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Low p27Kip1 expression is an independent prognostic factor in gallbladder carcinoma
Martin Filipits1, Harald Puhalla, Friedrich Wrba
1Department of Internal Medicine I, Division of Oncology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. martin.filipits@akh-wien.ac.at
Background:
The cyclin-dependent kinase inhibitor p27Kip1 is an important regulator of the cell cycle and low expression of p27Kip1 is associated with poor prognosis in a variety of malignant diseases. The objective of the current study was to determine the prognostic value of this protein in patients with gallbladder carcinoma.
Materials And Methods:
We studied p27Kip1 expression in 55 unselected patients with gallbladder carcinoma by means of immunohistochemistry and evaluated its impact on overall survival.
Results:
Low p27Kip1 expression (< 50% nuclear staining) was observed in 36 out of 55 (65%) samples. Comparison with clinical parameters of the patients showed that low p27Kip1 expression was significantly associated with a higher T classification (p = 0.02), lymph node metastasis (p = 0.04), distant metastasis (p = 0.007) and an advanced TNM stage (p = 0.009). Kaplan-Meier analyses revealed that patients with low p27Kip1 expression had a significantly shorter overall survival than patients with high p27Kip1 expression (median 0.3 years vs. 0.8 years; p = 0.001). Cox proportional hazards regression analyses identified p27Kip1 (p = 0.002) and residual tumour stage (p = 0.001) to be independent prognostic factors for death.
Conclusion:
The results of our study suggest that low p27Kip1 expression is an independent prognostic factor associated with poor prognosis in patients with gallbladder carcinoma.