EXPRESSION OF P21(WAF1 CIP1) IN ADENOCARCINOMA OF THE UTERINE CERVIX - A POSSIBLE IMMUNOHISTOCHEMICAL MARKER OF A FAVORABLE PROGNOSIS/

BACKGROUND. The purpose of this study was to assess the prognostic sig nificance of the expression of estrogen receptor and cell cycle regula tory gene products in cervical adenocarcinoma. METHODS. In 40 cases of adenocarcinoma of the uterine cenix and 10 normal cervices, expressio n of estrogen receptor and cell cycle regulatory gene products (cyclin E, p16, p21(WAF1/CIP1), p27, p53, and Ki-67) was studied using immuno histochemical techniques. The survival of the patients was analyzed in terms of such variables as the expression of these molecules in the t umor and conventional clinicopathologic features, and the Cox proporti onal hazards model was used to predict the survival of patients with c ervical adenocarcinoma. RESULTS. Expression of estrogen receptor was c onsistently observed in normal cervical glands, but in cervical adenoc arcinoma it was lost (in 28 cases) or significantly diminished (in 12 cases). Normal cervical glandular cells were usually negative for the cell cycle regulatory gene products, whereas 47.5-85% of cervical aden ocarcinomas were positive for these molecules. When the expression of these molecules was analyzed, significant positive correlations were f ound between p16 and p27, cyclin E and p27, and cyclin E and p21(WAF1/ CIP1). Univariate survival analysis revealed that the presence of para metrial invasion, the presence of lymph node metastasis, negative stai ning for p21(WAF1/CIP1), and a moderately or poorly differentiated tum or all correlated significantly with a poor prognosis. In a stepwise r egression analysis, the expression of p21(WAF1/CIP1) and negative pelv ic lymph nodes were the best predictors of a favorable prognosis. CONC LUSIONS. Expression of p21(WAF1/CIP1) correlated with a favorable prog nosis for patients with cervical adenocarcinoma and may serve as a use ful marker of survival in cases of this disease. (C) 1998 American Can cer Society.