[Expression and clinical significance of p53 protein and p21(WAF1) in non-small-cell lung carcinoma].

OBJECTIVE: To investigate the relationships between expression of tumor suppressor gene p53 protein, p21(WAF1), clinicopathology and prognosis in human non-small-cell lung carcinoma (NSCLC). METHODS: SP immunohistochemistry performed in all cases. RESULTS: One hundred forty-seven resected NSCLC were examined. There were 63 squamous cell carcinomas, 66 adenocarcinomas, 14 adenosquamous carcinomas and 4 large cell carcinomas. Overall 90 (61.2%) of the 147 cases had positive p53 staining. The positive ratios of p53 overexpression of squamous cell carcinomas, adenocarcinomas, adenosquamous carcinomas and large cell carcinomas were 63.5% (40/63), 57.6% (38/66), 71.4% (10/14) and 50% (2/4) respectively. The average positive ratio of p21(WAF1) expression was 40.1% (59/147) in lung carcinoma. The positive ratios of p21(WAF1) expression of squamous cell carcinomas, adenocarcinomas, adenosquamous carcinomas and large cell carcinomas were 41.3% (26/63), 42.4% (28/66), 28.6% (4/14) and 25% (1/4) respectively. Over expression of p53 protein was associated with prognosis of the patients with adenocarcinomas. The positive ratio of p53 expression in over 3 year survival patients was 75% (21/28) and in less than 3 year survival, 44.7% (17/38) (P < 0.025). The positive expression of p21(WAF1) was related to prognosis of NSCLC. The ratio of 3-year survival (64.4%) in p21(WAF1) positive NSCLC was much higher than in p21(WAF1) negative patients (46.6%) (P < 0.05). Prognosis of patients with p53 positive but p21(WAF1) negative expression was poorer than those with p53 negative and p21(WAF1) positive NSCLC (P < 0.01). CONCLUSION: These findings suggest that over expression of p53 in adenocarcinomas could be used as a prognostic factor for patients. p21(WAF1) is of protein has a definite value in judging the prognosis in NSCLC. Combined expression of p53 and p21(WAF1) can be used as the prognostic markers in NSCLC and are of significance in estimating the prognosis of patients.