Diagnostic Utility of p63 (Ab-1) and (Ab-4) Tumor Markers in the Squamous Cell Carcinomas of Head and Neck

  • Khan, Nauman Rauf (Sharif Medical & Dental College) ;
  • Khan, Amna Nauman (Sharif Medical & Dental College) ;
  • Bashir, Saira (Department of Pathology, CMH Lahore Medical College) ;
  • Khan, Ayyaz Ali (Department of Oral Health Sciences, Shaikh Zayed Post Graduate Medical Complex) ;
  • Suleman, Bilquis A. (UHead Department of Histopathology, University of Lahore) ;
  • Chaudhry, Saima (Department of Oral Health Sciences, Shaikh Zayed Post Graduate Medical Complex)
  • Published : 2012.03.31


P63 is a gene product required in cell cycle regulation which plays vital roles in tumor differentiation. Aims of the present study were to assess the frequency, pattern, sensitivity and specificity of two p63 protein clones P63 4A4 and P63 4A4+Y4A3 in squamous cell carcinomas (SCCs). Thirty cases of head and neck region SCC diagnosed on the basis of H&E staining were examined along with 60 cases of head and neck region biopsies other than squamous cell carcinoma, negative on H&E staining, were taken as control. Immunostaining was performed on slides according to the Thermo Scientific UltraVision LP detection System. P63 4A4+Y4A3 clone is more sensitive 96.6% in comparison to 86% in P63 4A4 with having greater NPV of 98.3%. The results signify the importance of P63 4A4+Y4A3 marker over the old markers and may be used as a confirmatory marker of squamous cell carcinoma.


  1. Andrea T, Anette W (2001). Tumor markers in squamous cell carcinoma of the head and neck: clinical effectiveness and prognostic value. Eur Arch Otorhinolaryngol, 258, 83-8.
  2. Bircan S, Candir O, Kapucoglu N, Baspinar S (2006). The expression of p63 in basal cell carcionomas and association with histological differentiation. J Cutan Pathol, 33, 293-8.
  3. Buffa FM, Bentzen SM, Daley FM (2004). Molecular marker profiles predict locoregional control of head and neck squamous cell carcinoma in a randomized trial of continuous hyperfractionated accelerated radiotherapy. Clin Cancer Res, 10, 3745.
  4. Chen YK, Hsue SS, Lin LM (2003). Immunohistochemical demonstration of p63 in DMBA-induced hamster buccal pouch squamous cell carcinogenesis. Oral Dis, 9, 235-40.
  5. Chen YK, Huse SS, Lin LM (2003). Differential expression of p53, p63 and p73 proteins in human buccal squamous-cell carcinomas. Clin Otolaryngol, 28, 451-5.
  6. Choi HR, Batsakis JG, Zhan F, et al (2002). Differential expression of p53 gene family members p63 and p73 in head and neck squamous tumorigenesis. Hum Pathol, 33, 158-64.
  7. Coindre JM (2003). Immunohistochemistry in the diagnosis of soft tissue tumors. Histopathology, 43, 1-16.
  8. Di Como CJ, Urist MJ, Babayan I, et al (2002). p63 expression profiles in human normal and tumor tissues. Clin Cancer Res, 8, 494-501.
  9. Faridoni-laurens L, Bosq J, Janot F (2001). P73 expression in basal layers of head and neck squamous epithelium: a role in differentiation and carcinogenesis in concert with p53 and p63. Oncogene, 20, 5302-12.
  10. Foschini MP, Gaiba A, Cocchi R (2004). Pattern of p63 expression in squamous cell carcinoma of the oral cavity. Virchows Arch, 444, 332-9.
  11. Gath H, Brakenhoff R (1999). Minimal residual disease in head and neck cancer. Cancer Metastasis Rev, 18, 109-26.
  12. Ivan D, Diwan AH, Prieto VG (2005). Expression of p63 in primary cutaneous adnexal neoplasms and adenocarcinoma metastatic to the skin. Mod Pathol, 18, 137-42.
  13. Jimenez FJ, Grichnik JM, Buchanan MD, Clark RE (1995). Immunohistochemical techniques in Mohs micrographic surgery: their potential use in the detection of neoplastic cells masked by inflammation. J Am Acad Dermatol, 32, 89-94.
  14. Kargi A, Gurel D, Tuna B (2007). The diagnostic value of TTF-1, CK 5/6, and p63 immunostaining in classification of lung carcinomas. App Immunohistochemist Mol Morphol, 15, 415-20.
  15. Kaufmann O, Fietze E, Mengs J, Dietel M (2001). Value of p63 and Cytokeratin 5/6 as immunohistochemical markers for the differential diagnosis of poorly differentiated and undifferentiated carcinomas. Am J Clin Pathol, 116, 823-30.
  16. Koga F, Kawakami S, Fujii Y (2003). Impaired p63 expression associates with poor prognosis and uroplakin III expression in invasive urothelial carcinoma of the bladder. Clin Cancer Res, 9, 5501-7.
  17. Kristiansen G, Fritzsche FR, Wassermann K, et al (2008). GOLPH2 protein expression as a novel tissue biomarker for prostate cancer: implications for tissue-based diagnostics. Br J Cancer, 99, 939-48.
  18. Levrero M, De Laurenzi V, Costanzo A, et al. (1999). Structure, function and regulation of p63 and p73. Cell Death Differ, 6, 1146-53.
  19. Moskaluk CA (2002). Standardization of Clinical Immunohistochemistry: why, how, and by whom? Am J Clin Pathol, 118, 669-71.
  20. Muzio LL, Santarelli A (2005). p63 overexpression associates with poor prognosis in head and neck squamous cell carcinoma. Hum Pathol, 36, 187-94.
  21. Muzio LL, Campisi G, Farina A, et al (2007). Effect of p63 expression on survival in oral squamous cell carcinoma. Cancer Invest, 25, 464-9.
  22. Nylander K, Coates PJ, Hall PA (2000). Characterization of the expression pattern of p63 and np63 in benign and malignant oral epithelial lesions. Int J Cancer, 87, 368-72.<368::AID-IJC9>3.0.CO;2-J
  23. Pitiphat W, Diehl SR, Laskaris G, et al (2002). Factors associated with delay in the diagnosis of oral cancer. J Dent Res, 81, 192-7.
  24. Rassam MB, Al-Bashir NN, Al-Salihi AR, et al (1995). Heatstable alkaline phosphatase: A putative tumor marker of head and neck squamous cell carcinoma. Acta Oncol, 34, 49-52.
  25. Sayan BS, Sayan AE, Yang AL et al (2007). Cleavage of the transactivation inhibitory domain of p63 by caspases enhances apoptosis. PNAS, 104, 10871-6.
  26. Strong EW, Kasdorf H, Henk JM (1995). Squamous cell carcinoma of the head and neck. In: Prognostic factors in cancer. Eds. Hermanek P, Gospodarowicz MK, Henson DE, et al. Springer, Berlin Heidelberg New York pp 12-22.
  27. Yang A, Kagdah M, Wang Y, et al (1998). p63, a p53 homolog at 3q27-29, encodes multiple products with transactivating, death-inducing, and dominant-negative activities. Mol Cell, 2, 305-16.