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

Gordana Ž Cvetkovič; Goran  Plavec; Željka  Tatomirović; Milena  Jović; Olivera Lončarević; Zoran  Trifunović; Jelena Vuković; Marko Stojsavljević; Gordana Milić

doi:10.2298/VSP160616220C

Gordana Ž Cvetkovič Military Medical Academy, Pulmonology Clinic, Belgrade, Serbia
Goran Plavec Military Medical Academy, Pulmonology Clinic, Belgrade, Serbia
Željka Tatomirović University of Belgrade, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Milena Jović University of Belgrade, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Olivera Lončarević Military Medical Academy, Pulmonology Clinic, Belgrade, Serbia
Zoran Trifunović Military Medical Academy, Institute for Pathology and Forensic Medicine, Belgrade, Serbia
Jelena Vuković Military Medical Academy, Pulmonology Clinic, Belgrade, Serbia
Marko Stojsavljević Military Medical Academy, Pulmonology Clinic, Belgrade, Serbia
Gordana Milić Military Medical Academy, Pulmonology Clinic, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP160616220C

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

Abstract

Abstract

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.

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