Background: The cyclin-dependent kinase inhibitor p27Kip1 is an important regulator of the cell cycle and low expression of p27Kip1 is associated with poor prognosis in a variety of malignant diseases. The objective of the current study was to determine the prognostic value of this protein in patients with gallbladder carcinoma.
Materials and methods: We studied p27Kip1 expression in 55 unselected patients with gallbladder carcinoma by means of immunohistochemistry and evaluated its impact on overall survival.
Results: Low p27Kip1 expression (< 50% nuclear staining) was observed in 36 out of 55 (65%) samples. Comparison with clinical parameters of the patients showed that low p27Kip1 expression was significantly associated with a higher T classification (p = 0.02), lymph node metastasis (p = 0.04), distant metastasis (p = 0.007) and an advanced TNM stage (p = 0.009). Kaplan-Meier analyses revealed that patients with low p27Kip1 expression had a significantly shorter overall survival than patients with high p27Kip1 expression (median 0.3 years vs. 0.8 years; p = 0.001). Cox proportional hazards regression analyses identified p27Kip1 (p = 0.002) and residual tumour stage (p = 0.001) to be independent prognostic factors for death.
Conclusion: The results of our study suggest that low p27Kip1 expression is an independent prognostic factor associated with poor prognosis in patients with gallbladder carcinoma.