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Correspondence and Brief Communications |

Is the p53 Gene Mutation of Prognostic Value in Hepatocellular Carcinoma?

Irene Oi-Lin Ng, MD, FRCPath; Sheung-Tat Fan, MS, MD, FRCS (Edin and Glasg)
Arch Surg. 2000;135(12):1476. doi:10.1001/archsurg.135.12.1476.
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The prognostic value of p53 overexpression in hepatocellular carcinoma (HCC) is controversial. It has been reported that p53 protein overexpression is associated with a poorer prognosis in terms of patients' survival.1 Jeng et al2 report a significant association of p53 overexpression with a more invasive phenotype of the tumor and higher rates of recurrence, but the survival lengths were not significantly affected. In other studies, p53 overexpression in HCC has also been associated with more aggressive behavior of the tumor, poorer cellular differentiation, venous permeation, and intrahepatic metastasis.3 These and other data4,5 imply that p53 overexpression plays a significant role in tumor progression, particularly at a later stage of hepatocarcinogenesis. However, in some reports with either univariate or multivariate analysis,6,7p53 overexpression in HCC has not been found to have prognostic significance despite the finding that tumors with p53 overexpression often had more malignant characteristics. Interestingly, the controversy of prognostic significance is not confined to p53 protein in HCC tissue but is also seen with serum anti-p53. It has been found that the presence of serum anti-p53 is related to both poor8 and positive prognoses,9 with longer disease-free survival.

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