CLINICAL-SIGNIFICANCE OF P53, NM23, AND BCL-2 IN T3-4N1M0 ESOPHAGEAL-CARCINOMA - AN IMMUNOHISTOCHEMICAL APPROACH

Background and Objective: The purpose of this retrospective study was to test whether the expression of p53, nm23, and bcl-2 in T3-4N1M0 oes ophageal carcinoma is associated with patient survival. Methods: Immun ohistochemical localisation of p53, nm23, and bcl-2 was performed on f ormalin-fixed, paraffin-embedded tissue sections (N = 46). The observe d range of follow-up period was 0.2-24.0 months with a median of 11.0 months. A total of 85% (39/46) of the patients died within 24.0 months , which could be due to advanced disease at presentation. The immunohi stochemical signal was expressed as the proportion of positive cells. The immunostaining for p53 was nuclear, whereas that for nm23 and bcl- 2 was cytoplasmic in the neoplastic cells. Results: p53 was expressed in 70% (32/46) of cases; nm23 in 29% (13/45), and bcl-2 in 67% (29/43) of tumours. The univariate analysis showed that the expression of two markers, i.e., expression of p53 and absence of nm23 were independent ly associated with unfavourable overall survival time. Despite a small number of patients treated with adjuvant therapy, we observed that tu mours positive for p53 had an unfavourable prognosis when compared wit h tumours negative for p53. Conclusions: Our preliminary findings sugg est: expression of p53 and nm23 negativity may be related to an unfavo urable prognosis in patients with advanced oesophageal carcinoma. (C) 1997 Wiley-Liss, Inc.