Immune Expression of p53 and Its Association with Histological Risk Classification in Wilms Tumor

Background: Wilms' tumor, a type of kidney cancer that occurs in children. The p53 gene serves a crucial function as a tumor suppressor. Mutations in p53 are closely linked to the emergence of anaplastic features, which are notably aggressive and suggest an unfavorable prognosis. Methods: This study was conducted at the Department of Pathology, Dhaka Medical College. A total 30 samples were collected from Dhaka Medical College and a private laboratory. The histological assessments were conducted at the same institutes. Immunohistochemistry was conducted at the Private Diagnosis Centre. Qualitative data were expressed as frequency and percentage. Fisher’s exact test was used to examine the relation between qualitative variables. A p-value less than 0.05 was considered significant. Results The age of the patients ranged from 5 months to 14 years, with a mean of 4.9 ± 3.4 years. The male-to-female ratio was 1:1.1. The mean size of the tumor was 8.5 ± 3.4 cm. Tumor laterality varied, with 40.0% on the left, 36.7% on the right, and the remaining 20.0% was not available. Histologically, 83.3% were favorable, and 16.7% were unfavorable. Risk classification showed that 33.3% were low-risk, 50.0% intermediate-risk, and 16.7% high-risk. P53 expression was observed in 23.3% of cases. Favorable histology was associated with negative p53 (100.0%), unfavorable histology with positive p53 (71.4%). Low-risk histology was linked to negative p53 (43.5%), intermediate risk showed mixed patterns (28.6% positive, 56.5% negative), and high-risk histology strongly correlated with positive p53 (71.4%). Conclusion The presence of positive p53 protein in Wilms' tumor could serve as a marker for high-risk tumors as it is associated with an unfavorable prognosis.