p53 protein accumulation predicts malignant progression in Barrett's metaplasia: a prospective study of 275 patients.

Abstract

AIMS:

The purpose of this study was to determine prospectively whether p53 protein accumulation in biopsies of Barrett's metaplasia (BM) is a predictor of malignant progression, without relying on dysplasia grading.

METHODS AND RESULTS:

Sections of formalin-fixed paraffin-embedded tissue from the initial biopsies of 275 patients with BM, who had no high-grade dysplasia (HGD) or oesophageal adenocarcinoma (EAC), were stained for p53 by immunohistochemistry. The mean follow-up was 41 months. p53-positive biopsies were divided into four groups: scattered positive cells, multifocal scattered positive cells, aggregates of positive cells, and multifocal aggregates of positive cells. Kaplan-Meier analysis with the log-rank test was used to determine the rate of progression to HGD/EAC. Of the 275 patients, 227 had initial biopsies that were completely negative for p53, and, of these, one (0.4%) progressed to HGD/EAC; none of 24 (0%) patients with scattered positive cells and none of four (0%) of patients with multifocal scattered positive cells progressed. In contrast, five of 16 (31.25%) patients with aggregates of positive cells and three of four (75%) of those with multifocal aggregates of positive cells progressed to HGD/EAC. Kaplan-Meier analysis with log-rank statistics showed the difference in progression rate between the five groups to be highly significant (P < 0.0001).

CONCLUSIONS:

We conclude that p53 protein accumulation, detected by immunohistochemistry in aggregates of cells, is a significant predictor of malignant progression in patients with BM.

• Authors: Mamoun Younes, Keith Brown, Gregory Y Lauwers, Gulchin Ergun, Frank Meriano, A Carl Schmulen, Alberto Barroso, Atilla Ertan
• Journal: Histopathology (Histopathology) Vol. 71 Issue 1 Pg. 27-33 (Jul 2017) ISSN: 1365-2559 [Electronic] England
• PMID: 28226185 (Publication Type: Journal Article)
• Copyright: © 2017 John Wiley & Sons Ltd.

Chemical References

• Biomarkers, Tumor
• TP53 protein, human
• Tumor Suppressor Protein p53

Topics

• Adenocarcinoma (pathology)
• Adult
• Aged
• Aged, 80 and over
• Barrett Esophagus (pathology)
• Biomarkers, Tumor (analysis)
• Cell Transformation, Neoplastic (pathology)
• Disease Progression
• Esophageal Neoplasms (pathology)
• Female
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Precancerous Conditions (pathology)
• Prospective Studies
• Tumor Suppressor Protein p53 (analysis, biosynthesis)
• Young Adult