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However, patients carrying mutations in tumour protein p53 (<jats:italic>TP53<\/jats:italic>) do not benefit from modern chemotherapy\u2010based treatments and have poor prognosis. Thus, there is a clinical need to identify missense mutations through routine analysis to enable patient stratification. Sequencing is not widely implemented in clinical practice for MCL, and immunohistochemistry (IHC) is a feasible alternative to identify high\u2010risk patients. The aim of the present study was to investigate the accuracy of p53 as a tool to identify patients with<jats:italic>TP53<\/jats:italic>missense mutations and the prognostic impact of overexpression and mutations in a Swedish population\u2010based cohort. In total, 317 cases were investigated using IHC and 255 cases were sequenced, enabling analysis of p53 and<jats:italic>TP53<\/jats:italic>status among 137 cases divided over the two\u2010cohort investigated. The accuracy of predicting missense mutations from protein expression was 82%, with sensitivity at 82% and specificity at 100% in paired samples. We further show the impact of p53 expression and<jats:italic>TP53<\/jats:italic>mutations on survival (hazard ratio of 3\u00b71 in univariate analysis for both), and the association to risk factors, such as high MCL International Prognostic Index, blastoid morphology and proliferation, in a population\u2010based setting.<\/jats:p>","DOI":"10.1111\/bjh.17023","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T08:03:50Z","timestamp":1596528230000},"page":"796-805","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["p53 is associated with high\u2010risk and pinpoints<i>TP53<\/i>missense mutations in mantle cell lymphoma"],"prefix":"10.1111","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1806-331X","authenticated-orcid":false,"given":"Joana M.","family":"Rodrigues","sequence":"first","affiliation":[{"name":"Department of Immunotechnology Lund University Lund 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