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p21 WAF1/CIP1 expression in colorectal carcinoma correlates with advanced disease stage and p53 mutations
Author(s) -
Viale Giuseppe,
Pellegrini Caterina,
Mazzarol Giovanni,
Maisonneuve Patrick,
Silverman Mark L.,
Bosari Silvano
Publication year - 1999
Publication title -
the journal of pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.964
H-Index - 184
eISSN - 1096-9896
pISSN - 0022-3417
DOI - 10.1002/(sici)1096-9896(199902)187:3<302::aid-path243>3.0.co;2-u
Subject(s) - stage (stratigraphy) , oncology , colorectal cancer , p53 expression , cancer research , medicine , expression (computer science) , disease , biology , immunohistochemistry , cancer , computer science , paleontology , programming language
Defects in the mechanisms controlling the cell cycle are crucial in cell transformation and/or tumour progression. p21 WAF1/CIP1 is an inhibitor of cyclin‐dependent kinases, induced by p53‐dependent and p53‐independent pathways, which can block progression through the cell cycle. p21 WAF1/CIP1 expression has been investigated immunohistochemically in a series of 191 patients with colorectal cancer of known p53 status. The purpose of the study was two‐fold: to assess the relationship between p21 WAF1/CIP1 immunoreactivity and p53 alterations, and to evaluate the prognostic significance of p21 WAF1/CIP1 expression. In 96 carcinomas (51 per cent), p21 WAF1/CIP1 was expressed in over 10 per cent of tumour cells, whereas in 26, p21 WAF1/CIP1 was detected in under 10 per cent of neoplastic cells; 69 tumours lacked p21 WAF1/CIP1 expression. Immunoreactivity was more frequent in tumours of the right colon ( p < 0·003) and was inversely correlated with tumour stage ( p < 0·03), p53 gene mutations ( p < 0·0007), p53 protein accumulation ( p < 0·019), and Bcl‐2 expression ( p < 0·0005). In univariate analysis, down‐regulation of p21 WAF1/CIP1 expression was associated with poor overall ( p = 0·0022) and disease‐free survival ( p = 0·0009). Multivariate analysis, however, did not confirm any independent prognostic significance of p21 WAF1/CIP1 expression. The results indicate that p21 WAF1/CIP1 is associated with abnormal accumulation of p53 protein and the occurrence of p53 gene mutations in colorectal cancer and that lack of p21 WAF1/CIP1 expression is correlated with reduced patient survival in univariate analysis. These data underline the crucial pathogenetic role of the p53–p21 WAF1/CIP1 pathway in carcinomas of the large bowel. Copyright © 1999 John Wiley & Sons, Ltd.