Clinical Significance of p53 Mutations in Adenocarcinoma of the Esophagus and Cardia
| Autor: | Jeffrey H. Peters, Darryl Shibata, Para Chandrasoma, Adrian P. Ireland, Tom R. DeMeester, Reginald V. Lord |
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| Rok vydání: | 2000 |
| Předmět: |
Male
Pathology medicine.medical_specialty Esophageal Neoplasms Adenocarcinoma Gene mutation medicine.disease_cause Stomach Neoplasms medicine Humans Clinical significance Esophagus Polymorphism Single-Stranded Conformational Mutation business.industry Esophageal disease Cancer Original Articles DNA Neoplasm Middle Aged Genes p53 medicine.disease digestive system diseases medicine.anatomical_structure Immunohistochemistry Female Surgery business |
| Zdroj: | Annals of Surgery. 231:179-187 |
| ISSN: | 0003-4932 |
| DOI: | 10.1097/00000658-200002000-00005 |
| Popis: | p53 gene abnormalities are common in human tumors, 1 and involvement of p53, by mutation, 2–10 altered mRNA expression, 11,12 allelic loss, 8,13–18 or protein overexpression, is found in a majority of esophageal adenocarcinomas. Although numerous studies have investigated the role of p53 alterations in the development of esophageal adenocarcinoma and its precursor lesion Barrett esophagus, many of these studies measured immunohistochemical p53 protein overexpression as a surrogate for p53 gene mutation. The reported accuracy of p53 protein expression measurement for the detection of mutation has varied widely, 3 but significant false-positive and false-negative rates have been found for immunohistochemistry compared with genomic mutation analysis in studies of many cancers, 1 including studies of esophageal adenocarcinoma. 9,19 Despite the frequency and importance of p53 alterations in the development of Barrett cancers, the clinical importance of these findings remains uncertain. In particular, whether there is an association between the p53 mutation status of these cancers and the prognosis is uncertain. Studies that used immunohistochemical methods have reported varying results concerning p53 protein expression and clinical outcomes, 20–27 and few studies 9,28,29 have examined the prognostic value of p53 mutation analysis in patients with esophageal adenocarcinoma. As a result, assessment of p53 mutation, allelic loss, or p53 protein expression has not become part of the routine assessment of patients with Barrett esophagus or Barrett cancer. 30 Molecular analysis of cancer tissues can be used to investigate the etiologic or other similarities of different tumor types. Adenocarcinomas of the esophagus and cardia (with the term cardia here indicating the esophagogastric junction and not the gastric cardia region in the proximal stomach) have some significant pathologic and epidemiologic similarities, but whether cardia cancers should be grouped with esophageal adenocarcinomas is disputed. This study was undertaken to investigate the genetic similarity of adenocarcinomas arising in the esophagus, cardia, and subcardia by determining the frequency and type of mutations in the p53 gene in tumors from each site. A second aim of this study was to determine whether the presence of p53 mutation in adenocarcinomas of the esophagus or cardia has any prognostic or other clinical importance for patients with these cancers. |
| Databáze: | OpenAIRE |
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