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Article
June 1997

p53 Mutation as a Prognostic Marker in Advanced Laryngeal Carcinoma

Author Affiliations

for the Department of Veterans Affairs Laryngeal Cancer Cooperative Study Group
From the Departments of Otolaryngology/Head and Neck Surgery (Drs Bradford, Zhu, Carey, and Wolf and Ms Poore), Pathology (Dr Beals), and Pediatrics and Communicable Diseases (Drs Thoraval and Hanash), University of Michigan Medical Center, Ann Arbor; the Department of Veteran Affairs Medical Center, Ann Arbor (Drs Bradford, Zhu, and Beals and Ms Poore); and the Department of Obstetrics and Gynecology, Loyola University, Maywood, Ill (Dr Fisher). A list of participants in the Department of Veterans Affairs Laryngeal Cancer Cooperative Study Group appears in the acknowledgment section at the end of the article.

Arch Otolaryngol Head Neck Surg. 1997;123(6):605-609. doi:10.1001/archotol.1997.01900060047008
Abstract

Objective:  To determine the relationship of p53 mutations in advanced laryngeal carcinomas to p53 immunohistochemistry, organ preservation, and patient survival.

Design:  Paraffin-embedded tumor specimens were obtained from patients enrolled in the Department of Veterans Affairs Laryngeal Cancer Cooperative Study, a multi-institutional randomized clinical trial comparing induction chemotherapy (cisplatin and fluorouracil) plus radiation therapy with surgery plus postoperative radiation therapy. Tumor specimens were analyzed for p53 mutations in exons 5 through 8 by using single-strand conformational polymorphism (SSCP) analysis followed by DNA sequencing of all variants. Fiveyear follow-up data were available for all patients studied.

Subjects:  Forty-four patients enrolled in the Department of Veterans Affairs Laryngeal Cancer Cooperative Study from whom paraffin-embedded tumor specimens were readily available.

Results:  p53 immunostaining did not correlate with p53 SSCP and DNA sequencing results. More than half (62% [16/26]) of the tumors that overexpressed p53 immunohistochemically did not have a detectable p53 gene mutation. Similarly, 39% (7/18) of tumors that did not overexpress p53 did have a p53 gene mutation. p53 mutations were present in 39% of tumors tested. Mutations within exon 5 made up 41% of p53 gene mutations in laryngeal carcinomas. Transitions were the most common type of mutation in this study (92% of mutations).

Conclusions:  The presence of a p53 mutation as detected by SSCP is associated with decreased patient survival. Further study is required to confirm this relationship and to determine whether specific p53 mutations predict organ preservation.Arch Otolaryngol Head Neck Surg. 1997;123:605-609

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