Yang R M, Naitoh J, Murphy M, Wang H J, Phillipson J, deKernion J B, Loda M, Reiter R E
Department of Urology, UCLA School of Medicine, USA.
J Urol. 1998 Mar;159(3):941-5.
p27 is an inhibitor of the cell cycle with potential tumor suppressor function. Decreased levels of p27 protein expression have been correlated with poor prognosis in patients with breast and colorectal carcinomas. Although as many as a third of patients with clinically localized prostate cancer will have relapse after radical prostatectomy, predicting who will have recurrence remains enigmatic. We examined the ability of p27 protein levels to predict outcome in patients with clinically localized disease who underwent radical prostatectomy.
p27 protein expression was evaluated in 86 patients with clinical stage T1-2 prostate cancer who were treated with radical prostatectomy. Archived paraffin embedded specimens were sectioned and immunostained with p27 antibody, and scored by 2 independent observers in a blinded fashion. The absence or presence of p27 protein was then correlated with biochemical relapse in univariate and multivariate analyses.
In a multivariate analysis that included age, preoperative prostate specific antigen, Gleason score and pathological stage p27 was a strong independent predictor of disease-free survival (p = 0.0184, risk ratio 3.04), second only to pathological stage (p = 0.0001, risk ratio 6.73). Even more strikingly, multivariate analysis demonstrated that p27 was the strongest predictor of biochemical recurrence (p = 0.0081, risk ratio 4.99) among factors studied in patients with pathological T2a-T3b disease.
Absent or low levels of p27 protein expression appear to be an adverse prognostic factor in patients with clinically organ confined disease treated by radical prostatectomy. This marker appears to be especially useful in those patients in whom surgery is believed to be potentially curative, that is patients with pathological T2-T3b disease. Patients with low or absent p27 protein expression may be candidates for novel adjuvant therapies.
p27是一种细胞周期抑制剂，具有潜在的肿瘤抑制功能。p27蛋白表达水平降低与乳腺癌和结直肠癌患者的不良预后相关。尽管多达三分之一临床局限性前列腺癌患者在根治性前列腺切除术后会复发，但预测谁会复发仍然是个谜。我们研究了p27蛋白水平预测接受根治性前列腺切除术的临床局限性疾病患者预后的能力。
对86例临床分期为T1-2期前列腺癌并接受根治性前列腺切除术的患者进行p27蛋白表达评估。对存档的石蜡包埋标本进行切片，并用p27抗体进行免疫染色，由2名独立观察者以盲法评分。然后在单变量和多变量分析中将p27蛋白的有无与生化复发相关联。
在一项包括年龄、术前前列腺特异性抗原、Gleason评分和病理分期的多变量分析中，p27是无病生存的强有力独立预测因子（p = 0.0184，风险比3.04），仅次于病理分期（p = 0.0001，风险比6.73）。更引人注目的是，多变量分析表明，在病理T2a-T3b期疾病患者所研究的因素中，p27是生化复发的最强预测因子（p = 0.0081，风险比4.99）。
p27蛋白表达缺失或水平低似乎是接受根治性前列腺切除术的临床器官局限性疾病患者的不良预后因素。该标志物在那些被认为手术可能治愈的患者中似乎特别有用，即病理T2-T3b期疾病患者。p27蛋白表达低或缺失的患者可能是新型辅助治疗的候选者。
