THE SIGNIFICANCE OF C-ERB B-2 AND P53 IMMUNOREACTIVITY IN PATIENTS WITH ADENOCARCINOMA OF THE ESOPHAGUS

Objective Studies in breast cancer suggest that p53 and c-erb B2 prote in overexpression are predictive of outcome. The authors determined wh ether these molecular markers correlated with treatment response and s urvival in patients with adenocarcinoma of the esophagus and esophagog astric junction. Method Immunostaining for p53 and c-erb 82 was perfor med on paraffin-embedded specimens from 42 patients with esophageal ad enocarcinoma. Ali patients received neoadjuvant chemotherapy (cisplati n and fluorouracil [5-FU] x 3 cycles) and irradiation (4500 rads) foll owed by resection. Results In this cohort of patients, 79% (33/42) wer e positive for p53, and 43% (18/42) were positive for c-erb B2. p53 po sitivity correlated with residual disease in the resection specimen bu t not with disease-free survival. Although c-erb B2 negativity correla ted with residual disease after resection and a 5-year survival of 10% , c-erb B2 positivity was associated with a 5-year actuarial survival of 60%. Conclusions Although p53 protein overexpression is commonly ob served in adenocarcinoma of the esophagus, its prognostic value appear s limited. In contrast, c-erb B2 protein expression predicts a favorab le response to therapy and improved survival.