title: Expression of p27(KIP1) and p21(WAF1/CIP1) in primary hepatocellular carcinoma: clinicopathologic correlation and survival analysis.
abstract: To investigate the possible roles of p27(KIP1) and p21(WAF1/CIP1), inhibitors of cyclin-dependent kinases, in hepatocellular carcinoma (HCC), we examined p27(KIP1) and p21(WAF1/CIP1) expression in primary HCC with immunohistochemistry and Northern blot hybridization and correlated the results with clinicopathologic features and survival. With immunohistochemistry, positive staining for p27(KIP1) and p21(WAF1/CIP1) protein was found in 54.3% and 63.8% of HCCs, respectively. Both p27(KIP1) and p21(WAF1/CIP1) scores of the tumors were significantly higher than those of the corresponding nontumorous livers (P <.0001 and.009, respectively). Higher levels of p27(KIP1) were associated with a lower incidence of direct liver invasion (P =.021) and, less significantly, with a low incidence of multiple tumor nodules (P =.056). Patients whose tumors had higher p27(KIP1) protein scores had longer disease-free survival (P =.011). For p21(WAF1/CIP1), in contrast to the overexpression of the p21(WAF1/CIP1) protein in HCC, the relative amounts of p21(WAF1/CIP1) messenger RNA (mRNA) in the tumors were found to be reduced compared with those of the nontumorous livers (P =.039). In conclusion, p27(KIP1) and p21(WAF1/CIP1) proteins were frequently overexpressed in HCC. Longer disease-free survival rates were seen in patients whose tumors had higher p27(KIP1) expression. The accumulation of p21(WAF1/CIP) protein in the presence of a reduced mRNA level suggests probable posttranslational protein stabilization, and the reduced transcription of p21(WAF1/CIP) may represent a form of dysfunction of cyclin-dependent kinase inhibitor involved in hepatocarcinogenesis.
authors.affiliation: Department of Pathology, the University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: L F
authors.initials: LF
authors.lastname: Qin
authors.forename: I O
authors.initials: IO
authors.lastname: Ng
mesh_terms: D000328:Adult; D000368:Aged; D015152:Blotting, Northern; D006528:Carcinoma, Hepatocellular / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D018797:Cell Cycle Proteins / Q000378:metabolism*; D050759:Cyclin-Dependent Kinase Inhibitor p21; D050760:Cyclin-Dependent Kinase Inhibitor p27; D018844:Cyclin-Dependent Kinases / Q000037:antagonists & inhibitors; D016213:Cyclins / Q000235:genetics / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008113:Liver Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D012333:RNA, Messenger / Q000378:metabolism; D012334:RNA, Neoplasm / Q000032:analysis; D015996:Survival Rate; D025521:Tumor Suppressor Proteins
chemical_list: C493956:CDKN1A protein, human; D018797:Cell Cycle Proteins; D050759:Cyclin-Dependent Kinase Inhibitor p21; D016213:Cyclins; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D025521:Tumor Suppressor Proteins; D050760:Cyclin-Dependent Kinase Inhibitor p27; D018844:Cyclin-Dependent Kinases