Mutant p53 protein as a predictor of survival in endometrial carcinoma

The expression of mutated p53 protein was studied in paraffin-embedded, formalin-fixed tumour specimens from 183 women with endometrial carcinoma. Fifty-five per cent of the specimens were negative, whereas the staining intensity was weak, moderate or strong in 15, 2 and 28% of cases, respectively. Strong p53 expression (> 75% of the cells stained) was more common in uterine papillary serous cancers and clear cell cancers than in other tumour subtypes (P < 0.001), as well as in poorly differentiated tumours (P < 0.01) and in tumours with nuclear grade 3 (P < 0.0001). Strong p53 expression was also more frequently found in aneuploid tumours (P < 0.0001) and in tumours with a high S-phase fraction (P < 0.001). Strong p53 expression was highly predictive of poor survival in the univariate analysis (P = 0.006) and in the Cox multivariate analysis which included age, stage and grade. However, it lost most of its impact when the strongly prognostic nuclear grade and ploidy were added to the multivariate models.