Abstract
BACKGROUND:
Pancreatic adenocarcinoma is one of the major causes of cancer death in the world. Alterations in the p53 tumor suppressor gene stand out as the most common alteration in many cancers including 75% of pancreas cancer. Pancreatic adenocarcinoma in which p53 is mutated carry a poor prognosis, because of late-stage detection, the presence of vascular invasion, metastases, and ineffective treatment options.
OBJECTIVE:
To evaluate the expression of P53 in pancreatic ductal adenocarcinoma immunohistochemically and clinicopathologic correlation with grade and stage.
MATERIALS AND METHODS:
This is a retrospective study of 40 pancreatic biopsies (formalin fixed, paraffin embedded) were collected from archived materials from GIT and Hepatology teaching hospital in Baghdad medical city (from December 2018 to October 2019). Study group include 40 cases of Pancreatic adenocarcinoma, 20 were EUS guided core needle biopsy, and the other 20 were pancreatic tissue from patients sustained whipple surgery.
Two sections of 5μm thickness were taken from each block, the first was stained with H&E, the second was stained Immunohistochemical for P53.
RESULTS:
Forty cases are studied and show +ve staining for P53 (100%), 24(60.0%) were males and 16(40.0%) were females, The age of patients ranged from 35 to 70 years with mean ± SD of 56.28±10.2 years. Seventeen were score 4+, thirteen were score 3+, six were score 2+ and four were score 1+.
Tumors with low grade were 20 (50.0%) cases, moderate grade were 15 (37.5%) cases, and high grade were 5 (12.5%) cases.
20 cases were staged from patients underwent whipple surgery.
Tumors with stage T1 N0 Mx were 2(10%), stage T2 N0 Mx were 5(25%), stage T2 N1 Mx were 4(20%), stage T3 N0 Mx were 8(40%), and stage T3 N1 Mx were 1(5%)
CONCLUSION:
There was statistical correlation between P53 expression and tumor grade but not with stage.
Keywords
10. Qureshi A, Hassan U, Azam M. Morphology, TNM staging and survival with pancreatico-duodenectomy specimens received at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan. Asian Pac J Cancer Prev. 2011;12:953-56.
11. Abdulghafour KH, Khalf SA. CA19-9 and CK immunohistochemical expression in pancreatic and ampulla of vater carcinomas (A clinicopathological study. Journal of the Faculty of Medicine. 2014;56:308-12.
12. Eissa AH. Carcinoma of The Pancreas A Retrospective Study of Pancreatic Cancer of 320 Case from 1976 to 2011. Medical Journal of Babylon. 2014;11:971-83.
13. Jeong J, Park YN, Park JS, Yoon DS, Chi HS, Kim BR. Clinical significance of p16 protein expression loss and aberrant p53 protein expression in pancreatic cancer. Yonsei medical journal. 2005 Aug 31;46:519-25.
14. Kim YC, Kim HJ, Park JH, Park DI, Cho YK, Sohn CI, Jeon WK, Kim BI, Shin JH. Can preoperative CA19‐9 and CEA levels predict the resectability of patients with pancreatic adenocarcinoma?. Journal of gastroenterology and hepatology. 2009 ;24:1869-75.
15. Linder S, Parrado C, Falkmer UG, Blåsjö M, Sundelin P, Von Rosen A. Prognostic significance of Ki-67 antigen and p53 protein expression in pancreatic duct carcinoma: a study of the monoclonal antibodies MIB-1 and DO-7 in formalin-fixed paraffin-embedded tumour material. British journal of cancer. 1997;76:54.
16. Talar-Wojnarowska R, Gasiorowska A, Smolarz B, Romanowicz-Makowskal H, Strzelczyk J, Janiak A, Malecka-Panas E. Comparative evaluation of p53 mutation in pancreatic adenocarcinoma and chronic pancreatitis. Hepato-gastroenterology. 2006;53:608-12.
17. Dong M, Dong Q, Zhang H, Zhou J, Tian Y, Dong Y. Expression of Gadd45a and p53 proteins in human pancreatic cancer: potential effects on clinical outcomes. Journal of surgical oncology. 2007;95:332-36.
18. Coppola D, Lu L, Fruehauf JP, Kyshtoobayeva A, Karl RC, Nicosia SV, Yeatman TJ. Analysis of p53, p21WAF1, and TGF-β1 in human ductal adenocarcinoma of the pancreas: TGF-β1 protein expression predicts longer survival. American journal of clinical pathology. 1998;110:16-23.