OVEREXPRESSION OF P53 PREDICTS SHORTER SURVIVAL IN DIFFUSE-TYPE GASTRIC-CANCER

Background It has been suggested that p53 plays an important part in g astric carcinogenesis but the data remain inconclusive. Methods Altera tion of the tumour suppressor gene p53 was prospectively investigated by immunohistochemistry in 168 primary gastric cancers. Results Positi ve staining? indicative of gene mutations, was detected in 34 tumours (20.2 per cent). No correlation was observed between expression of p53 and various clinicopathological factors, including age, sex, tumour s ite, gross type, tumour size, depth of invasion, lymph node metastases , distant metastases, and tumour node metastasis stage. However, p53 o verexpression was different between intestinal and diffuse type gastri c cancer. Survival analysis revealed a significant survival disadvanta ge of p53 expression in diffuse type gastric cancer (P = 0.039) but no t in the intestinal type. Multivariate analysis of all 168 patients re vealed that independent predictors of recurrent disease included age, invasion depth and nodal involvement but not p53 expression. Conclusio n The presence of p53 overexpression may identify a subset of more agg ressive tumours with a poor prognosis in diffuse type gastric cancer.