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Expression of p16, p53, and Ki-67 in colorectal adenocarcinoma: a study of 356 surgically resected cases.

BACKGROUND/AIMS
The aim of the present study was to investigate the clinicopathological significance of p53, Ki-67, and p16 expression in patients with colorectal adenocarcinoma.


METHODOLOGY
We evaluated p53, Ki-67, and p16 expression in 356 patients with primary colorectal adenocarcinoma using an immunohistochemical staining method. The relationships between these protein expressions and clinicopathological factors were statistically analyzed.


RESULTS
Positive p53 staining was detected more often in typical adenocarcinoma compared to mucinous adenocarcinoma (49% versus 17%, p = 0.007) and in well or moderately differentiated adenocarcinoma compared to poorly differentiated adenocarcinoma (50% versus 32%, p = 0.030). The level of expression of p53 protein was related to lymph node metastasis (p < 0.001) and the TNM stage of the colorectal adenocarcinoma (p = 0.006). The p53 protein expression was related to an increased tendency of lymphovascular invasion (p = 0.058). However, Ki-67 and p16 expression levels were not associated with any of the clinicopathological variables. The overexpression of p53 was correlated with a higher level of Ki-67 (p = 0.001) and positive staining of p16 (p < 0.001).


CONCLUSIONS
Our data suggest that overexpression of p53, which was correlated with Ki-67 and p16 expression, plays a critical role in aggressive tumor behaviors in patients with colorectal adenocarcinoma. However, further long-term followup studies are warranted to evaluate the clinical impacts of p53 in a larger group of patients.