Expression of p53 in the Tumor and Oral Epithelium in Patients with Cancer of Mouth and Pharynx

Summary

Introduction: Expressive percent of patients with oral and oral pharynx carcinomas presents with overexpression of protein p53 induced by tobacco, alcohol and radiotherapy.

Objective: To describe the p53 expression in areas of the normal mucosa adjacent to the tumor and in mouth and pharynx carcinomas.

Method: Prospective study with clinical follow-up of one year of 24 patients with oral and oral pharynx spinocellular carcinoma. We performed biopsies in the neoplasm and areas of the normal mucosa adjacent to the tumor, before and 9 months following radiotherapy and an immunohistochemical study of p53 expression.

Results: Before radiotherapy, there was a change to the p53 expression in 20 out of the 24 biopsies made in the neoplasm and in 14 in those of normal mucosa adjacent to the tumor. Eleven patients died 1 year before clinical follow-up. From the 2 initial patients with increase of p53 after radiotherapy it remained increased in 7 in the neoplasm region and in 6 in the normal mucosa regions. We noticed association of p53 with smoking and tumor stage (p < 5%), but not with the degree of cellular differentiation and alcoholism.

Conclusion: The increase to the p53 expression was viewed both in the neoplasm region and in the normal mucosa in most patients with oral and oral pharynx carcinoma before and after radiotherapy. There was a statistically significant correlation of the p53 expression with smoking and neoplasm stage.

Resumo

Introdução: Expressiva porcentagem de pacientes com carcinomas de boca e faringe apresentam superexpressão da proteína p53 induzida por tabaco, álcool e radioterapia.

Objetivo: Descrever a expressão da p53 em áreas de mucosa normal adjacente ao tumor e em carcinomas da boca e faringe.

Método: Estudo prospectivo, com seguimento clínico por um ano, de 24 pacientes com câncer espinocelular de boca e faringe. Foram feitas biópsias na neoplasia e em áreas de mucosa normal adjacente ao tumor, antes e 9 meses após a radioterapia, e realizado estudo imunohistoquímico da expressão da p53.

Resultados: Antes da radioterapia, houve alteração da expressão da p53 em 20 das 24 biópsias feitas na neoplasia e em 14 nas de mucosa normal adjacente ao tumor. Onze paciente morreram antes de 1 ano de seguimento clínico. Dos 2 pacientes iniciais com aumento da p53 após a radioterapia continuava aumentada em 7 na área da neoplasia e em 6 nas áreas de mucosa normal. Observou-se associação da p53 com o tabagismo e estádio do tumor (p < 5%) mas não com o grau de diferenciação celular e alcoolismo.

Conclusão: O aumento da expressão da p53 foi observado tanto na área da neoplasia como em mucosa normal na maioria dos pacientes com carcinoma de boca e faringe antes e após a radioterapia. Houve correlação estatisticamente significante da expressão da p53 com o tabagismo e estádio da neoplasia.

Keywords

mouth neoplasms - pharynx neoplasms - p53 genes - cocarcinogenesis

Palavras-chave

neoplasias bucais - neoplasias faríngeas - genes p53 - cocarcinogênese

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