P27(Kip1) Loss does not predict survival in patients with advanced gastriccarcinoma

BACKGROUND, p27(Kipl) is a cyclin-dependent kinase inhibitor whose loss is associated with disease progression and an unfavorable outcome in several m alignancies. The authors studied its expression in a consecutive series of resected gastric carcinomas. METHODS. Expression of p27(Kipl) in 71 advanced gastric carcinomas and 10 l ymph nodes containing metastases was determined using an avidin-biotin-pero xidase immunohistochemical method. The relations between p27(Kipl) expressi on and pathologic features, patient characteristics, and survival were anal yzed. RESULTS. p27(Kipl) levels in gastric carcinomas ranged from 0.63-82.97% (me dian, 23.10%; mean, 27.99%). There was no association found between p27(Kip l) expression and patient gender (P = 0.21), patient age (P = 0.13), tumor stage (P = 0.17), tumor grade (P = 0.22), or histologic type (P = 0.72). Un ivariate analysis showed that long term survival was related to stage (P < 0.0001) and grade (P = 0.03). However, tumors with p27(Kipl) levels above a nd below the median value were associated with a similar outcome, regardles s of whether all cases (P = 0.19) or those without metastatic disease (P = 0.50) or those with residual or metastatic disease (P = 0.92) were included . When entered into a multivariate analysis, stage (P < 0.0001) and grade ( P = 0.05), but not p27(Kipl) levels (P = 0.16), were found to be related to patient outcome. In lymph node metastases, p27(Kipl) expression (median, 1 6.5%) was similar to that found in the corresponding primary lesion (median , 30.9%). CONCLUSIONS. p27(Kipl) may play a role in the pathogenesis and progression of gastric carcinoma, but its expression is unlikely to be useful as a prog nostic indicator, at least in European patients with advanced disease. Canc er 2000;89: 1684-91. (C) 2000 American Cancer Society.