Mutations of the gene TP53 are most frequent among the genetic aberrations found in human cancers. The gene codes for a 43.65 kDa protein that is known to regulate cell cycle, including cell cycle arrest, apoptosis, senescence, DNA repair, or metabolic changes, in response to various cellular stresses. Hence, aberrations in TP53 lead to irregularities in the stress response system and cause cancerous changes in the cells. It has been reported that TP53 activates transcription of KAISO, a ZBTB33 protein, by binding to specific TP53-responsive DNA elements (p53REs) during early DNA damage responses. Significant expression patterns of KAISO have also been reported to play a role in determining field cancerization in oral cancer patients. Therefore, in this study, which was conducted during 2024-25, we have explored expressional patterns of TP53 in relation to KAISO and in terms of field cancerization in oral cancer patients.

Oral mucosa specimens were acquired from the tumor core, the tumor-free peripheral region after tumor excision, and the opposing non-diseased buccal mucosa of fifty OSCC patients. Normal mucosa samples were taken from fifty patients who volunteered for participation in the study while having elective wisdom tooth removal. Afterwards, specimens were processed for TP53 and KAISO expression using immunohistochemical testing. Image-J software was used to measure the expression, and optical density was calculated from the values obtained from the software. The data obtained was then subjected to statistical analysis.

TP53 expression was significantly increased (P-value: <0.0001) in Tumor core, whereas KAISO expression was significantly decreased (P-value: <0.0001) in Tumor core specimens as compared to Periphery (P), opposing mucosa and controls. Similarly, TP53 displayed a significant change in expression in the Nucleus vs. Cytoplasm of the Tumor core (P-Value: 0.0003), which was absent in control specimens, whereas KAISO displayed a significant difference in expression in Nucleus vs. Cytoplasm of Controls (P-Value: <0.0001), which was completely lost in tumor specimens.

TP53 and KAISO both show an opposing pattern of expression changes from each other in oral cancer patients, which defies the norm of function between the two partners, indicating a possible functional alteration in one or both partner proteins.