LIMITED PROGNOSTIC SIGNIFICANCE OF P27KIP1 EXPRESSION IN ADENOCARCINOMA OF THE PANCREATIC HEAD REGION.

The aim of this study was to establish the prognostic value of p27^kip1 expression in adenocarcinoma of the pancreatic head region. The study included 45 patients with adenocarcinomas of the pancreatic head region comprising 24 of the pancreatic head itself, 18 which were periampullar, and 3 of the uncinate process. All patients underwent a standard or pylorus preserving pancreatoduodenectomy. Immunohistochemistry was carried out on paraffin-embedded blocks. Quantitative determination of ^kip1 expression was based on the proportion of ^kip1-positive cells. Positive ^kip1 expression was detected in 22 tumours (49%), whereas 23 tumours (51%) were ^kip1-negative. There were no significant correlations between ^kip1-index and stage or lymph node involvement. The median survival time in patients with ^kip1-positive tumours was 19 months, whereas in ^kip1-negative tumours was 18 months (p = 0.53). A significant relationship was found between ^kip1 and radical resection (p = 0.04). Multivariate survival analysis revealed the localization of the tumour (pancreatic head/uncinate process vs periampullary) was the only significant and independent prognosticator (p = 0.01, Cox regression model). Conclusion: We conclude that ^kip1 has limited overall prognostic utility in resected carcinoma of the pancreatic head region, but its potential role as a marker of residual disease needs to be further assessed. [ABSTRACT FROM AUTHOR]