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p53 Mutation as a Prognostic Marker in Advanced Laryngeal Carcinoma

1997; American Medical Association; Volume: 123; Issue: 6 Linguagem: Inglês

10.1001/archotol.1997.01900060047008

1538-361X

Carol R. Bradford, Shuai Zhu, Jesse H. Poore, Susan G. Fisher, Theodore F. Beals, Didier Thoraval, Samir Hanash, Thomas E. Carey, Gregory T. Wolf,

Head and Neck Cancer Studies

Objective: To determine the relationship of p 53 mutations in advanced laryngeal carcinomas to p53 immunohistochemistry, organ preservation, and patient survival. Design: Paraffin-embedded tumor specimens were obtained from patients enrolled in the Department of Veterans Affairs Laryngeal Cancer Cooperative Study, a multi-institutional randomized clinical trial comparing induction chemotherapy (cisplatin and fluorouracil) plus radiation therapy with surgery plus postoperative radiation therapy. Tumor specimens were analyzed for p 53 mutations in exons 5 through 8 by using single-strand conformational polymorphism (SSCP) analysis followed by DNA sequencing of all variants. Fiveyear follow-up data were available for all patients studied. Subjects: Forty-four patients enrolled in the Department of Veterans Affairs Laryngeal Cancer Cooperative Study from whom paraffin-embedded tumor specimens were readily available. Results: p53 immunostaining did not correlate with p 53 SSCP and DNA sequencing results. More than half (62% [16/26]) of the tumors that overexpressed p53 immunohistochemically did not have a detectable p 53 gene mutation. Similarly, 39% (7/18) of tumors that did not overexpress p53 did have a p 53 gene mutation. p 53 mutations were present in 39% of tumors tested. Mutations within exon 5 made up 41% of p 53 gene mutations in laryngeal carcinomas. Transitions were the most common type of mutation in this study (92% of mutations). Conclusions: The presence of a p 53 mutation as detected by SSCP is associated with decreased patient survival. Further study is required to confirm this relationship and to determine whether specific p 53 mutations predict organ preservation. Arch Otolaryngol Head Neck Surg. 1997;123:605-609