. International journal of epidemiology. 1996 Dec 1;25(6):1146-53.
- Hermiz RS, Hussain AG. Immunohistochemical expression of p53 in gastric carcinoma (A Clinicopathological study). Iraqi Journal of Medical Sciences. 2008 June 8; 6 (2): 77-89.
- Steele RJ, Thompson AM, Hall PA, Lane DP. The p53 tumour suppressor gene. British Journal of Surgery. 1998 Nov 1;85(11):1460-7.
- Fukunaga M, Monden T, Nakanishi H, Ohue M, Fukuda K, Tomita N, Shimano T, Mori T. Immunohistochemical study of p53 in gastric carcinoma. American journal of clinical pathology. 1994 Feb 1;101(2):177-80.
- Brito MJ, Williams GT, Thompson H, Filipe MI. Expression of p53 in early (T1) gastric carcinoma and precancerous adjacent mucosa. Gut. 1994 Dec 1;35(12):1697-700.
- Craanen ME, Blok P, Dekker W, Offerhaus GJ, Tytgat GN. Chronology of p53 protein accumulation in gastric carcinogenesis. Gut. 1995 Jun 1;36(6):848-52.
- Kamran Ghaffarzadegan MD, Mohammad-Reza Zali MD, Khadijeh Jami-Ahmadi Pharm D, Hamid Asadzadeh MD. Correlation of nuclear P53 Immunoreaction with the histopathologic features in gastric carcinoma. Archives of Iranian Medicine. 2004 Oct;7(4):279-83.
- Al-Badri BA, Ali FG. P53 Expression in Gastric Dysplasia and carcinoma in Erbil City. J. Factual Med Baghdad 2011 190; 53 (2).
- Martin HM, Filipe MI, Morris RW, Lane DP, Silvestre F. p53 expression and prognosis in gastric carcinoma. International journal of cancer. 1992 Apr 1;50(6):859-62.
- Mueller WO, Borchard F. Prognostic influence of p53 expression in gastric cancer. The Journal of pathology. 1996 Mar 1;178(3):255-8.
- Rugge M, Shiao YH, Busatto G, Cassaro M, Strobbe C, Russo VM, Leo G, Parenti AR, Scapinello A, Arslan P, Egarter-Vigl E. The p53 gene in patients under the age of 40 with gastric cancer: mutation rates are low but are associated with a cardiac location. Molecular Pathology. 2000 Aug;53(4):207.
- Azarhoush R, Keshtkar AA, Amiriani T, Kazemi-Nejad V. Relationship between p53 expression and gastric cancers in cardia and antrum. Archives of Iranian medicine. 2008;11(5): 502-6.
- Kim JH, Takahashi T, Chiba I, Park JG, Birrer MJ, Roh JK, Lee HD, Kim JP, Minna JD, Gazdar AF. Occurrence of p53 gene abnormalities in gastric carcinoma tumors and cells lines. JNCI: Journal of the National Cancer Institute. 1991 Jul 3;83(13):938-43.
- Roviello F, Marrelli D, Vindigni C, De Stefano A, Spina D, Pinto E. P53 accumulation is a prognostic factor in intestinal-type gastric carcinoma but not in the diffuse type. Annals of surgical oncology. 1999 Dec 1;6(8):739-45.
- Hurlimann J, Saraga EP. Expression of p53 Protein in Gastric Carcinomas Association with Histologic Type and Prognosis. American journal of surgical pathology. 1994 Dec 1;18(12):1247-53.
- Filipe MI. Intestinal metaplasia subtypes and cancer risk. Gastric carcinoma. 1986:65-86.
- Flejou JF, Muzeau F, Potet F, Lepelletier F, Fekete F, Henin D. Over expression of the p53 tumor suppressor gene product in esophageal and gastric carcinomas. Pathology Research and Practice. 1994 Dec 31;190(12):1141-8.
Corresponding Author
Yasap Tana
Consultant, Department of Pathology, Tomo Riba Institute of Health and Medical Sciences, Naharlagun, Arunachal Pradesh, India