Cutaneous squamous cell carcinoma and p53 codon 72 polymorphism: A need for screening?

The association between human papillomavirus (HPV)-associated cervical canc er and cutaneous squamous ceil carcinoma and codon 72 polymorphism in the p 53 gene is not unequivocal. Especially, it is not known whether carriers of the arginine form have an increased risk of cancer that necessitates scree ning. The alternative is that the polymorphism is a tumor marker instead of a risk factor. We set out a case-control study to determine the risk of sq uamous cell carcinoma of the skin in individuals with the p53 codon 72 argi nine genotype in order to establish the possible need for screening. The di stribution of the different p53 codon 72 genotypes was examined in 86 subje cts with a history of cutaneous squamous ceil carcinoma and in 168 controls . Additionally, 121 subjects who had had histologically proven basal cell c arcinoma and 108 subjects who had had non-familial malignant melanoma were tested. p53 polymorphism was evaluated by polymerase chain reaction (PCR) u sing DNA samples from peripheral blood lymphocytes. In a subgroup of patien ts with squamous cell carcinoma and controls, the presence of epidermodypla sia verruciformis human papillomavirus (EV-HPV) DNA was determined in pluck ed eyebrow hair. Differences in the distributions of the genotypes among ca ses and controls were calculated, and univariate and multivariate analyses were performed to assess the risk to develop cutaneous squamous ceil carcin oma in the presence of the p53 codon 72 arginine genotype. Frequency distri butions of the three different genotypes (homozygous for the arginine allel e, heterozygous for the two alleles, and homozygous for the proline allele) were similar among the squamous cell carcinoma group and the control group : 47.1%, 46.0% and 6.9% versus 47.8%, 45.8% and 6.4% respectively. Statisti cal analysis showed no significant differences between these groups. In pat ients with squamous cell carcinoma and controls who harbored EV-HPV DNA in their plucked eyebrow hair, similar results were obtained. The distribution s of the p53 codon 72 genotypes in the basal cell carcinoma and malignant m elanoma group were also not significantly different from the control group. p53 codon 72 arginine homozygosity does not appear to represent a signific ant risk factor for cutaneous squamous cell carcinoma and screening seems n ot to be indicated. (C) 2001 Wiley-Liss.