Prognostic Implication of p53 Immunohistochemical Staining in Patients with Localized Renal Cell Carcinoma after Radical Nephrectomy

Lee, Sun Ju; Kim, Duk Kyo; Lee, Choong Hyun; Chang, Sung Goo; Kim, Jin Il; Kim, Youn Wha

Abstract

PURPOSE: p53 gene is a well-known suppressor gene of tumor. And the p53 protein expression in immunohistochemical staining acts a role as a prognostic indicator in prostate and bladder tumor. However, the validity of p53 protein expression was not determined as an independent factor of prognosis in renal cell carcinoma(RCC). Furthermore, there were not enough studies about whether the expression of p53 protein plays a role as a prognostic indicator in RCC or not. Therefore, we evaluate the prognostic significance of p53 protein expression in RCC.
MATERIALS AND METHODS
To evaluate the prognostic significance of p53 immunohistochemical staining in RCC, paraffin embedded specimens taken from 84 patients with RCC were studied from January 1982 to April 1997, retrospectively. In addition to the prognostic significance of p53 immunohistochemical staining, correlation between p53 immunohistochemical staining and pT category, nuclear grade, and histologic type was studied.
RESULTS
The expression rate of p53 protein was 19.0%(16/84). The most important prognostic indicator of RCC was pT category(relative risk=2.19, p=0.007). And the second important prognostic indicator was the expression of p53 protein(relative risk=1.82, p=0.017). Nuclear grade had prognostic significance(p=0.027) but was not an independent prognostic indicator. The expression of p53 protein did not correlate with pT category, nuclear grade or histologic pattern.
CONCLUSIONS
We have shown that the expression of p53 protein in RCC is the second most important prognostic indicator. In conclusion p53 immunohistochemical staining can be used to predict the prognosis in patients with localized RCC after radical nephrectomy.