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Aberrant expression of the cell cycle kinase inhibitors p16,p21,and p27has been associated with poor prognosis in a variety of human malignancies.Litt le is known,however,about their clinical impact in vulvar carcinoma patients.Thus,we analyzed a larger series of v ulvar squamous cell carcinomas and compared the results with clinical outcome.A total of 224vulvar squamous cell carcinomas were im-munohistochemically investigated for expression of p16,p21,and p27using the biotin -strept avidin -peroxidase method and the OptiMax Plus automate d cell staining sys-tem.High p16(≥5%)positive nuclear immunostaining was found in 69(31%)cases,high p21(any staining)protein levels was detected in 95(42%)cases,and lowp27(≤50%positive nuclei)staining was seen in 170(76%)cases.High expression of p16was related to lower patient age and low expression of p53.High expression of p16indicated a better prognosis in t he multivariate analysis(RR =0.5,95%CI =0.2-1.0)and less risk of de-veloping lymph node metastasis(OR =0.3,95%CI =0.2-0.7).High level of p21was significantly associated with shorter survival in patients staged FIGO I and II(RR=3.4,95%CI =1.3-9.3).We found no significant correlation between the expression of p27and any of the clinicopathological variables.Our study indicates a prog-nostic relevance for p16and p21immu noreactivity.Low level of p16protein and high level of p21protein were as-sociated with a shorter disease -related survival.We did not find p27protein expression to be useful as a prognostic indicator in vulvar carcinoma patie nts.
Aberrant expression of the cell cycle kinase inhibitors p16, p21, and p27has been associated with poor prognosis in a variety of human malignancies. Litt le is known, however, about their clinical impact in vulvar carcinoma patients. Tuber, we analyzed a larger series of v ulvar squamous cell carcinomas and compared the results with clinical outcome. A total of 224 vulvar squamous cell carcinomas were im-munohistochemically investigated for expression of p16, p21, and p27 using the biotin-strept avidin-peroxidase method and the OptiMax Plus automate d cell staining Positive nuclear immunostaining was found in 69 (31%) cases, high p21 (any staining) protein levels was detected in 95 (42%) cases, and lowp27 (≤50% positive nuclei ) staining was seen in 170 (76%) cases. High expression of p16was related to lower patient age and low expression of p53. High expression of p16indicated a better prognosis in t multivariate analysis (RR = 0.5, 95% CI = 0.2- 1.0) and less risk of de -veloping lymph node High level of p21 was significantly associated with shorter survival in patients staged FIGO I and II (RR = 3.4, 95% CI = 1.3-9.3). We found no significant correlation between the expression of p27 and any of the clinicopathological variables. Our study indicates a prog-nostic relevance for p16 and p21immu noreactivity. Low level of p16protein and high level of p21protein were as-sociated with shorter disease -related survival.We didnt find p27protein expression to be useful as a prognostic indicator in vulvar carcinoma patie nts.