A Prospective Study Between Molecular Marker P53 Analysis and HPE, for Tumour Positivity in Primary Resected Margins...

Area of Science:

• Oncology
• Molecular Pathology
• Surgical Pathology

Background:

• Head and neck malignancies are a significant global health concern, ranking as the 17th most common worldwide and the 2nd most common in India.
• Accurate assessment of tumor margins after resection is crucial for effective management of head and neck squamous cell carcinoma (HNSCC).

Purpose of the Study:

• To compare the efficacy of molecular marker p53 analysis versus standard Histopathological Examination (HPE) for detecting tumor positivity in primary resected margins of HNSCC.
• To evaluate the utility of p53 mutation analysis in identifying residual disease in cases with histopathologically negative margins.

Main Methods:

• A prospective observational cross-sectional study involving 61 patients with HNSCC undergoing primary resection.
• Resected tumor specimens were analyzed using both HPE and p53 mutation analysis on margins within 0.5-1 cm of the primary tumor.
• Data on p53 mutation status and HPE results were collected and compared.

Main Results:

• Histopathologically negative margins (HPE negative) were found to be positive for p53 mutation in 81% of cases.
• p53 mutation was significantly associated with PDSCC (pathologically defined positive margins) and residual tumor within 0.7 mm of the primary tumor site, even with HPE-negative margins.

Conclusions:

• p53 mutation analysis should be considered for PDSCC cases with HPE-negative margins within 1 cm to improve detection of residual tumor.
• Incorporating p53 profiling can benefit the management of PDSCC and margins up to 0.7 mm, potentially improving patient survival and reducing morbidity and mortality.