P53 PROTEIN EXPRESSION IN A POPULATION-BASED SERIES OF PRIMARY VULVARSQUAMOUS-CELL CARCINOMA AND IMMEDIATE ADJACENT FIELD CHANGE

Objectives. Our aim was to study correlations between survival, diseas e recurrence, and p53 protein expression in a well defined population- based series of vulval squamous cell carcinoma and immediate adjacent epithelial skin changes.Methods. One hundred fifteen vulval squamous c ell carcinoma were studied, Epithelial skin changes immediately adjace nt to tumor were classified into nonneoplastic epithelial disorders (N NED) or vulval intraepithelial neoplasia (VIN). Archival specimens con taining primary tumor and immediate adjacent skin were immunostained w ith a mouse monoclonal antibody to p53 protein. Results, p53 overexpre ssion, defined as greater than 10% nuclear epithelial staining, was ob served in 68% of tumors, Tumor immunostaining did not correlate with a ctuarial survival or disease-free interval, p53 overexpression was ass ociated with a nonsignificant trend toward shorter disease-free interv al in those tumors with nodal metastatic disease at diagnosis (P = 0.0 7). The only clinicopathological variable found to correlate with p53 expression was tumor grade (P = 0.002), Immediate adjacent abnormal sk in changes were associated with p53 overexpression in 32% of cases, Ad jacent normal skin did not immunostain for p53. p53 overexpression was most likely to occur in adjacent epithelial changes incorporating bot h NNED and high grade VIN (P = 0.005). Patterns of epithelial p53 over expression in adjacent abnormal skin were either basal or full thickne ss, Full thickness epithelial p53 overexpression was most likely to oc cur in those disorders containing VIN (P < 0.0001). Positive immunosta ining of adjacent skin abnormalities did not predict local tumor recur rence. Conclusions, This study demonstrates that although vulval squam ous tumor p53 expression is not of prognostic significance, distinct i mmunostaining patterns can be observed in immediate adjacent skin, Vul val epithelial skin disorders displaying histological features of both NNED and VIN III may contain a profile of underlying molecular change which is of significance in subsequent tumor development. (C) 1997 Ac ademic Press.