Expression of cyclin D1, p21WAF1, p53 and Ki-67 in hepatocellular carcinoma: a pathological study

Objective　To explore the expression of cyclin D1, p21WAF1, p53 and Ki-67 protein in hepatocellular carcinoma (HCC) and its relationship with prognosis of HCC patients. Methods　Liver specimens were collected from 80 HCC patients who received hepatectomy in the General Hospital of PLA from Jan. 2000 to Jan. 2005, and the expressions of cyclin D1, p21WAF1, p53 and Ki-67 protein were determined by immunohistochemical staining (EliVision method) to investigate the relationship between the protein expressions and the clinicopathologic characteristics of HCC, and their relationship with the survival rate of the patients was analyzed. Results　The positive expression rates of cyclin D1, p21WAF1, p53 and Ki-67 in HCC were 38.8%, 40.5%, 65.4% and 80.0% respectively, and they were significantly higher than those in matched normal tissues (19.0%, 11.5%, 0.0% and 6.3% respectively, P<0.005). Correlation analysis showed that the expression of cyclin D1 was positively related to the nuclear grade (P=0.041), the expression of p21WAF1 and p53 were positively related to the tumor differentiation (P=0.032, P=0.031) and vascular invasion (P=0.036, P=0.011), the expression of Ki-67 was positively related to the tumor differentiation (P=0.004), nuclear grade (P=0.045) and vascular invasion (P=0.001). Survival analysis showed the prognosis was poor in patients with high expression of cyclin D1 or/and Ki-67. The expression of Ki-67 was significantly related to the expression of p53 (P=0.000) and p21WAF1 (P=0.047), but no significant relation was found among the expression of other proteins. Cox regression analysis showed that the tumor size (P=0.042), tumor number (P=0.004) and vascular invasion (P=0.000) were independent prognostic factors of HCC. Conclusions　The cyclin D1, p21WAF1, p53 and Ki-67 protein may be involved in the biological process of HCC. The positive expression of cyclin D1 and Ki-67 may be used to evaluate the prognosis of patients with HCC. DOI: 10.11855/j.issn.0577-7402.2014.01.05