ANALYSIS AND CLINICAL IMPLICATIONS OF P53 GENE-MUTATIONS AND HUMAN-PAPILLOMAVIRUS TYPE-16 AND TYPE-18 INFECTION IN PRIMARY ADENOCARCINOMA OF THE UTERINE CERVIX

Mutant p53 is frequently detected in endometrial and ovarian carcinoma , but it is rare in cervical cancers. Previous reports focused on cerv ical squamous cell carcinoma, whereas cervical adenocarcinoma was give n little attention. We searched for p53 gene mutations in 74 primary c ervical adenocarcinomas with known human papillomavirus (HPV) status, Our aim was to evaluate the prevalence of p53 mutations and to investi gate their possible role as an independent prognostic factor. We found mutations in 13.5% with a high rate of G:C --> A:T transitions as obs erved in endometrial adenocarcinoma. As p53 mutations are more frequen tly detected in malignancies of high grade, high stage, and large size , this molecular event seems to play a role in the progression rather than in the induction of cervical adenocarcinoma, In our series, patie nts with HPV-negative tumors and patients with mutated neoplasms, irre spective of HPV infection, had a shorter survival. Yet the absence of HPV infection and presence of p53 mutations are not independent risk f actors for tumor-related death after adjustment for clinicopathologica l confounders, The only significant and independent predictors of surv ival are age of patient, stage of disease, tumor grade, and presence o f lymph node metastases.