骨肉瘤组织中Survivin基因表达及其与细胞周期蛋白D1表达的关系

目的 :探讨骨肉瘤中抗凋亡基因Survivin的表达状态及其与细胞周期蛋白D1(cyclinD1)表达的关系。方法 :采用原位杂交、免疫组织化学技术、DNA原位末端标记 (TUNEL)法检测 3 8例骨肉瘤、15例骨软骨瘤、5例正常骨组织中SurvivinmRNA表达及骨肉瘤组织中cyclinD1表达和细胞凋亡情况 ,比较SurvivinmRNA表达与骨肉瘤临床病理参数及cyclinD1表达的关系。结果 :SurvivinmRNA在正常骨和骨软骨瘤组织无明显表达 ,但显著表达于骨肉瘤中 65 8% ( 2 5 /3 8) ,其表达率与骨肉瘤组织学分级无关 ,与WHO分型及转移有关 ,P <0 0 5 ;骨肉瘤细胞凋亡指数(AI)均值为 8 3 % ( 0～ 17% ) ,Survivin阴性组AI值显著高于阳性组 ,P <0 0 1;骨肉瘤中cyclinD1过度表达 ( 71 1% ,2 7/3 8) ,其与Survivin表达正相关 ,rs=0 3 70 ,P <0 0 5。结论 :Survivin选择性表达于骨肉瘤组织 ,通过抑制细胞凋亡 ,并与cyclinD1协同作用参与骨肉瘤的发生发展 ,Sur vivin可能是评价骨肉瘤预后的重要参考指标     

肺癌组织中细胞周期素D1的扩增与表达

目的 :研究肺癌组织中细胞周期素 (cyclin)D1的扩增和表达及其与肺癌临床病理特征的关系。方法 :采用免疫斑点法和差异PCR方法 ,对 4 0例肺癌组织及 4 0例正常肺组织进行cyclinD1蛋白表达与基因扩增研究。结果 :肺癌组织cyclinD1蛋白表达的阳性率为 6 5.0 % ,高于正常肺组织的 2 2 .5% ;肺癌cyclinD1基因扩增的阳性率达 55.0 % ,也显著高于正常肺组织的 17.5% ;肺癌cyclinD1的高度扩增和过度表达与肺癌的转移及分期密切相关。结论 :cyclinD1基因的高度扩增和过度表达状态在肺癌的恶性进展中起重要作用 ,可作为判定肺癌恶性度的重要参数之一。     

胃癌中p21WAF1/CIP1、细胞周期素D1、p53表达的相关性

目的　探讨p2 1WAF1/CIP1、细胞周期素D1(cyclinD1)、p5 3在胃癌中表达之间的相关性。 方法　应用原位杂交技术检测p2 1WAF1/CIP1mRNA、细胞周期素D1mRNA及免疫组化技术检测p5 3蛋白在胃癌中的表达。结果　p2 1WAF1/CIP1mRNA在癌组织及癌旁正常粘膜中阳性表达率各为 93.15 % (6 8/73)及76 .71% (5 6 /73) ,二者相比具有显著差异 (P <0 .0 5 )。CyclinD1mRNA在癌组织及癌旁正常粘膜中阳性表达率各为 5 4 .79% (40 /73)及 30 .16 % (2 2 /73) ,二者具有显著差异 (P <0 .0 5 )。p5 3蛋白在胃癌中的阳性表达率为 32 .87% (2 4 /73) ,p5 3过表达者 ,其 p2 1WAF1/CIP1mRNA表达较p5 3阴性者为低 ,二者存在显著差异 (P <0 .0 5 )。p2 1WAF1/CIP1表达与细胞周期素D1表达呈负相关。结论　p2 1WAF1/CIP1、CyclinD1、p5 3的异常表达及它们之间可能存在的相互作用 ,对于胃癌的发生发展具有重要意义。     

妊娠滋养细胞肿瘤中cyclinD1和CDK4的表达及意义

目的 :探讨细胞周期素D1(cyclin dependentkinas ,cyclinD1)和细胞周期依赖激酶 4(cyclin dependentkinase 4,CDK4)在妊娠滋养细胞肿瘤发生、发展中的作用。方法 :采用免疫组化SP法检测cyclinD1、CDK4在妊娠滋养细胞疾病中的表达。结果 :cyclinD1在葡萄胎、侵蚀性葡萄胎和绒毛膜癌组织中的阳性表达率分别为 2 0 %、72 2 2 %和88 89% ,CKD4的阳性表达率分别为16 67%、61 11%和 72 2 2 % ,妊娠滋养细胞肿瘤组与葡萄胎比较 ,cyclinD1和CDK4的表达率明显增高 ,差异有统计学意义 ,P <0 0 1;在妊娠滋养细胞肿瘤中 ,cyclinD1和CDK4的表达成正相关 ,r =5 675 ,P =0 0 17;妊娠滋养细胞肿瘤Ⅰ～Ⅱ期、Ⅲ～Ⅳ期组织中 ,cy clinD1的阳性表达率分别为 70 %和 93 75 % ,CDK4的阳性表达率分别为 5 0 %和 87 5 % ,随肿瘤临床期别的增加 ,cyclinD1和CDK4的表达率逐渐升高。结论 :cyclinD1和CDK4在妊娠滋养细胞疾病中过度表达 ,并与其发生和发展有关     

cyclin E和cdk2在肺癌中表达及其临床意义

目的 :探讨细胞周期调控因子在肺癌发病中的作用。方法 :应用免疫组化方法检测细胞周期蛋白E(cyclinE)和细胞周期蛋白依赖性激酶 2 (cdk2 )在 38例肺癌和 6例正常肺组织中的表达状况。结果 :cyclinE和cdk2在肺癌中阳性率分别为 6 0 .5%、6 5.8% ,显著高于正常肺组织 (P <0 .0 5) ;cdk2表达与肺癌分期密切相关 (P <0 .0 5) ,而cyclinE表达与肺癌分期、淋巴结转移和病理分型均无相关性 (P>0 .0 5) ;肺癌中两者共表达率为 31.8%。结论 :cyclinE和cdk2参与肺癌的发生发展过程 ,但可能不是反映肺癌生物学特征有价值的标记物。     

胰腺癌组织中cyclin D1和rasp21表达的研究

目的 :探讨细胞周期素 (cyclin)D1和rasp2 1蛋白在胰腺癌中的相互关系。方法 :应用免疫组化方法检测cyclinD1和rasp2 1在胰腺癌中的表达。结果 :cyclinD1和rasp2 1在胰腺癌中的阳性表达率分别为60 0 %和 72 5 % ,二者在胰腺癌中的表达差异有统计学意义 ,P <0 0 5。cyclinD1阳性表达与肿瘤的分化程度密切相关 ,P <0 0 5。结论 :cyclinD1和rasp2 1过表达在胰腺癌发生过程中具有协同作用。     

p27~(Kip1)和细胞周期蛋白D1在胃癌中的表达及其预后意义

目的 :研究p2 7Kip1、细胞周期蛋白D1(cyclinD1)在胃癌组织中的表达水平以及与生物学行为的关系和对预后评价的意义。方法 :以免疫组化方法检测 92例胃癌组织中p2 7Kip1、cyclinD1蛋白的表达水平。结果 :本组 92例胃癌中 ,p2 7Kip1蛋白阳性 39例 ,占 42 .4% ;cyclinD1蛋白表达阳性 44例 ,占 47.8% ;胃癌组织中 ,p2 7Kip1蛋白水平与胃壁浸润深度、TNM分期、病理组织学分级、区域淋巴结转移均相关 (P <0 .0 5 ) ;cyclinD1蛋白表达与病理组织学分级负相关 (P <0 .0 5 ) ;p2 7Kip1与cyclinD1蛋白阳性表达显著相关 (P <0 .0 5 ) ;单变量生存分析结果 ,p2 7Kip1高表达组三年、五年生存率分别为 77.1%、5 7.8% ,明显高于低表达组的 33.7%、2 6 .3 % (P =0 .0 0 7) ,多变量分析显示p2 7Kip1是一个独立的预后指标 (P =0 .0 0 0 3)。结论 :p2 7Kip1可作为反映肿瘤恶性表型的指标 ,对胃癌预后具有一定的价值 ;cyclinD1是胃癌发生、发展过程中早期的分子事件 ;p2 7Kip1在胃癌进展中起着比cyclinD1更重要的作用。     

细胞周期素D_2在霍奇金淋巴瘤及间变性大细胞淋巴瘤中的表达及其意义探讨

 目的　检测细胞周期素D2 (cyclinD2 )在霍奇金淋巴瘤 (HL)及间变性大细胞淋巴瘤 (ALCL)中蛋白质水平的表达情况 ,探讨其表达在HL和ALCL的发生发展中所起的作用。方法　收集 2 88例恶性淋巴瘤石蜡包埋标本 ,筛选出HL2 6例 ,ALCL19例 ,切片经微波抗原修复 ,cyclinD2 免疫组化染色 ,光学显微镜镜下计数阳性细胞。结果　cyclinD2 在HL病例组中的表达率为 92 .3% (2 4 / 2 6 ) ,在ALCL组中阳性率为 (36 .8% ) 7/ 19,两组病例的表达差异有统计学意义 (P <0 .0 5 )。结论　 (1)cyclinD2 在HL和ALCL中的表达差异提示HL和ALCL在发生过程中起因不同并存在不同的生长调控机制。 (2 )cyclinD2 在HL和ALCL表达的差异对两者的鉴别诊断有帮助。 (3)HL与ALCL的细胞起源不同 ,但两者也可能存在一些重叠与过渡的形式 ,还有可能存在两种肿瘤的混合类型     

细胞周期蛋白D1在浸润性乳腺癌中的表达及其临床意义

目的　探讨浸润性乳腺癌组织中细胞周期蛋白D 1(cyclinD1)的表达 ,及其与激素受体和临床病理特征的相关性。方法　采用免疫组化方法检测 97例浸润性乳腺癌组织和 2 0例正常乳腺组织中cyclinD1的表达情况 ;采用免疫组化方法检测肿瘤组织中的雌、孕激素受体 (ER、PR)的表达。结果　浸润性乳腺癌组织中 ,cyclinD1蛋白表达率 (5 7.7% )显著高于正常乳腺组织(15 .0 % ) (P <0 .0 1)。ER阳性、PR阳性的乳腺癌组织中cyclinD 1表达较ER阴性、PR阴性者增高。cyclinD 1高表达与腋淋巴结转移、肿瘤大小、TNM分期显著相关 ,而与患者年龄、肿瘤病理类型无关。结论　cyclinD1的高表达在乳腺癌的发生、发展中可能起重要作用 ,并与激素受体、腋淋巴结转移、TNM分期相关     

槲皮素对人乳腺癌裸鼠移植瘤细胞周期的影响

 目的　研究槲皮素对人乳腺癌细胞株MCF 7裸鼠移植瘤细胞周期的影响。方法　 2 4只MCF 7细胞株移植成功的裸鼠分为对照组、槲皮素组、阿霉素组及联合用药组 ,每组 6只。用流式细胞仪分析细胞周期分布 ,用免疫组化测定cyclinD1表达水平。结果　G0 /G1期占细胞周期比例对照组明显低于槲皮素组 ,阿霉素组及联合用药组 (P <0 .0 1) ,S期占细胞周期比例对照组明显高于槲皮素组 ,阿霉素组及联合用药组 (P <0 .0 1) ,cyclinD1表达水平对照组明显高于槲皮素组、阿霉素组及联合用药组 (P <0 .0 1)。结论　槲皮素可作用于MCF 7移植瘤的G1/S节点 ,可抑制移植瘤细胞增殖及cyclinD1表达 ,延缓肿瘤生长。     

EXPRESSION OF CYCLIN D1 AND CDK4 IN OSTEOSARCOMA OF THE JAWS

The main cause of the cellular malignant proliferation is the disorder of cell division and growth. The alterations of proteins and genes that involved in this process correlate closely with the occurrence and vicious phenotype of neoplasm. Cyclin D1 and cyclin-dependent kinase 4 (CDK4) regulatory proteins in G1 phase have a direct bearing on carcinogenesis. Presently, gene amplification, overexpression, chromosome inversion andtranslocation of cyclin D1 and CDK4 have been discovered in ma…     

Expression and significance of cell cycle-related proteins Cyclin Dl, CDK4, p27, E2F-l and Ets-1 in chondrosarcoma of the jaws

To elucidate the expression and significance of cell cycle-associated proteins in chondrosarcoma of the jaws, Cyclin Dl, CDK4, p27, E2F-l and Ets-l expressions were examined in chondrosarcoma and osteochondroma of the jaws by immunohistochemical ABC method. The results demonstrated that Cyclin Dl, CDK4, p27, E2F-1 and Ets-1 were positive 75% (15 of 20), 60% (12 of 20), 25% (5 of 20), 65% (13 of 20) and 60% (12 of 20) in chondrosarcoma of the jaws, respectively. There was no remarkable difference in the expression of these proteins among histological grades of the chondrosarcoma (P>0.05). In osteochondroma of the jaws, CDK4 and E2F with an equal positivity of 12.5% (1 of 8), whereas p27 was positive 75% (6 of 8). None of the osteochondroma cases was immunohistochemically positive for Cycin Dl and Ets-1. In addition, the positive rate of Cyclin Dl, CDK4, E2F-l and Ets-1 proteins was significantly higher, whereas p27 was lower in chondrosarcoma than in osteochondroma of the jaws (P<0.05). These data show that the expression of cell cycle regulatory proteins is altered in chondrosarcoma of the jaws: cyclin Dl, CDK4, E2F-1 and Ets-1 are over-expressed and p27 is low-expressed.     

p57KIP2、cyclin D1、cyclin E在男性乳腺癌组织中的表达及其临床意义

  目的  探讨p57KIP2、cyclin D1、cyclin E在男性乳腺癌（male breast cancer，MBC）组织中的表达及其临床意义。  方法  收集2000年1月至2016年12月60例温州医科大学附属第一医院MBC患者的组织标本，分为乳腺浸润性导管癌组（infiltrating ductal carcinoma，IDC）40例、乳腺导管原位癌组（ductal carcinoma in situ，DCIS）20例，选取20例男性乳腺发育症（gynecomastia，GYM）作为对照组。应用RT-PCR、免疫组织化学法分别检测IDC、DCIS、GYM组织中的p57KIP2、cyclin D1、cyclin E mRNA及蛋白的表达情况。  结果  IDC的p57KIP2 mRNA表达水平为0.18±0.07，低于DCIS的0.42±0.05、GYM的0.75±0.04；IDC的p57KIP2蛋白阳性率为25%（10/40），低于DCIS的60%（12/20）、GYM的90%（18/20）；p57KIP2 mRNA及蛋白表达三组间两两比较，差异均具有统计学意义（P < 0.05）。IDC的cyclin D1、cyclin E mRNA表达水平分别为0.92±0.12、0.96±0.08，高于DCIS的0.72±0.06、0.64±0.01及GYM的0.38± 0.03、0.21±0.02；IDC的cyclin D1、cyclin E蛋白阳性率分别为90%（36/40）、88%（35/40），高于DCIS的80%（16/20）、85%（17/20）及GYM的25%（5/20）、20%（4/20），差异均具有统计学意义（P < 0.05）。在IDC组织中p57KIP2、cyclin D1、cyclin E表达均与临床分期、组织学分级相关（P < 0.05），p57KIP2蛋白的表达与淋巴结转移相关（P < 0.05）；p57KIP2与cyclin D1、p57KIP2与cyclin E呈负相关（P < 0.05），cyclin D1与cyclin E呈正相关（P < 0.05）。  结论  p57KIP2、cyclin D1、cyclin E可能参与了MBC的发生发展过程，联合检测p57KIP2、cyclin D1、cyclin E可为进一步发现MBC的发病机制及治疗提供重要参考。      

Overexpression of cdk4/cyclin D1, a possible mediator of apoptosis and an indicator of prognosis in human primary lung carcinoma

The relation between expression of cell cycle-regulator molecules and apoptosis was examined in surgical specimens and cultured human lung carcinoma cell lines. Immunohistochemical analysis for 133 cases revealed 2 types of staining pattern. The first group consisted of 95 cases (71.4%) characterized by apoptotic cells showing intensely positive staining for cdk4 and cyclin D1 but negative for other proteins (type A). In the second group (type B), comprising 38 cases (28.6%), apoptotic cells exhibited intense positive staining for any cyclins and cdks. Most of the latter cases had lost expression of Rb protein. When tumor cells retrieved from paraffin-embedded tissue were examined by flow cytometry, higher proportions of cells expressing only cdk4 or cyclin D1 in type A cases and of cells expressing any cyclin or cdk in type B cases showed a subdiploid DNA content. In survival analysis using the LI of apoptotic cells and cyclin/cdk-positive cells, the high-apoptosis/high-cyclin D1 group showed the poorest prognosis. Furthermore, forced overexpression of only cdk4 or cyclin D1 induced apoptosis in cultured cells with normal Rb protein, whereas overexpression of any cyclin or cdk induced apoptosis in cells defective for Rb protein. In conclusion, upregulation of cdk4/cyclin D1 may be a primary and critical factor in induction of apoptosis in human lung carcinomas in vivo. Moreover, inactivation of Rb protein renders cells more prone to apoptosis by abnormal expression of any cell-cycle protein.     

Alterations of p53, pRb, cyclin D(1) and cdk4 in human oral and pharyngeal squamous cell carcinomas

Alteration of expression of tumour suppressor genes and cell cycle regulators may be responsible for oral and pharyngeal cancer development. We have studied the expression of p53, pRb, cyclin D(1) and cdk4 in 53 cases of oral and pharyngeal squamous cell carcinomas using immunohistochemistry. Tumour expression of all nuclear proteins was scored according to the percentage of positive cancer nuclei. Positive p53 expression was detected in 27/53 (50.94%) cases. Lack of pRb immunostaining was observed in 39/53 (73.58%) cases. Overexpression of cyclin D(1) was shown in 21 (39.62%) tumours. The overexpression of cdk4 was detected in 43/53 (81.13%) cases. There was no significant association among these cell cycle regulatory proteins. This implies that the aberration of an important cell cycle regulator may be sufficient to disrupt regulatory mechanism in a manner favouring tumourigenesis. In summary, our results suggest that inappropriate expression of p53, pRb, cyclin D(1) or cdk4 is likely to contribute to the development of oral and pharyngeal cancers. The lack of pRb expression and/or overexpression of cdk4 play a crucial role in the development of this malignancy.     

Cyclin D1 expression in transitional cell carcinoma of the bladder: correlation with p53, waf1, pRb and Ki67

Normal cell proliferation is closely regulated by proteins called cyclins. One of these, cyclin D1, in combination with its corresponding cyclin-dependent kinase (cdk), is essential for G(1)/S phase transition. Cyclin/cdk complexes are generally inhibited by cyclin-dependent kinase inhibitors(ckis), some of which are induced by wild-type p53. The aims of this study were: to investigate levels of cyclin D1 expression in transitional cell carcinoma (TCC) of the bladder; to correlate these results with data concerning the expression of p53, waf1, pRb and Ki67; and to determine whether cyclin D1 expression could predict clinical outcome. Paraffin-sections from 150 newly diagnosed bladder tumours (Ta/T1 = 97; T2-T4 = 53) were stained for cyclin D1 using immunohistochemistry and a cyclin D1 index assigned. These results were correlated with data relating to the expression of p53 and waf1 by the same tumours. A representative subset of 54 tumours (Ta/T1 = 28; T2-T4 = 26) was also stained for Ki67 and 55 were stained for pRb. The clinical course of each patient was recorded and multivariate analyses of risk factors for tumour recurrence, stage progression and overall survival were performed. Positive staining for cyclin D1 was found in 83% of tumours. The staining pattern varied between tumours with nuclear, cytoplasmic or a combination of the two evident in different tumours. 89% of Ta/T1 and 74% of T2-T4 tumours showed nuclear staining with or without cytoplasmic staining. The median value for cyclin D1 staining was significantly higher in Ta/T1 tumours (41%) compared with T2-T4 tumours (8%, P< 0.005) with 26% of muscle-invasive tumours demonstrating absent staining. In addition, the median value for cyclin D1 staining was significantly higher in G1/G2 tumours (43%) compared with G3 tumours (14%, P< 0.005). There was a significant positive correlation between expression of cyclin D1 and waf1 expression (P< 0.0001) as well as pRb expression but not between cyclin D1 expression and expression of p53. Ki67 expression was significantly associated with increasing tumour stage (P< 0.005) and histological grade (P< 0.05) but did not correlate with cyclin D1 expression. A cyclin D1 index > or = 8% was associated with significantly better survival in those patients with muscle-invasive disease (T2-T4). In addition, there was a significantly higher progression rate for those patients with Ta/T1 disease whose tumours demonstrated cytoplasmic cyclin D1 staining. These results indicate that cyclin D1 expression is significantly higher in low-stage, well differentiated bladder tumours and strongly correlates with waf1 expression. In a multivariate analysis, cyclin D1 expression is an independent prognostic indicator of survival in those patients with muscle-invasive disease.     

骨肉瘤中细胞周期素D1,p16蛋白表达的研究

目的;研究细胞周期素Ｄ１,ｐ１６蛋白在骨肉瘤中的表达状态及意义。方法：采用免疫组织化学方法（ＳＰ法）检测了４３例骨肉瘤和１５例骨软骨瘤中２种蛋白的表达,并在２种肿瘤间及骨肉瘤患者不同年龄组,组织类型,分化程度间进行比较。     

Expression profile of proteins involved in the xenotransplantability of non-small cell lung cancers into athymic nude mice.

The aim of this study was to evaluate the expression profile of proteins involved in growing of human non-small cell lung cancer (NSCLC) in athymic nude mice. The expressions of 20 gene products in primary NSCLC of 170 patients were analyzed and the proteins were correlated with the transplantability of the carcinomas in nude mice. There was no relationship between xenotransplantability of human non-small cell lung cancer in nude mice and histology, stage or lymph node involvement. Of the analyzed proliferative factors PCNA, cyclin A, cyclin D, cdk2, cdk4 and cell cycle phases only cyclin D, cdk4 and the cell cycle phases were up-regulated in growing carcinomas. There was also a correlation between the apoptotic indices and the take rate in nude mice. Concerning microvessel density and angiogenic factors only VEGF showed a relation to xenotransplantability. Of the proto-oncogenes and suppressor gene products N-RAS, P53, FOS and JUN revealed a relationship to the take rate of NSCLC, while such a relationship was not found with MYC, ERBB-1 and ERBB-2. In a second step, a hierarchical cluster analysis was carried out. The resulting clusters were correlated with the take rate of the carcinomas in nude mice. The expression of JUN, N-RAS, FOS, cyclin D, and cdk4 were significantly different in both groups with non- overlapping confidence intervals. Thus, the up-regulation of the proteins JUN, N-RAS, FOS, cyclin D and cdk4 predicts the growth of NSCLC in nude mice.     

膀胱移行细胞癌组织中cyclinD1和CDK4的表达及其与临床病理的关系

目的　研究膀胱移行细胞癌组织中cyclinD1和CDK 4的表达及其与临床病理变化的关系。方法　采用免疫组化方法对 8例正常膀胱和 69例膀胱移行细胞癌组织中cyclinD1和CDK 4的表达进行观察。 结果　膀胱移行细胞癌组织中cyclinD1的表达高于正常膀胱组织 (P <0 .0 5 )。cyclinD1表达阳性者的肿瘤细胞分化较差 ,术后易复发 ,生存时间较短 ;而CDK 4的阳性表达仅与患者术后复发有关 (P <0 .0 5 ) ,与病理分级和生存时间无关 (P >0 .0 5 )。结论　cyclinD1的表达可作为判断膀胱细胞癌病理分级 ,术后复发和临床预后的指标 ,而CDK 4只能作为术后复发的参考指标。     

Prognostic implications of cyclins (D1, E,A), cyclin-dependent kinases (CDK2, CDK4) and tumor-suppressor genes (pRb,p16INK4A) in childhood acute lymphoblastic leukemia

Immunohistochemistry was used to analyze samples of 40 newly diagnosed childhood acute lymphoblastic leukemias (ALL) for their expression of cyclins (D1, E, A), cyclin-dependent kinases (cdk2, cdk4) and tumor-suppressor genes (pRb, p16^INK4A), in order to discover whether or not the expression of these various proteins may be of prognostic relevance for the survival of children with ALL. Patients with ALL who were strongly positive for cyclin D1 had a lower probability of remaining in first continuous remission than ALL patients who were negative or weakly positive for this trait. There was also a significant correlation between expression of cyclin D1 and frequency of recurrence. For cyclin E and cyclin A, in contrast, there was no difference in the duration of relapse-free-intervals or the frequency of recurrence in patients. Children with cdk4-positive ALL had a lower probability of remaining in first continuous remission than children with cdk4-negative ALL. No prognostic relevance was found for cdk2. Patients with ALL who expressed pRb had a higher probability and patients who expressed p16 a lower probability of remaining in first continuous remission, but the results were not statistically significant. This investigation demonstrated that cyclin D1 and cdk4 were the most important prognostic factors for children with ALL, and that the combination of them showed the strongest prognostic relevance. Int. J. Cancer 74:508–512, 1997. © 1997 Wiley-Liss, Inc.