Abstract
Esophageal squamous cell carcinoma (ESCC) is the most common histological subtype of esophageal cancer and one of the most aggressive types of malignancy, with a high rate of mortality. Early diagnosis and treatment may improve the prognosis of ESCC and, thus, survival rates. As a significant tumor suppressor, p53 is closely associated with apoptosis and the differentiation of cancer cells. The present study evaluated the expression levels of the p53 protein and the clinical significance in patients presenting with ESCC. The p53 protein expression level of 64 paired ESCC and tumor-adjacent normal tissues was evaluated using western blot analysis. In addition, immunohistochemistry (IHC) was performed to detect the p53 expression level in specimens from 118 paraffin-embedded cancerous tissues. The correlation of the p53 expression level with the clinicopathological parameters and prognosis of the ESCC patients was also analyzed. The p53 protein was identified to be highly expressed in the ESCC tissue, with western blot analysis demonstrating that the expression level of p53 in the cancerous tissue was 1.89 times that of the tumor-adjacent normal tissue (P<0.001); furthermore, IHC indicated that there was a marked positive expression of p53 in the ESCC tissue (49.15%). The expression level of p53 protein was identified to be significantly correlated with the tumor grade (P<0.001), N stage (P=0.010). Additionally, the higher level of p53 expression was found to be associated with a poor survival rate in the ESCC patients (P=0.0404). The univariate analysis showed that the survival time of patients was significantly correlated with the T stage (RR=3.886, P<0.001), N stage (lymph node metastasis; RR=3.620, P<0.001) and TNM stage (RR=3.576, P<0.001). Furthermore, the multivariate analysis revealed that the T stage (RR=3.988, P<0.001) and N stage (RR=4.240, P=0.004) significantly influenced the overall survival of the ESCC patients.
Highlights
Human esophageal squamous cell carcinoma (ESCC) is one of the most aggressive types of cancer and is ranked as the sixth most frequent cause of cancer‐associated mortality in the world, with a high incidence in northern China, South Africa, Turkey and Iran [1,2,3]
Increased level of p53 expression was observed in ESCC tissues when compared with paired non‐neoplastic tissues
IHC revealed that the p53 protein was predominantly localized in the nucleus (Fig. 2A) and the expression level of p53 in the ESCC tissue was identified to be significantly higher when compared with that in the adjacent normal tissues (Fig. 2A)
Summary
Human esophageal squamous cell carcinoma (ESCC) is one of the most aggressive types of cancer and is ranked as the sixth most frequent cause of cancer‐associated mortality in the world, with a high incidence in northern China, South Africa, Turkey and Iran [1,2,3]. Tumor suppressor p53, encoded by the p53 gene located at chromosome 17q13.1, is highly associated with a poor prognosis in human cancers [4,5]. It is well known that the p53 protein may induce cell apoptosis and regulate cell proliferation. Mutation of the p53 gene results in the loss of its ability to induce cell death, which leads to uncontrolled cell growth, promoting tumorigenesis [6,7]
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