Oliveira A M, Nascimento A G, Okuno S H, Lloyd R V
Department of Laboratory Medicine and Pathology and Department of Oncology, Mayo Clinic, Rochester, MN, USA.
J Clin Oncol. 2000 Aug;18(15):2888-93. doi: 10.1200/JCO.2000.18.15.2888.
The p27(kip1) protein (p27) is a cyclin-dependent kinase inhibitor that has been shown to be an independent prognostic factor in a variety of human neoplasms. Low expression of p27 tends to occur in more aggressive neoplasms. The role of p27 as an independent prognostic factor in the spectrum of myxoid and round-cell liposarcomas has not been examined.
Forty-seven cases of myxoid and round-cell liposarcomas were examined. Clinicopathologic features and immunohistochemical expression of p27 and Ki-67 antigen were studied in all cases. Survival analysis was performed using the log-rank test and the Cox multivariate regression model.
The male:female ratio was 1. 4:1, and the mean age at diagnosis was 45 years. The tumors were located in the lower extremities (94%) and retroperitoneum (6%). The median tumor size was 13.5 cm. The median follow-up was 6.3 years, and the overall 5- and 10-year survival rates were 76% and 67%, respectively. Low expression of p27 was identified in 34 cases (72%) and correlated with decreased metastasis-free (P =.026) and overall survival (P =.008). In a multivariate analysis, only round-cell differentiation and low expression of p27 independently predicted decreased metastasis-free and overall survival.
p27 expression predicts the clinical behavior of myxoid and round-cell liposarcomas, even in neoplasms with few or no round-cell differentiation.
p27（kip1）蛋白（p27）是一种细胞周期蛋白依赖性激酶抑制剂，已被证明是多种人类肿瘤的独立预后因素。p27低表达往往出现在侵袭性更强的肿瘤中。p27作为黏液样和圆形细胞脂肪肉瘤谱系中独立预后因素的作用尚未得到研究。
检查了47例黏液样和圆形细胞脂肪肉瘤。研究了所有病例的临床病理特征以及p27和Ki-67抗原的免疫组化表达。使用对数秩检验和Cox多变量回归模型进行生存分析。
男女比例为1.4：1，诊断时的平均年龄为45岁。肿瘤位于下肢（94%）和腹膜后（6%）。肿瘤中位数大小为13.5 cm。中位随访时间为6.3年，总体5年和10年生存率分别为76%和67%。34例（72%）病例中发现p27低表达，且与无转移生存率降低（P = 0.026）和总生存率降低（P = 0.008）相关。在多变量分析中，只有圆形细胞分化和p27低表达独立预测无转移生存率和总生存率降低。
p27表达可预测黏液样和圆形细胞脂肪肉瘤的临床行为，即使在圆形细胞分化很少或没有圆形细胞分化的肿瘤中也是如此。
