p27 expression in post-treatment rectal cancer: a potential novel approach for predicting residual nodal disease

Am J Surg. 2014 Aug;208(2):228-34. doi: 10.1016/j.amjsurg.2014.02.003. Epub 2014 Apr 13.

Abstract

Background: Expression profiles of p21, p27, p53, Ki-67, and thymidylate synthase may be associated with response to neoadjuvant chemoradiation. The relationship between post-treatment protein expression and regional lymph node involvement has not been fully explored.

Methods: Tumor cores from 126 rectal cancer patients underwent immunohistochemical analysis for the aforementioned proteins. Staining indices (SIs) using percentage of stained cells and staining intensity were calculated for 10 tumor cores per patient. SI for each marker was compared between node negative and node positive patients.

Results: Twenty-six (20.6%) cancer patients had a pathologic complete response and 37 had inadequate tissue or cancer cells, leaving 63 for analysis. Thirty-seven (58.7%) cancer patients were node negative and 26 (41.3%) were node positive. There was an association between increased p27 SI and nodal positivity (P = .04).

Conclusion: Increased p27 expression in post-treatment rectal cancer is associated with nodal positivity and may determine which patients are suitable for local excision.

Keywords: Lymph node positivity; Molecular marker; Post-treatment rectal cancer; Tissue microarray.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chemoradiotherapy
  • Female
  • Humans
  • Immunohistochemistry
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm, Residual / diagnosis*
  • Prognosis
  • Proliferating Cell Nuclear Antigen / biosynthesis
  • Proliferating Cell Nuclear Antigen / metabolism*
  • Rectal Neoplasms / metabolism*
  • Rectal Neoplasms / therapy*
  • Tissue Array Analysis

Substances

  • Proliferating Cell Nuclear Antigen
  • p27 antigen