Cyclin D1 and p53 overexpression predicts multiple primary malignant neoplasms of the hypopharynx and esophagus

Background: Multiple primary upper aerodigestive tract carcinomas can occur in up to 15% of patients. We have shown previously that half of the patien ts with multiple upper aerodigestive tract squamous cell carcinomas are ini tially seen with synchronous tumors. Most metachronous squamous cell carcin omas become manifest within 3 years. Objective: To examine the expression of 2 proteins-cyclin D1 and p53-in an attempt to predict the occurrence of multiple primary malignant neoplasms ( MPs). Materials and Methods: Monoclonal antibodies to cyclin D1 (DCS-6 [dilution, 1:50], Novocastra Laboratories Ltd, Newcastle, England) and p53 (DO-7 [dil ution, 1-100], Dako Corp, Carpinteria, Calif) proteins were used. Resection specimens from a total of 47 patients, 12 patients with MP and 35 patients with nonmultiple primary malignant neoplasms, were analyzed. Those in the nonmultiple primary malignant neoplasm group had longer than 3 years' follo w-up to ascertain the absence of MP. Results: Tumor overexpression of cyclin D1 was significantly associated wit h the development of MP (P<.01). Tumor overexpression of p53 was also frequ ent in patients with MP although statistical significance was not achieved. The combination of these 2 parameters was an even greater predictor of MP (P<.001). Conclusions: Overexpression of cyclin D1 and p53 proteins was highly correl ated with the development of MP. Additional studies are neccesary to confir m this finding. :Immunohistochemical evaluation of primary squamous cell ca rcinomas-for cyclin D1 and p53 overexpression may become an important fact of surgical pathologic reporting for primary upper aerodigestive tract squa mous cell carcinomas.