p53 Immunoexpression as a Prognostic Indicator of Survival in Head and Neck Squamous Cell Carcinoma

Background: Morbidity and mortality of head and neck squamous cell carcinoma (HNSCC) remain substantial across the globe. Despite all the considerable technical efforts and intensive therapeutics, HNSCC survival rates have not improved significantly over the past two decades. HNSCC are subject to various recommendations for early detection and management in order to control this devastating disease. Therefore, it is essential to ascertain new prognostic molecular markers which may help to recognize the biological behaviour of the tumor and identify patients with high risk of disease recurrence. The aberrations in the p53 pathway in HNSCC imply that molecular and immunohistochemical analysis (IHC) of this critical tumour suppressor marker may be of diagnostic and prognostic utility in the clinical management of the disease and improve the survival of HNSCC patients. Aim & objective: The prospective study was aimed to determine the association of p53 protein expression in HNSCC cases with certain clinicopathological variables, disease recurrence, overall survival and disease free survival and to assess whether tumor suppressor p53 protein has any prognostic significance in primary HNSCC. Materials & Methods: Expressions of p53 protein were assessed in a series ofhundred histopathologically diagnosed, surgically treated, randomly selected and formalin fixed paraffin embedded (FFPE) biopsy specimens of HNSCC by IHC procedure. Clinical and histopathological data were gathered and patients were followed up for one year/death from the date of surgery. Pearsonchi-square test/ Fisher exact test were used to explore the statistical associations of p53 protein expression with clinicopathological parameters and disease recurrence of HNSCC. In order to investigate the relevance of p53 staining with overall survival and disease free survival, survival analysis was performed by using Kaplan-Meier log rank test. Results and Conclusion: The positive nuclear immunoexpression of p53 was found in 70% of the investigated malignancies, using a threshold of 10% stained cell nuclei. Out of 100 HNSCC cases, 41 died and 16 had disease recurrence during one year follow up. Statistically significant associations were observed for individual tumor stage (p = 0.010), early and advanced tumor stage (p = 0.004) and lymph node involvement (p = 0.028) with p53 immunoexpression. However, no significant correlation was found between p53 immunostaining and disease recurrence (p = 0.634), overall survival (p = 0.556) and