Correlation of p53 Expression with clinicopathological characteristics of breast carcinoma
Keywords:
Breast cancer, Invasive Ductal carcinoma, Lymph node, Nucleus, p53 over expression, Immunohistochemical.Abstract
Background: Breast carcinoma has become the most common malignancy in the female population. The p53 gene is a breast cancer progression gene that regulates the cell cycle and DNA repair and it’s over expression associated with a worse prognosis.  The importance of studying the various prognostic factors in breast carcinoma so as to identify patients at high risk of early recurrence and thus to more effectively target aggressive adjuvant chemotherapy, radical mastectomy & intensive follow up protocols.
Methods: The prospective study was conducted in the department of Pathology, M.K.C.G. Medical College, Berhampur from 2013 to 2015. Immuno-histochemical evaluation of a total 72 Patients was conducted who were confirmed to have breast carcinoma histologically.
Result: Our study showed that majority of 64 cases was positive for p53 expression. Maximum no. of T1, T2, T3 tumors showed moderate & high p53 expression. Maximum number of cases showed moderate & high p53 expression in patients with N2 & N3 lymph node involvement. 50% of patients showed high p53 expression in patients with N3 lymph node involvement. 47% of Grade I tumors showed moderate p53 expression. Maximum no. of Grade II tumors and 41% of Grade III showed moderate to high p53 expression. Invasive Ductal carcinoma (Not Otherwise Specific) showed maximum of moderate to high p53 expression.
Conclusion: A significant correlation of p53 with tumor grade and also with lymph node status was found, but not with tumor size. In breast cancer, we suggested that the over expression of p53 protein in the nucleus is an indicator of poor prognosis.Â
References
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17. Peiró G, Adrover E, Aranda FI, Peiró FM, Niveiro M, Sánchez-Payá J. Prognostic Implications of HER-2 Status in Steroid Receptor–Positive, Lymph Node–Negative Breast Carcinoma. American journal of clinical pathology. 2007 May 1;127(5):780-6.
18. Pleşan DM, Georgescu CV, Pătrană NI, Pleşan C, Stoica D. Immunohistochemical study of p53 and Ki67 in a group of patients with mammary carcinoma. Rom J Morphol Embryol. 2010; 51(3): 459-65.
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23. Han JS, Cao D, Molberg KH, Sarode VR, Rao R, Sutton LM, Peng Y. Hormone receptor status rather than HER2 status is significantly associated with increased Ki-67 and p53 expression in triple-negative breast carcinomas, and high expression of Ki-67 but not p53 is significantly associated with axillary nodal metastasis in triple-negative and high-grade non–triple-negative breast carcinomas. American journal of clinical pathology. 2011 Feb 1;135(2):230-7.
24. Porter PL, Gown AM, Kramp SG, Coltrera MD. Widespread p53 overexpression in human malignant tumors. An immunohistochemical study using methacarn-fixed, embedded tissue. The American journal of pathology. 1992 Jan; 140(1):145-153.
25. Song HS, Do YR, Kang SH, Jeong KY, Kim YS. Prognostic significance of immunohistochemical expression of p53 gene product in operable breast cancer. Cancer Research and Treatment. 2006 Dec 31;38(4):218-23.
26. Yamashita H, Nishio M, Toyama T, Sugiura H, Zhang Z, Kobayashi S, Iwase H. Coexistence of HER2 over-expression and p53 protein accumulation is a strong prognostic molecular marker in breast cancer. Breast Cancer Res. 2004 Jan 1;6(1):R24-30.
27. Cass JD, Varma S, Day AG, Sangrar W, Rajput AB, Raptis LH, Squire J, Madarnas Y, SenGupta SK, Elliott BE. Automated quantitative analysis of p53, cyclin D1, Ki67 and pERK expression in breast carcinoma does not differ from expert pathologist scoring and correlates with clinico-pathological characteristics. Cancers. 2012 Jul 18;4(3):725-42.
28. Matsubara N, Mukai H, Fujii S, Wada N. Different prognostic significance of Ki-67 change between pre-and post-neoadjuvant chemotherapy in various subtypes of breast cancer. Breast cancer research and treatment. 2013 Jan 1; 137(1): 203-12.
29. Billgren AM, Tani E, Liedberg A, Skoog L, Rutqvist LE. Prognostic significance of tumor cell proliferation analyzed in fine needle aspirates from primary breast cancer. Breast cancer research and treatment. 2002 Jan 1; 71(2):161-70.
2. Carter D, Schnitt SJ, Millis RR. Chapter 9. The breast: Sternberg SS, Mills SE, Carter D, editors. Sternberg's diagnostic surgical pathology. 5th ed. Lippincott Williams & Wilkins; 2004: 321.
3. Susan C. Lester. Chapter 23. The Breast. Robbins and Cortan Pathologic Basis of Disease. 8th Edition. South asia: Elsevier publication; 2011: 1089.
4. Mirza AN, Mirza N Q, Vlastos G, Singletary SE. Prognostic factors in node-negative breast cancer: a review of studies with sample size more than 200 and follow-up more than 5 years. Annals of surgery. 2002 Jan 1;235(1):10-26
5. Taylor CR, Shi SR, Barr NJ, Wu N. Techniques of immunohistochemistry: principles, pitfalls, and standardization. Diagnostic immunohistochemistry. 2nd edition, Churchill Livingston. Elsevier; 2006: 3-44.
6. Gu, Jian, et al. "Roles of tumor suppressor and telomere maintenance genes in cancer and aging—an epidemiological study." Carcinogenesis 2005; 26.10: 1741-1747.
7. Liu, Kang, et al. "Regulation of p53 by TopBP1: a potential mechanism for p53 inactivation in cancer." Molecular and cellular biology 2009; 29.10: 2673-2693.
8. Axelrod DE., et al. "Prognosis for survival of young women with breast cancer by quantitative p53 immunohistochemistry." Cancer and clinical oncology 2012; 1.1: 52-65.
9. Robab S, et al. "Immunohistochemical assessment of P53 protein and its correlation with clinicopathological characteristics in breast cancer patients." Indian Journal of Science and Technology 2014; 7.4: 472-479.
10. Costa JM, Tadroo T, hitton G, Birdsong G. Breast fine needle aspiration cytology utility as a screening tool for clinically palpable lesion. Actacytol 1993; 37(4): 461-77.
11. Hasty P, Christy BA. p53 as an intervention target for cancer and aging. Pathobiology of Aging & Age-related Diseases. 2013:8; 3.
12. Meena SP, Hemrajani DK, Joshi N. A comparative and evaluative study of cytological and histological grading system profile in malignant neoplasm of breast--an important prognostic factor. Indian journal of pathology & microbiology. 2006 Apr; 49(2):199-202.
13. Lee AH. Why is carcinoma of the breast more frequent in the upper outer quadrant? A case series based on needle core biopsy diagnoses. The Breast. 2005 Apr 30;14(2):151-2.
14. Raina V, Bhutani M. Bedi R. Sharma A, Deo SV, Shukla NK et al. Clinical features and prognostic factors of early cancer at a major cancer canter in north india. Indian Journal cancer. 2005; 42: 40-5
15. Badwe RA, Gangawal S, Mittra I, Desai PB. Clinico-pathological features and prognosis of breast cancer in different religious communities in India. Indian Journal of cancer. 1990 Dec; 27(4):220-8.
16. Zafrani B, Aubriot MH, Mouret E, De Cremoux P, De Rycke Y, Nicolas A, Boudou E, Vincentâ€Salomon A, Magdelenat H, Sastreâ€Garau X. High sensitivity and specificity of immunohistochemistry for the detection of hormone receptors in breast carcinoma: comparison with biochemical determination in a prospective study of 793 cases. Histopathology. 2000;37(6):536-45.
17. Peiró G, Adrover E, Aranda FI, Peiró FM, Niveiro M, Sánchez-Payá J. Prognostic Implications of HER-2 Status in Steroid Receptor–Positive, Lymph Node–Negative Breast Carcinoma. American journal of clinical pathology. 2007 May 1;127(5):780-6.
18. Pleşan DM, Georgescu CV, Pătrană NI, Pleşan C, Stoica D. Immunohistochemical study of p53 and Ki67 in a group of patients with mammary carcinoma. Rom J Morphol Embryol. 2010; 51(3): 459-65.
19. Lebe BA, Canda TÜ, Tuna BU, Sagol O, Ozer E. The evaluation of p53 and Ki67 expressions in invasive micropapillary carcinoma of the breast and its relation with other prognostic parameters: Thirty two cases. Turk J Cancer. 2002; 32:48-14.
20. Feki A, Irminger-Finger I. Mutational spectrum of p53 mutations in primary breast and ovarian tumors. Critical reviews in oncology/hematology. 2004 Nov 30; 52(2):103-16.
21. Sirvent JJ, Salvado MT, Santafe M, Martinez S, Brunet J, Alvaro T, Palacios J. p53 in breast cancer. Its relation to histological grade, lymph-node status, hormone receptors, cell-proliferation fraction (ki-67) and c-erbB-2. Immunohistochemical study of 153 cases. Histopathol 1995;10: 531 -539
22. Ivković-Kapicl T, Panjković M, NinÄić D, Knežević-UÅ¡aj S. Factors correlating with lymph node metastases in patients with T1 ductal invasive breast cancer. Archive of Oncology. 2006;14(1-2):19-22.
23. Han JS, Cao D, Molberg KH, Sarode VR, Rao R, Sutton LM, Peng Y. Hormone receptor status rather than HER2 status is significantly associated with increased Ki-67 and p53 expression in triple-negative breast carcinomas, and high expression of Ki-67 but not p53 is significantly associated with axillary nodal metastasis in triple-negative and high-grade non–triple-negative breast carcinomas. American journal of clinical pathology. 2011 Feb 1;135(2):230-7.
24. Porter PL, Gown AM, Kramp SG, Coltrera MD. Widespread p53 overexpression in human malignant tumors. An immunohistochemical study using methacarn-fixed, embedded tissue. The American journal of pathology. 1992 Jan; 140(1):145-153.
25. Song HS, Do YR, Kang SH, Jeong KY, Kim YS. Prognostic significance of immunohistochemical expression of p53 gene product in operable breast cancer. Cancer Research and Treatment. 2006 Dec 31;38(4):218-23.
26. Yamashita H, Nishio M, Toyama T, Sugiura H, Zhang Z, Kobayashi S, Iwase H. Coexistence of HER2 over-expression and p53 protein accumulation is a strong prognostic molecular marker in breast cancer. Breast Cancer Res. 2004 Jan 1;6(1):R24-30.
27. Cass JD, Varma S, Day AG, Sangrar W, Rajput AB, Raptis LH, Squire J, Madarnas Y, SenGupta SK, Elliott BE. Automated quantitative analysis of p53, cyclin D1, Ki67 and pERK expression in breast carcinoma does not differ from expert pathologist scoring and correlates with clinico-pathological characteristics. Cancers. 2012 Jul 18;4(3):725-42.
28. Matsubara N, Mukai H, Fujii S, Wada N. Different prognostic significance of Ki-67 change between pre-and post-neoadjuvant chemotherapy in various subtypes of breast cancer. Breast cancer research and treatment. 2013 Jan 1; 137(1): 203-12.
29. Billgren AM, Tani E, Liedberg A, Skoog L, Rutqvist LE. Prognostic significance of tumor cell proliferation analyzed in fine needle aspirates from primary breast cancer. Breast cancer research and treatment. 2002 Jan 1; 71(2):161-70.
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Gupta KK, Dash AK, Mishra DP. Correlation of p53 Expression with clinicopathological characteristics of breast carcinoma. Ann of Pathol and Lab Med [Internet]. 2016 Aug. 12 [cited 2024 Nov. 19];3(3):A162-170. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm610
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Copyright (c) 2016 Kamal Kant Gupta, Ashok Kumar Dash, Debi Prasad Mishra
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