Low levels of cell cycle inhibitor p27kip1 combined with high levels of Ki-67 predict shortened disease-free survival in T1 and T2 invasive breast carcinomas
R. Lau et al., Low levels of cell cycle inhibitor p27kip1 combined with high levels of Ki-67 predict shortened disease-free survival in T1 and T2 invasive breast carcinomas, INT J ONCOL, 18(1), 2001, pp. 17-23
Breast cancer is the second leading cause of cancer death in North American
women. There is considerable need for better prognostic markers to identif
y those subsets of patients who would benefit from more aggressive therapy
because their tumors show an increased risk of poor clinical behavior, p27k
ip1 is an important inhibitor of the cell cycle that acts by binding and in
activating cyclin-dependent kinases (CDKs). The aim of this study was to de
termine the prognostic value of loss of p27 protein in invasive breast canc
er. We performed an immunohistochemical study of 147 patients with T1 and T
2 invasive breast cancers and compared survival in the high p27 expressing
group with that of the low p27 expressing group. On univariate analysis com
paring tumor size, nodal status, Ki-67, c-erbB-2, p53 and estrogen receptor
, low or absent p27kip1 is a strong predictor of reduced disease-free survi
val. Importantly, on multivariate analysis, the combined effect of low p27
with high Ki-67 is a stronger predictor of reduced disease-free survival th
an either marker alone. This simple, reliable and inexpensive assay, partic
ularly when used in combination with Ki-67, improves the ability to predict
disease recurrence and could become a useful adjunct of breast cancer eval
uation to better identify high risk patients.