Survival of Lung Cancer Patients Dependent on the LOH Status for DMP1, ARF, and p53

Correlation Analysis of the TP53 Mutation With Clinical Characteristics in the Prognosis of Non-Small Cell Lung Cancer

Background

Non-small cell lung cancer (NSCLC) with TP53 mutations has a worse prognosis. It was generally more resistant to chemotherapy and radiation. Our aim was to investigate the correlation between the TP53 co-mutated gene and clinical features, and prognostic value in patients with NSCLC.

Methods

Seventy-three patients with a diagnosis of NSCLC at our hospital were recruited. They were divided into the TP53 mutation status (minor) (TP53 MU) and TP53 wild-type (major) (TP53 WT) groups according to their clinical characteristics after their mutation data and clinical information were collected. Serum markers were compared between groups using Mann-Whitney U test. Other clinical factors were compared between groups using χ2 test and Fisher exact test. The log-rank test was used to compare survival curves.

Results

Of the 73 patients with NSCLC, 37 (50.68%) were found to carry TP53 mutation. TP53 MU and TP53 WT groups (n = 36) showed a significant difference in the number of smokers, incidence of squamous cell carcinoma, EGFR mutation, and number of advanced patients (P < .05), while gender, age, lymph node metastasis, and KRAS mutation did not differ significantly between the 2 groups. The survival curves in the TP53/KRAS and the TP53/EGFR co-mutation groups suggest that patients with NSCLC may have a shorter progression-free survival (PFS) if they carry one of the 2 types of co-mutation.

Conclusions

TP53 gene mutations are more common in patients with NSCLC and squamous cell carcinoma. New predictive markers for NSCLC prognosis may be TP53/KRAS and TP53/EGFR co-mutations.

Prognostic value of PD-1, PD-L1 and P53 in patients with non-small cell lung cancer after postoperative adjuvant chemoradiotherapy

OBJECTIVE

To explore the value of programmed cell death protein 1 (PD-1), programmed cell death ligand 1 (PD-L1) and protein 53 (P53) in estimating the prognosis of patients with non-small cell lung cancer (NSCLC) after postoperative adjuvant chemoradiotherapy.

METHODS

The clinical data of 100 patients with NSCLC who were treated with adjuvant chemoradiotherapy after pulmonary lobectomy in our hospital were retrospectively analyzed. The expression levels of PD-1, PD-L1 and P53 in tumor tissues were detected by immumohistochemical staining. The efficacy of chemoradiotherapy and survival time between patients with positive and negative expression of PD-1, PD-L1 and P53 were compared respectively to evaluate the correlation of PD-1, PD-L1 and P53 with chemoradiotherapy results in NSCLC. General data of patients were analyzed by single factor analysis. Multivariate logistic regression analysis was used to identify independent risk factors impacting the prognosis of NSCLC patients with postoperative adjuvant chemoradiotherapy.

RESULTS

A significantly lower chemoradiotherapy effective rate and a remarkably shorter survival time were found in NSCLC patients with positive expression levels of PD-1, PD-L1 and P53 in tumor tissues as compared with those of negative results (all P<0.05). Single factor analysis revealed that gender, age, history of smoking, histological type, degree of differentiation, T stage, lymph node metastasis, expression levels of PD-1, PD-L1 and P53 showed significant correlations with the prognosis of NSCLC patients with postoperative adjuvant chemoradiotherapy (all P<0.05). High T stage (odds ratio (OR)=7.269), history of smoking (OR=5.128), lymph node metastasis (OR=4.647), PD-1 (+) (OR=7.556), PD-L1 (+) (OR=6.674), P53 (+) (OR=9.070), PD-1 (+) PD-L1 (+) (OR=6.095), PD-1 (+) P53 (+) (OR=6.752), PD-L1 (+) P53 (+) (OR=7.363), and PD-1 (+) PD-L1 (+) P53 (+) (OR=8.524) were determined by multiple logistic regression analysis to be independent risk factors influencing the effect of postoperative adjuvant chemoradiotherapy in NSCLC patients.

CONCLUSION

There are numerous risk factors affecting the effect of postoperative adjuvant chemoradiotherapy in NSCLC patients, of which NSCLC patients with positive expression of PD-1, PD-L1 and P53 had a worse prognosis than those with negative results. PD-1, PD-L1 and P53 can serve as effective prognostic indicators for NSCLC after chemoradiotherapy. In clinical practice, monitoring these three indicators contributes to the adjustment of therapeutic regimen and gives some guidance.

The Interactions of DNA Repair, Telomere Homeostasis, and p53 Mutational Status in Solid Cancers: Risk, Prognosis, and Prediction

The disruption of genomic integrity due to the accumulation of various kinds of DNA damage, deficient DNA repair capacity, and telomere shortening constitute the hallmarks of malignant diseases. DNA damage response (DDR) is a signaling network to process DNA damage with importance for both cancer development and chemotherapy outcome. DDR represents the complex events that detect DNA lesions and activate signaling networks (cell cycle checkpoint induction, DNA repair, and induction of cell death). TP53, the guardian of the genome, governs the cell response, resulting in cell cycle arrest, DNA damage repair, apoptosis, and senescence. The mutational status of TP53 has an impact on DDR, and somatic mutations in this gene represent one of the critical events in human carcinogenesis. Telomere dysfunction in cells that lack p53-mediated surveillance of genomic integrity along with the involvement of DNA repair in telomeric DNA regions leads to genomic instability. While the role of individual players (DDR, telomere homeostasis, and TP53) in human cancers has attracted attention for some time, there is insufficient understanding of the interactions between these pathways. Since solid cancer is a complex and multifactorial disease with considerable inter- and intra-tumor heterogeneity, we mainly dedicated this review to the interactions of DNA repair, telomere homeostasis, and TP53 mutational status, in relation to (a) cancer risk, (b) cancer progression, and (c) cancer therapy.