Relationship of p21(WAF1) expression with disease-free survival and biochemical recurrence in prostate adenocarcinomas (PCa).
BACKGROUND
The p21(WAF1) gene is considered to be one of the major regulators of the cell cycle. Its level of expression has been shown to correlate with pathologic stage and Gleason score in prostatic cancer. However, its relationship to clinical outcome is not yet well-characterized.


METHODS
Immunohistochemical staining for p21(WAF1) protein expression was performed in 62 consecutive radical prostatectomy specimens from our institution. The results were correlated with the disease-free survival and biochemical recurrence of the patients.


RESULTS
Thirty-four of the 62 patients were Caucasian and 28 were African American. There was a significant correlation between p21(WAF1) expression and biochemical recurrence after radical prostatectomy (P < 0.0095). However, while p21(WAF1) staining in prostate cancer was a prognostic indicator of disease-free survival in Caucasians (P < 0.0001), it appeared not to be a factor in African-American men (P = 0.908).


CONCLUSIONS
This study suggests that p21(WAF1) may have a role in the pathogenesis and progression of prostate carcinoma, and may serve as a predictor of biochemical recurrence of this tumor. The differences in the values of p21(WAF1) as a prognostic marker of disease-free survival in Caucasians vs. African Americans suggest that progression of prostate cancer may have different mechanisms in different ethnic groups.
Department of Pathology, Karmanos Cancer Institute at Wayne State University School of Medicine, Detroit, Michigan, USA. fsarkar@med.wayne.edu
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D000230:Adenocarcinoma / Q000175:diagnosis / Q000235:genetics* / Q000601:surgery; D044383:Black People; D050759:Cyclin-Dependent Kinase Inhibitor p21; D016213:Cyclins / Q000235:genetics*; D018572:Disease-Free Survival; D004791:Enzyme Inhibitors; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000601:surgery; D044465:White People; D001741:Black or African American
C493956:CDKN1A protein, human; D050759:Cyclin-Dependent Kinase Inhibitor p21; D016213:Cyclins; D004791:Enzyme Inhibitors; D017430:Prostate-Specific Antigen