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Chonnam Med J. 2017 May;53(2):140-146. English. Original Article. https://doi.org/10.4068/cmj.2017.53.2.140
Baek DW , Kang BW , Hwang S , Kim JG , Seo AN , Bae HI , Kwon OK , Lee SS , Chung HY , Yu W .
Department of Oncology/Hematology, Kyungpook National University Medical Center, Kyungpook National University Cancer Research Institute, Kyungpook National University School of Medicine, Daegu, Korea. jkk21c@knu.ac.kr, bwkang@knu.ac.kr
Department of Pathology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
Abstract

This study assessed the expression of the p53 protein, beta-catenin, and HER2 and their prognostic implications in patients with EBV-associated gastric cancer (EBVaGC). After reviewing 1318 consecutive cases of surgically resected or endoscopic submucosal dissected gastric cancers, 117 patients were identified as EBV-positive using EBV-encoded RNA in-situ hybridization. The immunohistochemistry results were interpreted as follows: strong p53 nuclear expression in at least 50% of tumor nuclei was interpreted as a positive result, strong beta-catenin expression in at least 10% of cytoplasmic nuclei was interpreted as a positive result, and moderate or strong complete or basolateral membrane staining in 10% of tumor cells was interpreted as a positive result for HER2. Immunohistochemical staining for p53 was performed on tumor tissue from 105 patients, among whom 25 (23.8%) tested positive. Meanwhile, beta-catenin expression was positive in 10 patients (17.5%) and HER2 expression was positive in 8 patients (6.8%). The positive expression of p53 was significantly associated with a high T stage (p=0.006). More patients with lymph node metastasis were p53-positive (p=0.013). In the univariate analysis, the p53-positive patients showed significantly decreased disease-free survival (DFS) when compared with the p53-negative patients (p=0.022), although the p53 status was only marginally associated with overall survival (OS) (p=0.080). However, p53 expression showed no prognostic significance on DFS in the multivariate analysis. Moreover, beta-catenin and HER2 showed no association with DFS and OS in the survival analysis. The current study found a significant correlation between p53 expression and tumor progression and lymph node metastases in patients with EBVaGC.

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