P53 AND DISEASE PROGRESSION IN PATIENTS WITH NON-SMALL-CELL LUNG-CANCER

Present methods of predicting nodal progression preoperatively in pati ents with nonsmall cell lung cancer (NSCLC) are inadequate. Our hypoth esis was that p53 expression in primary NSCLC would predict disease pr ogression, making it a useful marker of adverse outcome. From 1987 to 1992, sixty-eight consecutive NSCLC patients underwent potentially cur ative lung resection and mediastinal lymph node dissection by one surg eon. Primary tumours were analysed using the p53 monoclonal antibody 1 801. p53 overexpression was found in 53% of tumours, p53 expression di d not correlate with age, gender, histology or stage. A trend toward a higher incidence of p53 expression was seen in tumours with nodal spr ead (P = 0.06), and p53 expression correlated significantly (P = 0.03) with improved disease-free survival in patients with squamous cell ca rcinoma (SCC). p53 was the fourth most important independent predictor of survival, behind histology, gender and nodal disease. As a weak in dependent predictor of survival, the correlation of p53 expression wit h survival in patients with SCC must be evaluated with caution. If bor ne out in a larger patient population, p53 expression may be a marker of nodal disease progression in patients with NSCLC.