doiSerbia

Expression of p63 as predictive and prognostic factor in advanced non-small-cell lung cancer

Cvetković Gordana (Military Medical Academy, Pulmonology Clinic, Belgrade + Faculty of Medicine of the Military Medical Academy, Belgrade)
Plavec Goran (Faculty of Medicine of the Military Medical Academy, Belgrade)
Tatomirović Željka (Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Institute for Pathology and Forensic Medicine, Belgrade)
Jović Milena (Military Medical Academy, ‡Institute for Pathology and Forensic Medicine, Belgrade)
Lončarević Olivera (Military Medical Academy, Pulmonology Clinic, Belgrade )
Trifunović Zoran (Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Clinic for Cardiosurgery, Belgrade)
Vuković Jelena (Military Medical Academy, Pulmonology Clinic, Belgrade )
Stojsavljević Marko (Military Medical Academy, Pulmonology Clinic, Belgrade )
Milić Gordana (Military Medical Academy, Pulmonology Clinic, Belgrade )

Background/Aim. Serbia belongs to the group of countries with a high lung cancer incidence and mortality rate. p63 gene plays an important role in development of lung cancer and immunohistochemical expression of p63 is considered to be a reliable marker for squamous histology. The results of some in vitro studies show a significant association of p63 expression and cisplatin chemoresistance. The aim of this study was to estimate the significance of p63 expression as predictive and prognostic factor in advanced non-small-cell lung cancer (NSCLC). Methods. Expression of p63 in 85 NSCLC (stages III, and IV) was investigated by the use of immunohistochemistry. Four weeks after the completion of 2 cycles of platinum-based doublet chemotherapy all the patients were evaluated based on the treatment response. Kaplan-Meier analysis with log-rank tests were used for overall survival (OS) and progression free survival (PFS) calcultations. Results. The expression of p63 was present in 49.4% of the patients out of whom 38.8% were with positive expression (p63+) and 10.6% of the patients were with weak expression (p63+-). Positive expression of p63 was seen in 93.9% of squamous cell carcinomas (SQCC), 5% of adenocarcinomas (AC), and in no patient with not otherwise specified (NOS) NSCLC. Weak expression of p63 was found in 12.5% of AC, 25% of NOS and only in 3% of SQCC. Analysis of the impact of the presence of p63 expression on the initial response to chemotherapy showed no statistical significance. The patients with weak p63 expression had a significantly shorter OS than the patients with no p63 expression (p = 0.049), and the tendency of shorter OS than the patients with p63 expression (p = 0.068). Conclusion. This study shows that p63 expression has no predictive significance for tumor response to initial chemotherapy regimen gemcitabine/ cisplatin or paclitaxel/cisplatin observed in advanced NSCLC. Weak expression of p63 have a negative prognostic effect in stage III and IV NSCLC.

Keywords: carcinoma, non-small-cell lung, neoplasm staging, immunohistochemistry, disease progression, predictive, value of tests