Brief Article
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World J Gastroenterol. Oct 21, 2010; 16(39): 4958-4967
Published online Oct 21, 2010. doi: 10.3748/wjg.v16.i39.4958
Association of p53/p21 expression with cigarette smoking and prognosis in esophageal squamous cell carcinoma patients
Noushin Taghavi, Firouzeh Biramijamal, Masoud Sotoudeh, Omeed Moaven, Hooman Khademi, Mohammad Reza Abbaszadegan, Reza Malekzadeh
Noushin Taghavi, Firouzeh Biramijamal, Department of Medical Genetics, National Institute of Genetic Engineering and Biotechnology, Tehran 14977-16316, Iran
Masoud Sotoudeh, Hooman Khademi, Reza Malekzadeh, Digestive Disease Research Center, Tehran University of Medical Sciences, Shariati Hospital, North Karegar Ave, Tehran 14117-13135, Iran
Omeed Moaven, Mohammad Reza Abbaszadegan, Division of Human Genetics, Immunology Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad 91967-73117, Iran
Author contributions: Taghavi N, Biramijamal F, Sotoudeh M and Malekzadeh R designed the research; Taghavi N performed the research; Taghavi N, Moaven O and Khademi H analyzed the data; Taghavi N and Moaven O wrote the paper; Biramijamal F, Abbaszadegan MR and Malekzadeh R scientifically edited the paper.
Supported by The National Institute of Genetic Engineering and Biotechnology, Projects No. 291, 316; and the Digestive Diseases Research Center of Tehran University of Medical Sciences
Correspondence to: Firouzeh Biramijamal, PhD, Department of Medical Genetics, National Institute for Genetic Engineering and Biotechnology, Shahrak-e Pajoohesh, 17km, Tehran-Karaj High way, PO Box 14965/161, Tehran 14977-16316, Iran.
Telephone: +98-21-44580382 Fax: +98-21-44580399
Received: April 28, 2010
Revised: May 27, 2010
Accepted: June 3, 2010
Published online: October 21, 2010

AIM: To investigate the expression of p53 and p21 and associations with possible risk factors, such as cigarette smoking, in esophageal squamous cell carcinoma (ESCC) in northeastern Iran, a region with a high incidence of ESCC.

METHODS: The expression of p53 and p21 proteins was investigated immunohistochemically in tumor tissue from 80 ESCC patients and in 60 available paraffin-embedded blocks of adjacent normal specimens from the cases, along with normal esophageal tissue from 80 healthy subjects.

RESULTS: Positive expression of p53 protein was detected in 56.2% (45/80) of ESCC cases, and in none of the normal esophageal tissue of the control group (P < 0.001). Furthermore, 73.8% (59/80) of ESCC cases and 43.8% (35/80) of controls had positive expression of p21 protein (P < 0.001). Cigarette smoking was significantly associated with p53 over-expression in ESCC cases (P = 0.010, OR = 3.64; 95% CI: 1.32-10.02). p21 over-expression was associated with poorer clinical outcome among the ESCC patients (P = 0.009).

CONCLUSION: Over-expression of p53 in association with cigarette smoking may play a critical role in ESCC carcinogenesis among this high-risk population of northeastern Iran. Furthermore, p21 over-expression was found to be associated with poor prognosis, specifically in the operable ESCC patients.

Keywords: Esophageal squamous cell carcinoma, p53, p21, Immunohistochemistry, Survival, Smoking