P53 protein expression in nephroblastoma and its association with different histological types and components as seen in the Department of Pathology, Makerere University Kampala, Uganda

Abstract

Background: Wilms’ tumour is one of the common solid tumours of childhood with an incidence of approximately 1 in 10,000 children. It is highly responsive to chemotherapy and carries overall good prognosis. However, 10 to 15% of tumours are metastatic at presentation or recur/metastasize after initial therapy. Histological classification of Wilms’ tumour into anaplastic significance, because anaplastic variant exhibits a lesser response to chemotherapy especially when it is diffuse. Many studies have established an association between p53 protein expression and presence of anaplasia in Wilms’ tumour. Therefore, it is on this background this study was done to establish the association between p53 protein and presence of anaplastic nuclear changes in nephroblastoma. Objective: To determine p53 protein expression in nephroblastoma and its association with different histological types or components as seen in the department of Pathology MakCHS. Method: A descriptive and cross-sectional laboratory based study was carried out in the department of Pathology, Makerere University, College of Health Sciences from December 2016 to October 2017. Eighty three archived paraffin embedded tissue blocks of patients histologically diagnosed with nephroblastoma were used. The corresponding demographic and clinical information obtained from the departmental archive. Serial sections were stained with H&E for histological confirmation and immunohistochemistry using a monoclonal antibody. Data was entered and analysed using STATA version 12 and presented in form of tables, graph and pi-charts. Results: Eighty-three cases of nephroblastoma were identified, 77 type and 6 (were biphasic and 12 favourable histology expressed p53 protein, while 5 histology expressed p53 protein cases were blastemal predominant and 3(cases, 2 cases were epithelial predominant and 1 case was mesenchymal predominant. All 3 biphasic cases were negative for p53 protein and 3 positive for p53 protein. There was no significant association between p53 protein expression and both biphasic and monophasic 1.47-72.05; P = 0.381) expression and blastemal predominant nephroblastoma Conclusion: p53 protein was highly expressed in nephroblastoma with unfavourable histology compared to those with favourable histology. The p53 protein was more expressed in monophasic blastemal predominant as compared to the other component of this tumour. There was no statistical difference between p53 protein expression in biphasic and, in tri-phasic nephroblastoma.