THE PROGNOSTIC-SIGNIFICANCE OF THE BIOMARKERS P21(WAF1 CIP1), P53, AND BCL-2 IN LARYNGEAL SQUAMOUS-CELL CARCINOMA/

BACKGROUND. The clinical course of laryngeal squamous cell carcinoma ( LSCC) varies considerably among patients. New biologic markers are nee ded to facilitate the stratification of individual patients within the conventional clinicopathologic stages of LSCC. METHODS. Eighty-three LSCCs from an equal number of patients who received at least 10 years of follow-up were investigated for p53, p21(WAF1/CIP1), and bcl-2 prot ein expression by immunohistochemical techniques. The results were cor related with various clinicopathologic parameters, DNA content, and pa tient outcome by univariate and multivariate statistical analyses. RES ULTS. Stage IV disease, large tumor size (>3 cm), positive lymph node status, extranodal extension, and p53 overexpression (in > 75% of cell s) correlated significantly with prognosis in univariate analysis. The re was no correlation between patient outcome and age, gender, race, h istologic differentiation, or expression of bcl-2 or p21(WAF1/CIP1). I n multivariate analysis, lymph node status and p53 overexpression were the only factors significantly associated with survival. CONCLUSIONS. High p53 expression and positive lymph node status were independent p redictors of the outcomes of patients with LSCC. These factors may ass ist in prognostication and better classification of patients for treat ment. (C) 1998 American Cancer Society.