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Expression of p53 Protein in Advanced Head and Neck Squamous Cell Carcinoma Before and After Chemotherapy
Cherie H. Dunphy, MD;
Frank R. Dunphy, MD;
James H. Boyd, MD;
Mark A. Varvares, MD;
Han J. Kim, MD;
Val Lowe, MD;
Teresa L. Dunleavy, RN;
Jack Rodriguez, MD;
Erin M. McDonough, PhD;
Jeffrey Minster, MBA
Arch Otolaryngol Head Neck Surg. 1997;123(11):1223-1225.
Abstract
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Background
The expression of p53 protein has been reported to be in the range of 35% to 67% in head and neck squamous cell carcinoma (HNSCC). Mutations of the gene for p53 protein have been associated with rapidly proliferating tumors, and p53 protein expression has been shown to be a significant predictor of worse survival in surgically resected HNSCC. To determine whether p53 protein expression in advanced (stages III and IV) HNSCC has any impact on tumor response to 2 to 3 courses of paclitaxel (Taxol) and carboplatin, we prospectively studied prechemotherapy specimens from patients with previously untreated, advanced-stage HNSCC. We also attempted to study residual tumors after chemotherapy to determine if the p53 status of the tumor changed.
Design
The expression of p53 protein was evaluated by immunohistochemical analysis (clone BP53-12-1; Bio-Genex, San Ramon, Calif).
Setting
Tertiary university medical center.
Intervention
Two to 3 courses of chemotherapy with paclitaxel and carboplatin.
Main Outcome Measures
Pathologic complete remission or residual tumor.
Results
The results of p53 immunostaining were positive in 24 (67%) of 36 HNSCC specimens before chemotherapy. After chemotherapy, 8 patients achieved pathologic complete remission. Before chemotherapy, the tumor was p53 negative in 2 patients and positive in 6 patients.
Conclusions
No correlation of p53 protein expression with response to chemotherapy was noted. The expression of p53 protein converted from positive to negative in 5 (42%) of 12 specimens from patients with residual tumor after chemotherapy, with no impact on clinical outcome.
Arch Otolaryngol Head Neck Surg. 1997;123:1223-1225
Author Affiliations
From the Departments of Pathology (Dr C. H. Dunphy), Internal Medicine (Drs F. R. Dunphy and Rodriguez and Ms Dunleavy), Otolaryngology (Drs Boyd and Varvares), Radiation Oncology (Dr Kim), Radiology (Dr Lowe), Psychiatry and Human Behavior (Dr McDonough), and Economics (Mr Minster), St Louis University Health Sciences Center, St Louis, Mo.
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