IMUNODETECÇÃO DA PROTEÍNA p53 EM SARCOMAS DE PARTES MOLES NO ADULTO

Abstract

Soft tissue sarcomas are rare neoplasms, usually with dismal prognosis, that account for 1% of all malignancies. Several challenges are described for their management, specially when the tumor is larger than 5cm, with high histological grade, trunk localization and presenting metastasis. Immunohistochemical data demonstrate a possible prognostic role for the immunodetection of p53 protein, but any Brazilian study has ever been carried out on this assumption. The goal of the present study was to investigate the possible association between the immunodetection of p53 protein and prognosis in a group of 104 adult patients with soft tissue sarcoma assisted at the Hospital Araújo Jorge, Associação de Combate ao Câncer em Goiás from 1996 to 2000. Our study demonstrated that 41 cases (39.4%) had positive immunodetection of p53 protein, of whom, fibrosarcoma was the histological type with the higher immunodetection rate (29.2%), followed by leiomiosarcoma (19.5%). No statistically significant association was demonstrated between immunodetection of p53 and clinical-pathological features. The immunodetection of p53 protein in tumor cells revealed a labeling index higher than 50% in 32 cases (78%), and lower than 50% in 9 cases (32%). The 5-year survival rate was higher for patients with negative p53 immunodetection (60.6%), when compared with those with positive immunodetection (39.4%), however, the difference between the two groups was not statistically significant (p=0.279). The prognostic role of the p53 protein in the present study revealed that a labeling index higher than 50% was significantly associated with a lower 5-year survival rate (85.7% vs 28.3%) (p= 0.015). This parameter should be useful as a prognostic factor for soft tissue sarcoma, and should be better investigated in larger multiinstitutional prospective studies, justified by its potential influence in therapeutic decisions.