The prognostic significance of p53, p21 (Waf1/Cip1), and cyclin D1 protein expression in esophageal cancer patients.

Recently, various cell cycle regulators have been studied as biological markers of malignant potential. These regulators might influence survival rates and the effects of adjuvant therapies. In this study, we analyzed the expression of p53, p21(Waf1/Cip1), and cyclin D1 in 64 esophageal cancer patients and their relation to clinicopathologic parameters and patient survival. For p53, p21, and cydin D1 oncoprotein expression, we defined positive cases as those with over 10% of examined cells stained. Positive rates were 48.4%, 42.2%, and 43.8% for p53, p21, and cyclin D1, respectively. In a multivariate analysis, tumor depth, chemotherapy, and p21 expression were determined to be significant prognostic factors. Five-year survival rates of p53-negative/p21-positive and p53-positive/p21-negative patients were 53.0% and 28.5%, respectively, and were not significantly different. These results suggest that, of various cell cycle regulators, p21 might be a good predictor of prognosis for esophageal cancer patients.