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Cumulative prognostic value of p53 mutations and bcl‐2 protein expression in head‐and‐neck cancer treated by radiotherapy
Author(s) -
Gallo Oreste,
Chiarelli Ilaria,
Boddi Vieri,
Bocciolini Corso,
Bruschini Luca,
Porfirio Berardino
Publication year - 1999
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/(sici)1097-0215(19991222)84:6<573::aid-ijc6>3.0.co;2-r
Subject(s) - head and neck squamous cell carcinoma , head and neck cancer , medicine , cancer research , radiation therapy , oncology , cancer , gene mutation , univariate analysis , mutation , carcinoma , gene , pathology , biology , multivariate analysis , biochemistry
Abstract We investigated the prognostic significance of p53 ‐gene mutation (exon 5–9) and bcl‐2‐protein expression in primary squamous‐cell carcinoma of the head and neck (HNSCC) treated by curative radiotherapy (RT). Primary squamous‐cell carcinomas for analysis were obtained from 85 consecutive head‐and‐neck‐cancer patients, with complete follow‐up data. We detected bcl‐2 protein in 24% (20/85) of HNSCC studied; 38 (45%) of the 85 tumours had cells bearing p53 mutations. A strong association was observed between tobacco exposure and bcl‐2‐protein expression ( p = 0.003), an association also evident in those patients who had a p53 ‐mutated carcinoma ( p = 0.049). Moreover, we found that most of the bcl‐2‐positive cancers (70%) were also mutated in the p53 gene ( p = 0.010). In univariate and in multivariate analyses, the simultaneous detection of bcl‐2 expression and a p53 ‐gene mutation in a tumour biopsy specimen was associated with greater risk of locoregional failure ( p = 0.002 and 0.001 respectively) and worse survival ( p = 0.045 and 0.033) within 5 years in HNSCC patients treated by RT. The present study shows a cumulative prognostic value of simultaneous detection of bcl‐2 over‐expression and p53 ‐gene aberration in some primary HNSCC treated with conventional RT, and provides further evidence for cross‐talk between p53 and bcl ‐2, suggesting that these genes are important determinants of radiation‐induced apoptosis, thereby modulating resistance to RT. Int. J. Cancer (Pred. Oncol.) 84:573–579, 1999. © 1999 Wiley‐Liss, Inc.