Mối liên hệ giữa biểu hiện p53 và các đặc điểm lâm sàng, mô bệnh học trong ung thư đại – trực tràng sau hóa trị tân bổ trợ: Một nghiên cứu tại Bệnh viện Chợ Rẫy

Colorectal cancer (CRC) remains a global health challenge, ranking as the third most common cancer and the second leading cause of cancer-related mortality worldwide. Despite advancements in multi-modal treatments, including neoadjuvant chemotherapy, which significantly improve resectability and survival, evaluating histopathological features post-treatment remains crucial for prognosis and personalized therapy. The tumor suppressor gene p53, often referred to as the "guardian of the genome," plays a central role in cell cycle regulation and DNA repair. Abnormal p53 expression, resulting from TP53 gene mutations, is observed in over half of all human cancers and is associated with adverse pathological characteristics. While its prognostic role in CRC after neoadjuvant chemotherapy is not fully elucidated, particularly in the Vietnamese context, understanding the relationship between p53 expression and clinicopathological features is vital for enhancing risk stratification and optimizing individualized treatment strategies.

Oncologists, pathologists, cancer researchers, and medical professionals involved in the diagnosis and treatment of colorectal cancer, particularly those focusing on neoadjuvant therapy and prognostic markers.

This cross-sectional analytical study investigated the correlation between p53 expression and clinicopathological features in 40 colorectal cancer patients with liver metastases who underwent FOLFOXIRI neoadjuvant chemotherapy followed by colectomy at Cho Ray Hospital. Post-chemotherapy tumor specimens were analyzed using immunohistochemistry to classify p53 expression into wild-type, complete loss, and overexpression patterns. The findings revealed abnormal p53 expression in 65% of patients, with 57.7% showing overexpression and 42.3% complete loss. Crucially, a statistically significant association was found between abnormal p53 expression, particularly overexpression, and adverse outcomes such as increased lymph node metastasis (p = 0.009) and high tumor budding (p = 0.027). The overexpression group exhibited a remarkably higher rate of lymph node metastasis (73.3%). These results underscore the potential of p53 as a significant prognostic marker for risk stratification and individualized treatment planning in patients with colorectal adenocarcinoma receiving neoadjuvant chemotherapy. Despite the study's limitations, including a small sample size and lack of pre-treatment p53 data, it provides valuable insights into the biological implications of p53 expression in the post-neoadjuvant setting and encourages further research into its underlying mechanisms and clinical utility. The study contributes to a better understanding of how p53 expression can guide therapeutic decisions for improved patient outcomes in this challenging disease context.