Quantitative analysis of p53 expression and cell proliferation in gastric carcinomas. An immunohistochemical study

BACKGROUND/AIMS: Adenocarcinoma of the stomach is still among the leading malignancies in human morbidity and mortality statistics in spite of endoscopic screening of the high-risk patients. Investigation of prognostic factors of gastric cancer disease seems to be still very important. The authors present a clinicopathological study based on the analysis of 49 gastric carcinomas. METHODOLOGY: P53 overexpression and proliferation activity of the cells were examined by immunohistological method with peroxidase-antiperoxidase technique. The percentage of the positive cells was calculated after counting of 300 tumor cells in each case. The rate of the labeled cells was related to different pathological characteristics of the carcinomas i.e., TNM stage of the tumor, histological subtypes of Ming's as well as Laurén's and Goseki's classification respectively, grade of differentiation and lymph node status. RESULTS: According to the above-mentioned parameters, p53 overexpression was significantly higher in carcinomas of the cardiac region than in those of the distal parts of the stomach. These findings are consistent with results published in the literature: cell proliferation rate alone is not an independent prognostic factor, but the degree of cell proliferation activity and p53 expression are changing usually parallel with each other and with other prognostic markers as well. CONCLUSIONS: The assessment of p53 activity and cell proliferation rate in gastric carcinoma is of prognostic value especially if evaluated together with other clinical and histopathological characteristics. The examination of these markers is useful in detecting early gastric cancer, in selecting high-risk patients and in planning proper individual treatment.