Correlation of tumor markers p53, bcl-2 and cathepsin-D with clinicopathologic features and disease-free survival in laryngeal squamous cell carcinoma

Various recognized prognostic factors in squamous cell carcinoma (SCC) of t he larynx influence the therapeutic options offered to an individual patien t in order to extend the survival expectancy. Additional prognostic indicat ors are required in specific patient subgroups. The present study used a st andard immunohistochemical technique in order to retrospectively evaluate t he accumulation of p53 gene product and the immunoreactivity of bcl-2 prote in and cathepsin-D as possible prognostic markers of laryngeal SCC. Formali n-fixed, paraffin-embedded tumor materials were obtained from a series of 6 4 patients with cancer of the larynx. Immunostaining was evaluated by compu terized image analysis. The accumulation of p53 protein was found in 57.8% (37/64) of the patients and was associated with large tumor size. The perce ntage of p53-positive neoplastic cells increased in high-grade carcinomas, particularly when they simultaneously demonstrated cathepsin-D immunoreacti on in stromal cells (P = 0.049); bcl-2 immunoexpression was found to be gen erally limited. Cathepsin-D immunostaining was observed in tumor parenchyma l and stromal cells (31.25% and 37.5% of all cases, respectively); it was f ound to be useful in defining patient subgroups with differences in relapse -free survival. Among patients with positive lymph nodes, those with cathep sin-D immunopositive tumor cells were at higher risk for relapsing (P = 0.0 395). Although the classical prognostic factors of laryngeal carcinoma reta in their predominance, cathepsin-D immunoreactivity may serve as an additio nal prognosticator in specific patient subgroups.