Combined expression of p53, cyclin D1 and epidermal growth factor receptor improves estimation of prognosis in curatively resected oral cancer

p53, cyclin D1 and epidermal growth factor receptor ( EGFR) are molecular markers that regulate the cell cycle or cell growth and play important roles in tumor development and progression. In this study, we examined the impact of immunohistochemical expression of these markers on tumor progression in 140 oral cancers. p53, cyclin D1 and EGFR were expressed in 64 cases ( 46%), 54 cases ( 39%) and 54 cases ( 39%), respectively, but there was no inter-relationship between any two of these markers. In the association of these markers with clinicopathological features, EGFR expression alone was significantly associated with poor differentiation ( P = 0.0008) and invasive growth pattern ( P = 0.0003). Any of these markers, including EGFR, had no significant impact on survival. Coexpression of all these markers, however, was significantly associated with invasive growth pattern ( P = 0.0149) and shortened survival ( P = 0.0181), and was a significant and independent unfavorable prognostic factor ( P = 0.0002), along with tumor size ( P = 0.0040), nodal metastasis ( P = 0.0137) and growth pattern ( P = 0.0017) in a multivariate analysis. Simultaneous coexpression of these markers in oral cancers might prove to be a useful indicator for identification of low-or high-risk patients.