Premium
P21/WAF1 is an independent survival prognostic factor for patients with hepatocellular carcinoma after resection
Author(s) -
Kao JungTa,
Chuah SengKee,
Huang ChaoCheng,
Chen ChaoLong,
Wang ChihChi,
Hung ChaoHung,
Chen ChienHung,
Wang JingHoung,
Lu ShengNan,
Lee ChuanMo,
Changchien ChiSin,
Hu TsungHui
Publication year - 2007
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2007.01499.x
Subject(s) - hepatocellular carcinoma , medicine , resection , oncology , carcinoma , gastroenterology , surgery
Background/Aims: The cyclin kinase inhibitor p21/WAF1 is regulated by p53‐dependent or independent pathways and inhibits the action of proliferating cell nuclear antigen (PCNA). The prognostic role of p21/WAF1 in hepatocellular carcinoma (HCC) is ambiguous. To further clarify this, we examined the expression of three genes in HCC. Methods: A total of 122 resected HCC specimens were collected from 1987 to 1998. Expression of p21/WAF1, p53, and PCNA in HCC was analysed by immunohistochemistry. Results: Immunoreactivity was detectable for p21/WAF1 in 37%, and for p53 in 41.8% of HCCs. Positive expression of both genes does not relate to each other, but both are associated with a high PCNA labelling index (LI) ( P <0.05) in tumour. p53 (+) is also associated with high serum α‐foetoprotein (αFP) ( P <0.001), tumour dedifferentiation ( P =0.001) and advanced pathologic stages ( P =0.017). However, p21/WAF1 (+) did not show clinicopathologic significance. Survival analysis indicated that poor prognostic factors were p21/WAF1 (−) ( P =0.024), p53 (+) ( P =0.008), high PCNA ( P <0.001), tumour without capsule ( P =0.001), poor tumour differentiation ( P =0.004), advanced pathologic stage ( P <0.001), and high serum αFP( P <0.001). Independent factors were p21/WAF1 expression, pathologic stage, and PCNA. Conclusion: In HCC, increased proliferation index PCNA is significantly associated with positive p53 and p21/WAF1. But p21/WAF1 expression did not relate to p53 expression. P21/WAF1 (+) is a good event and serves as an independent survival prognostic factor for HCC, which is a novel finding apart from previous reports.