PROGNOSTIC VALUE OF P53 PROTEIN ACCUMULATION IN CANCER CELL-NUCLEI INADENOCARCINOMA OF THE UTERINE CERVIX

Adenocarcinoma of the uterine cervix (CxAd) is one of the most distres sing malignancies of the female reproductive system because of its ten dency to spread aggressively and to be resistant to radiation and syst emic therapies. To clarify the prognostic significance of p53 alterati on in CxAd, we immunohistochemically examined the incidence of p53 nuc lear accumulation, which is considered to be mostly parallel with p53 gene mutation, and its association with clinicopathological parameters in 26 patients with CxAd. The overall incidence of p53 nuclear accumu lation was 46% (12 of 26), being higher in groups with clinically adva nced disease, higher degrees of cellular atypia, and deeper myometrial invasion, but significantly lower in patients with integration of hum an papillomavirus (HPV) type 16 or 18 DNA. Nuclear p53 immunoreactivit y as well as lymph node status, depth of invasion and the absence of H PV-DNA integration were significant indicators of a poor prognosis. Ex amination of p53 nuclear accumulation could be applied to biopsy mater ial, and would be of practical assistance in predicting the prognosis of CxAd both preoperatively and postoperatively.