Investigation of the prognostic value of the apoptotic marker p53 gene and vascular endothelial growth factor in evaluating the clinical course of nasopharyngeal angiofibroma
Аннотация
Objective. To investigate the prognostic value of the apoptotic markers (p53) and vascular endothelial growth factor (VEGF) in evaluating the clinical course of juvenile nasopharyngeal angiofibroma (JNA).Subjects and methods. The investigation enrolled 43 patients with primary JNA (a study group) and 20 with its relapses (a control group). The expression of VEGF and mutant p53 (mtp53) gene was immunohistochemically determined using DAKO kits (Denmark). The results of reactions with antibodies to VEGF-A and mtp53 located in the nuclei and membranes were expressed as percentages in terms of stained cell counts per 100 cells examined in different visual fields.Results. An associative analysis showed that both study and control group patients with high mtp53 gene expression in the tumor cells had clinical stages IIIA–B and IV and those in whom the expression of this gene in the tumor cells was weak or absent were found to have clinical stages I and II. The high (3+) and moderate (2+) mtp53 gene expressions suggest that the disease is severe. Consequently, this is of prognostic value and a poor predictor and the absence of mutations or the decreased expression of this gene is associated with a favorable disease outcome.Our investigations indicated that the high expression of the VEGF gene was detected in none of the tumor specimens. In the study group, the tumor cell expression of this gene was found to be moderate (2+) in 18 (41.9 %) patients, weak in 6 (13.9 %) and absent in 19 (44.2 %) of the 43 patients. In the control group, the absence of VEGF gene expression in the tumor specimens was 9 times lower than that in the study group.A comparison with the clinical characteristics of the patients demonstrated that in both the study and control groups, the VEGF expression was observed to be moderate, or weak and absent in those with clinical stages IIIA–B and IV or in those with stage II and I, respectively.Conclusion. The associative analysis showed that both study and control group patients with high tumor cell mtp53 expression had clinical stages IIIA–B and IV.