p27(kip1) immunoreactivity correlates with long-term survival in pleural malignant mesothelioma

Cancer. 2001 Sep 1;92(5):1245-50. doi: 10.1002/1097-0142(20010901)92:5<1245::aid-cncr1444>3.0.co;2-g.


Background: Pleural malignant mesothelioma (PMM) is a rare and highly aggressive tumor, whose development is strictly related to occupational exposure to asbestos. The prognosis of PMM is generally poor (median survival, 4-12 months), but a few have a relatively long survival. The objective of this study was to evaluate the use of the cell cycle-related proteins p27(kip1) and MIB-1 as prognostic indicators of survival in PMMs.

Methods: Of 621 PMMs, the authors selected 27 cases with a relatively long-term survival (> 24 months) and a control group of 36 PMMs having a shorter (usual) survival (< 24 months).

Results: The expression of the p27(kip1) was significantly higher in the long-term survival group compared with the control (short survival) group (81.41% vs. 31.94%; P < 0.0001). The PMMs of epithelioid histotype had a significantly higher p27(kip1) immunoreactivity compared with those of biphasic type (59.24% vs. 38.94%; P = 0.02). In agreement with the data in the literature, the proliferative activity (as detected by MIB-1 immunoreactivity) was significantly higher in short than long survival PMMs (43.53% vs. 14.11%; P < 0.0001) and in the biphasic histotype than in the epithelioid type (43.19% vs. 26.02%; P = 0.006).

Conclusions: The combined expression of high/low p27(kip1) and low/high Ki-67 values identified with 100% specificity and sensitivity long versus short survivors. p27(kip1) represents a reliable additional predictive factor for PMMs and a useful marker to identify patients having a more favorable prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antigens, Nuclear
  • Cell Cycle Proteins / metabolism*
  • Cyclin-Dependent Kinase Inhibitor p27
  • Female
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen / metabolism
  • Male
  • Mesothelioma / metabolism*
  • Mesothelioma / mortality
  • Mesothelioma / pathology
  • Middle Aged
  • Nuclear Proteins / metabolism
  • Pleural Neoplasms / metabolism*
  • Pleural Neoplasms / mortality
  • Pleural Neoplasms / pathology
  • Survival Analysis
  • Tumor Suppressor Proteins*


  • Antigens, Nuclear
  • Cell Cycle Proteins
  • Ki-67 Antigen
  • Nuclear Proteins
  • Tumor Suppressor Proteins
  • Cyclin-Dependent Kinase Inhibitor p27