p53 in surgically treated and pathologically staged cervical cancer: Correlation with local tumor progression, but not with lymphatic spread

There is only limited information about the prognostic value of p53 immunos taining in cervical cancer. The purpose of this study was to assess the cli nical significance of p53 and prognosis in operatively treated cervical car cinoma. A hundred and fourteen primary surgically treated cervical carcinomas (CX) were obtained from the so called Wertheim Archive in the Department of Obst etrics and Gynecology at the University of Leipzig. These included 105 squa mous cell cancer (SCC) and nine adenocarcinomas (AC). No cases received neo adjuvant therapy. For immunohistochemical analysis, the cases were tested w ith the monoclonal antibody DO-7 (DAKO Diagnostics, Denmark). Two hundred t umor cell nuclei were counted for positive nuclear immunostaining, regardle ss of staining intensity. Cases were stated as positive when a minimum of 1 0% nuclei showed positive staining. Fresh frozen tissue was available from 21 CX for p53-mutation analysis (exons 4-9) using PCR-based amplification a nd SSCP-analysis. Of the squamous cell cancers (SCC), 63.8% showed positive nuclear p53-immun ostaining; adenocarcinomas (AC) were completely negative (P = 0.0000, Chi(2 )-test). Stage-by-stage analysis revealed no differences in p53-expression. However, combining pT1b- and pT2-cases, the difference in positive immunos taining reached statistical significance (44.4% vs. 71.7%; P = 0.007). Ther e were no differences in p53-reactivity regarding the presence of pelvic ly mph node metastases, tumor grading, relapse-free survival and tumor recurre nce. In addition, only 5% of CX with positive p53-immunostaining showed gen omic alterations in mutational analysis. p53-immunoreactivity showed signif icant correlation with local tumor progression but not with lymphatic sprea d, lacking any prognostic impact in surgically treated cervical cancer. The re is no correlation of p53-immunostaining with the occurrence of p53-gene mutations in cervical cancer.