[Protein p53 in gastric carcinoma: clinical use of cancer research on neoplasms].

Mutations of the tumour-suppressor p53 gene are a very frequent event in many human cancers. In normal cells and tissue, p53 protein has a very short half-life and attains such a low level that is not detectable immunohistochemically. In contrast, the altered forms, present in 30 to 80% of different neoplasms, are more stable and accumulate to concentration that can be detected by immunohistochemistry. Changes in the p53 gene product can be immunogenic. Thus a simple procedures as immunohistochemistry or Elisa test which stratifies cancer patients into those with and without p53 accumulation or p53 auto- antibodies can be analyzed for useful correlations with clinical and histopathological data. The p53 studies have demonstrated that in gastric carcinoma the expression of p53 protein can be properly assessed prior to surgery, using immunohistochemistry on a small tissue samples obtained during endoscopy. It has been shown that p53 assessment in this carcinoma can be helpful in identifying patients at high risk for metastatic spread, including regional lymph node involvement, and in the discrimination of those patients with especially poor prognosis. Furthermore it was demonstrated that in stomach p53 accumulation is a marker of malignancy. Thus, when combined with routine procedures, a simple test as p53 immunohistochemistry might allow better planing of appropriate treatment strategies and help in the pre-operative diagnosis of gastric carcinoma. Further studies are required to determine the clinical significance of p53 serum antibodies in gastric cancer.