p53 expression as a prognostic determinant in resected distal bile duct carcinoma

Aims: To determine the incidence and prognostic value of p53 immunopositivity in resectable distal bile duct carcinoma (DBDC). Methods: Forty-seven paraffin-embedded archival tumour samples of patients with DBDC, who underwent subtotal pancreatoduodenectomy from 1985 to 1996, were immunohistochemically examined for p53 positivity, using the anti-p53 antibody D07. Results: Nineteen (40%) of the 47 tumours demonstrated positive (> 30%) p53 protein immunostaining. Focally positive or negative staining was seen in the remaining 28 (60%) cases. Patients in this low p53 category survived significantly longer than those in the high p53 category, with median survival durations of 29 and 13 months respectively (P = 0.039). p53 positivity was independent of age, sex, tumour size, radicality of resection, histopathological grading, lymph-node status, perineural invasion and vasoinvasive growth. Conclusions: This study indicates that low (0-30%) p53 expression is a favourable prognostic factor in patients with resected DBDC.