Expression of cell-cycle regulators p27 and cyclin E correlates with survival in gastric carcinoma patients

Background. Cell-cycle control is important in carcinogenesis and cancer pr ogression. p27 and cyclin E are cell-cycle regulators, which control the G1 -S phase transition. Recently, these two factors were found to be affected in many human cancers. The aim of the study was to examine the expression o f p27 and cyclin E in gastric cancer and to evaluate their prognostic impli cation. Materials and methods. Paraffin blocks of 56 samples of advanced gastric ca ncer, 15 samples of early gastric cancer, and 17 samples of normal gastric mucosa were studied. Expression of p27 and cyclin E was analyzed by immunoh istochemistry. The relationship between the expression and clinicopathologi cal data was examined. Results. Expression of p27 was reduced in 89% of advanced cancer samples, 4 4% of early cancer samples, and 12% of normal mucosa samples (P < 0.0001). Among the cancers, reduced expression of p27 was associated with a large tu mor size, increased cancer invasion, nodal metastases, and the presence of residual tumor after operation. No significant difference in cyclin E expre ssion was found. Kaplan-Meier plots of survival showed tumors with low p27 were associated with poorer survival than those with high p27 expression (R R, 5.3; CI = 1.6-17.4; P = 0.005). Tumors with low p27 and high cyclin E ex pression were associated with the highest mortality expression (RR, 9.8; CI = 1.2-80; P = 0.03). Conclusions. Gastric cancer with low expression of p27 is associated with a ggressive characteristics and a poorer outcome. (C) 2000 academic Press.