ANALYSIS OF EXPRESSION OF P63 AND CASPASE-3 AND THEIR PREDICTIVE VALUE IN PATIENTS WITH SQUAMOUS CELL CARCINOMA OF MAXILLARY SINUS

Abstract

Introduction: Maxillary sinus cancer is a malignant neoplasm with a prevalence of 3 to 5% of tumors in the head and neck and less than 1% of all malignant neoplasms. The role of p63 and caspase-3 and their predictive value in squamous cell carcinoma of maxillary sinus (SCCMS) remains an underdeveloped and controversial issue that determined the relevance of the study. The aim: To analyze the relationship between the level of expression of p63 and caspase-3 and clinical and morphological characteristics of squamous cell carcinoma of maxillary sinus and to determine their prognostic significance as immunohistochemical markers of tumor progression (relapse and metastases). Materials and methods: A comprehensive investigation with immunohistochemical study of squamous cell carcinoma of maxillary sinus of 103 patients with maxillary sinus cancer II - IV stage (T2-4 N0-3 M0) of the second clinical group was conducted. Results: The moderate and high expression rate of caspase-3 in the overall sample was 50.49% and 16.50% respectively, and one third of cases (33.01%) was characterized by a weak reaction. In the group without metastases (p <0.001), moderate expression of the marker (56.25%) prevailed; in the SCCMS group with metastases it was (60.87%). The mean level of expression of p63 in the examined patients with squamous cell carcinoma of maxillary sinus was 46.0%. The number of p63-positive specimens was statistically significantly (p = 0.034) higher in the SCCMS group with metastases. In patients with the development of squamous cell carcinoma of maxilla on the background of papilloma, a significantly higher (p <0.001) mean level of p63 expression was only moderate (90.91%) and high (9.09%). Conclusions: There was observed a relatively strong associate of the increase in the expression of caspase-3 with SCCMS metastases (p <0.001) and no correlation of immunohistochemical reaction of this marker with relapses. There was determined that the probability of metastases at high expression level of p63 is higher than in tumors with low and moderate level of the oncoprotein (p = 0.003). Based on the level of expression of p63, it is possible to predict the likelihood of development of SCCMS with papillomas (p <0.001); and the development of relapses of squamous cell carcinoma of maxillary sinus (p <0.001).