Correlation of P53 Expression with Various Clinicopathological Parameters of Gastric Carcinoma and Its Relationship with Survival

Abstract

AIM: Gastric cancer is the most aggressive type of cancer. The immunohistochemical protein expression of mutant p53 has been proposed as a potential tool to evaluate the biological behavior of gastric cancer. Predictive value of p53 for survival is debatable; hence this study was formulated to know the survival of patients with p53 expression in gastric cancer.

METHODS: It is prospective study from September 2014 - July 2015, included 58 consecutive patients of gastric cancer. Biopsy specimens were treated immuno-histochemically and expression of p53 gene was analyzed by Immunoreactive Score (IRS). These findings were then compared with clinico-pathological parameters like age, gender, tumor location, tumor size, Laurens classification and TNM staging according to American joint committee for cancer guidelines, using CT scan of abdomen, and histopathological grading and types according to WHO classification.

RESULTS: Mp53 expression was observed in 90% of gastric cancer patients among which 37 (63.8%) patients showed high and 21 (36.2%) patients showed low p53 expression. Level of p53 expression was found significantly associated with age, tumor site, tumor size, histological grade, T stage, M stage and Clinical stage. Multivariate analysis shows that high p53 expression is an independent predictor of survival. On Kaplan-Meier survival analysis, patients with p53 high expression had significantly shorter overall survival than those patients with low p53 expression.

CONCLUSION: Expression of p53 correlates with the survival and is a simple, effective and reproducible modality to determine the prognosis and survival in various grades & stages of gastric cancer.