The prognostic significance of p53, p27kip1, p21waf1, HER-2/neu, and Ki67 proteins expression in gastric cancer: A clinicopathological and immunohistochemical study of 121 Arab patients

M. S. Al-Moundhri, V. Nirmala, I. Al-Hadabi, K. Al-Mawaly, I. Burney, M. Al-Nabhani, V. Thomas, S. S. Ganguly, C. Grant

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Abstract

Background: The variability of prognosis within a pathological stage of gastric cancer (GC) at presentation, underscores the need for specific biological markers to identify subgroups of patients with aggressive course for intensive treatment. To our knowledge, this is the first study from an Arab population reporting on the relationship of p53, p27kip1, p21 waf1, HER-2/neu, and Ki67 expression, and clinicopathological features and their prognostic significance. Methods: Formalin-fixed paraffin-embedded tumors were studied by immunohistochemistry, using monoclonal antibodies to p53, p27kip1, p21waf1, HER-2/neu, and Ki67. The results were correlated with clinicopathological features and survival. Results: M:F = 80:41; median age = 60 years; stage III and IV = 71%; and median follow-up = 34.4 months. Positive expression rates of p53, p27kip1, p21waf1, Ki67, and HER-2/neu were 54%, 40%, 8.3%, 70%, and 12% respectively. p53 expression correlated with age 5cm (P = 0.01), p27kip1 and Ki67 expression (P = 0.0001), and HER-2/neu (P = 0.04). p21waf1correlated inversely with T-stage (P = 0.008) and Her-2/neu expression correlated with histological grade (P = 0.04) and T-stage (P = 0.008). Univariate analysis showed that p53 overexpression (P = 0.01), fungating and infiltrative macroscopic appearance (P = 0.02), size >5 cm (P = 0.0001), lymph node metastasis (P = 0.0001), p T3 and T4 disease (P = 0.01), and overall stage III and IV (P = 0.0001) disease were adverse prognostic factors. Patients with tumor profiles p53 (-)/p27 (+) had better survival than those with p53 (+)/p27kip1 (-)(P = 0.02). On multivariate analysis by Cox regression model, the expression of p53 (P = 0.03) and lymph node involvement (P = 0.01) were significant adverse prognostic factors for overall survival. Conclusions: The expression of p53 in Arab patients with GC correlates with aggressive tumor characteristics and is an independent prognostic factor. The combined analysis of p53 and p27kip1 is of added prognostic value.

Original languageEnglish
Pages (from-to)243-252
Number of pages10
JournalJournal of Surgical Oncology
Volume91
Issue number4
DOIs
Publication statusPublished - Sep 15 2005

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Stomach Neoplasms
Survival
Proteins
Lymph Nodes
Neoplasms
Proportional Hazards Models
Paraffin
Formaldehyde
Multivariate Analysis
Biomarkers
Immunohistochemistry
Monoclonal Antibodies
Neoplasm Metastasis
Population
Therapeutics

Keywords

  • Arabs
  • Gastric cancer
  • HER-2/neu
  • Immunohistochemistry
  • Ki67 antigen
  • p21
  • p27
  • p53
  • Prognosis
  • Stomach

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

@article{0c36145a525747528c2b8b70154d4a3b,
title = "The prognostic significance of p53, p27kip1, p21waf1, HER-2/neu, and Ki67 proteins expression in gastric cancer: A clinicopathological and immunohistochemical study of 121 Arab patients",
abstract = "Background: The variability of prognosis within a pathological stage of gastric cancer (GC) at presentation, underscores the need for specific biological markers to identify subgroups of patients with aggressive course for intensive treatment. To our knowledge, this is the first study from an Arab population reporting on the relationship of p53, p27kip1, p21 waf1, HER-2/neu, and Ki67 expression, and clinicopathological features and their prognostic significance. Methods: Formalin-fixed paraffin-embedded tumors were studied by immunohistochemistry, using monoclonal antibodies to p53, p27kip1, p21waf1, HER-2/neu, and Ki67. The results were correlated with clinicopathological features and survival. Results: M:F = 80:41; median age = 60 years; stage III and IV = 71{\%}; and median follow-up = 34.4 months. Positive expression rates of p53, p27kip1, p21waf1, Ki67, and HER-2/neu were 54{\%}, 40{\%}, 8.3{\%}, 70{\%}, and 12{\%} respectively. p53 expression correlated with age 5cm (P = 0.01), p27kip1 and Ki67 expression (P = 0.0001), and HER-2/neu (P = 0.04). p21waf1correlated inversely with T-stage (P = 0.008) and Her-2/neu expression correlated with histological grade (P = 0.04) and T-stage (P = 0.008). Univariate analysis showed that p53 overexpression (P = 0.01), fungating and infiltrative macroscopic appearance (P = 0.02), size >5 cm (P = 0.0001), lymph node metastasis (P = 0.0001), p T3 and T4 disease (P = 0.01), and overall stage III and IV (P = 0.0001) disease were adverse prognostic factors. Patients with tumor profiles p53 (-)/p27 (+) had better survival than those with p53 (+)/p27kip1 (-)(P = 0.02). On multivariate analysis by Cox regression model, the expression of p53 (P = 0.03) and lymph node involvement (P = 0.01) were significant adverse prognostic factors for overall survival. Conclusions: The expression of p53 in Arab patients with GC correlates with aggressive tumor characteristics and is an independent prognostic factor. The combined analysis of p53 and p27kip1 is of added prognostic value.",
keywords = "Arabs, Gastric cancer, HER-2/neu, Immunohistochemistry, Ki67 antigen, p21, p27, p53, Prognosis, Stomach",
author = "Al-Moundhri, {M. S.} and V. Nirmala and I. Al-Hadabi and K. Al-Mawaly and I. Burney and M. Al-Nabhani and V. Thomas and Ganguly, {S. S.} and C. Grant",
year = "2005",
month = "9",
day = "15",
doi = "10.1002/jso.20324",
language = "English",
volume = "91",
pages = "243--252",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "4",

}

TY - JOUR

T1 - The prognostic significance of p53, p27kip1, p21waf1, HER-2/neu, and Ki67 proteins expression in gastric cancer

T2 - A clinicopathological and immunohistochemical study of 121 Arab patients

AU - Al-Moundhri, M. S.

AU - Nirmala, V.

AU - Al-Hadabi, I.

AU - Al-Mawaly, K.

AU - Burney, I.

AU - Al-Nabhani, M.

AU - Thomas, V.

AU - Ganguly, S. S.

AU - Grant, C.

PY - 2005/9/15

Y1 - 2005/9/15

N2 - Background: The variability of prognosis within a pathological stage of gastric cancer (GC) at presentation, underscores the need for specific biological markers to identify subgroups of patients with aggressive course for intensive treatment. To our knowledge, this is the first study from an Arab population reporting on the relationship of p53, p27kip1, p21 waf1, HER-2/neu, and Ki67 expression, and clinicopathological features and their prognostic significance. Methods: Formalin-fixed paraffin-embedded tumors were studied by immunohistochemistry, using monoclonal antibodies to p53, p27kip1, p21waf1, HER-2/neu, and Ki67. The results were correlated with clinicopathological features and survival. Results: M:F = 80:41; median age = 60 years; stage III and IV = 71%; and median follow-up = 34.4 months. Positive expression rates of p53, p27kip1, p21waf1, Ki67, and HER-2/neu were 54%, 40%, 8.3%, 70%, and 12% respectively. p53 expression correlated with age 5cm (P = 0.01), p27kip1 and Ki67 expression (P = 0.0001), and HER-2/neu (P = 0.04). p21waf1correlated inversely with T-stage (P = 0.008) and Her-2/neu expression correlated with histological grade (P = 0.04) and T-stage (P = 0.008). Univariate analysis showed that p53 overexpression (P = 0.01), fungating and infiltrative macroscopic appearance (P = 0.02), size >5 cm (P = 0.0001), lymph node metastasis (P = 0.0001), p T3 and T4 disease (P = 0.01), and overall stage III and IV (P = 0.0001) disease were adverse prognostic factors. Patients with tumor profiles p53 (-)/p27 (+) had better survival than those with p53 (+)/p27kip1 (-)(P = 0.02). On multivariate analysis by Cox regression model, the expression of p53 (P = 0.03) and lymph node involvement (P = 0.01) were significant adverse prognostic factors for overall survival. Conclusions: The expression of p53 in Arab patients with GC correlates with aggressive tumor characteristics and is an independent prognostic factor. The combined analysis of p53 and p27kip1 is of added prognostic value.

AB - Background: The variability of prognosis within a pathological stage of gastric cancer (GC) at presentation, underscores the need for specific biological markers to identify subgroups of patients with aggressive course for intensive treatment. To our knowledge, this is the first study from an Arab population reporting on the relationship of p53, p27kip1, p21 waf1, HER-2/neu, and Ki67 expression, and clinicopathological features and their prognostic significance. Methods: Formalin-fixed paraffin-embedded tumors were studied by immunohistochemistry, using monoclonal antibodies to p53, p27kip1, p21waf1, HER-2/neu, and Ki67. The results were correlated with clinicopathological features and survival. Results: M:F = 80:41; median age = 60 years; stage III and IV = 71%; and median follow-up = 34.4 months. Positive expression rates of p53, p27kip1, p21waf1, Ki67, and HER-2/neu were 54%, 40%, 8.3%, 70%, and 12% respectively. p53 expression correlated with age 5cm (P = 0.01), p27kip1 and Ki67 expression (P = 0.0001), and HER-2/neu (P = 0.04). p21waf1correlated inversely with T-stage (P = 0.008) and Her-2/neu expression correlated with histological grade (P = 0.04) and T-stage (P = 0.008). Univariate analysis showed that p53 overexpression (P = 0.01), fungating and infiltrative macroscopic appearance (P = 0.02), size >5 cm (P = 0.0001), lymph node metastasis (P = 0.0001), p T3 and T4 disease (P = 0.01), and overall stage III and IV (P = 0.0001) disease were adverse prognostic factors. Patients with tumor profiles p53 (-)/p27 (+) had better survival than those with p53 (+)/p27kip1 (-)(P = 0.02). On multivariate analysis by Cox regression model, the expression of p53 (P = 0.03) and lymph node involvement (P = 0.01) were significant adverse prognostic factors for overall survival. Conclusions: The expression of p53 in Arab patients with GC correlates with aggressive tumor characteristics and is an independent prognostic factor. The combined analysis of p53 and p27kip1 is of added prognostic value.

KW - Arabs

KW - Gastric cancer

KW - HER-2/neu

KW - Immunohistochemistry

KW - Ki67 antigen

KW - p21

KW - p27

KW - p53

KW - Prognosis

KW - Stomach

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UR - http://www.scopus.com/inward/citedby.url?scp=24644467632&partnerID=8YFLogxK

U2 - 10.1002/jso.20324

DO - 10.1002/jso.20324

M3 - Article

C2 - 16121348

AN - SCOPUS:24644467632

VL - 91

SP - 243

EP - 252

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 4

ER -