人脑神经胶质瘤中p16、p21~(WAF1/CIP1)蛋白表达的研究

目的　探讨 p16、p2 1WAF1/CIP1两种抑癌基因与人脑神经胶质瘤恶性程度的关系。方法　采用SABC免疫组织化学方法对 6 4例人脑胶质瘤组织及 8例正常脑组织标本中p16和 p2 1WAF1/CIP1表达情况进行检测 ,并进行相关分析。结果　①p16和 p2 1WAF1/CIP1阳性表达率在人脑胶质瘤中分别为 4 5 .3%和 6 4 .1%与正常脑组织中的表达情况差异显著 (P <0 0 5 ) ;②p16蛋白和 p2 1WAF1/CIP1蛋白阳性表达率均随着胶质瘤的恶性程度的增高而降低 ,差异显著 (P <0 0 1) ,且呈负相关关系 ;③p16蛋白和 p2 1WAF1/CIP1蛋白可协同表达 ,且在正常脑组织和脑胶质瘤各分级中 p16蛋白和 p2 1WAF1/CIP1蛋白协同表达率差异显著 (P <0 0 5 ) ,并呈负相关关系。结论　p16与p2 1WAF1/CIP1蛋白的阳性表达率及协同表达率可在一定程度上反映胶质瘤细胞的恶性程度 ,可作为判断其恶性程度的有效指标     

胰腺癌p53上下游基因mdm2、p21WAF/CIP1以及P14ARF蛋白的表达及相互关系

目的 探讨p14ARF、p53、mdm2及p21WAF/CIP1蛋白在胰腺癌组织中的表达、相互关系及意义。方法 选取167例胰腺癌、101例癌旁与13例良性病变组织构建组织芯片(又称组织微阵列),应用免疫组织化学EnVision二步法检测这4种蛋白在胰腺良恶性病变中的表达。结果 p14ARF、p53、mdm12及p21WAF/CIP1在胰腺癌中表达的阳性率分别为35.3％(59/167)、57.5％(96/167)、64.1％(107/167)和39.5％(66/167)。同癌旁组织相比,p53和mdm2表达明显升高(P<0.01),而p14ARF和p21WAF/CIP1的表达明显降低(P<0.05)。p21WAF/CIP1的阳性表达与年龄、神经受累显著相关(P<0.05);p53的阳性表达与肿瘤的分化、淋巴结转移和神经受累均显著相关(P<0.05);mdm2的阳性表达与肿瘤的分化显著相关(P<0.05);p14ARF与年龄和浸润转移显著相关(P<0.05)。四者阳性表达两两之间统计学上具有关联性(P<0.05)。结论 p53和mdm2的过表达以及p14ARF和p21WAF/CIP1的缺失表达可能会导致胰腺癌的形成和进展;4种蛋白主要以p14ARF-p53-mdm2-p21WAF/CIP1通路的方式作用于细胞的转化和肿瘤的形成;联合检测p53和mdm2的表达可用于评定胰腺癌的恶性程度。     

膀胱癌中p53、c—myc和bcl—2的表达及意义

目的：研究癌基因和抗癌基因蛋白产物在膀胱移行细胞癌组织中异常表达与病理分级,临床分期间关系。方法：应用免疫组化S－P法检测96例膀胱移行细胞癌中p53,c-myc和bcl-2的表达水平。结果：96例膀胱移行细胞癌中p53,c-myc和bcl-2的阳性表达率分别为60．4％,68．8％和81．3％,结果表明,p53,c-myc和bcl-2异常表达与膀胱移行细胞癌的分级和分期间差异有统计学意义。结论：p53,c-myc和bcl-2表达在膀胱癌的发生发展中起重要作用。在膀胱癌变过程中,有多种癌基因的变化。     

食管鳞状细胞癌中p16基因甲基化及其表达

目的：探讨食管鳞状细胞癌p16／INK4基因启动子区高甲基化和p16、cyclinD1蛋白表达的意义。方法：用甲基化特异性PCR（MSP）法检测p16／INK4基因启动子区的高甲基化，用免疫组织化学方法检测p16、cyclind1蛋白的表达。结果：30例食管鳞状细胞癌中7例p16免疫组织化学阳性，15例cyclinD1阳性，组织学和统计学分析显示p16与cyclinD1的表达呈负相关。4例检出p16／INK4基因启动子区高甲基化，但与p16失表达无统计学意义。结论：（1）在食管鳞状细胞癌可检出p16／INK4基因启动子区的高甲基化，而甲基化不是引起p16失表达的主要原因。（2）p16与cyclinD1的表达呈负相关，提示细胞周期调控因子之间可能存在相互影响表达的反馈机制。     

siRNA干扰 BMI-1 基因对膀胱癌EJ细胞增殖的调控作用及其机制

目的: 对比观察膀胱癌EJ细胞及人膀胱移行上皮细胞中 BMI-1 基因及下游 p16^INK4a、p14^ARF 基因的mRNA及蛋白表达水平,探讨siRNA干扰 BMI-1 基因后对EJ细胞增殖的影响及其调控机制。方法: 细胞免疫荧光观察BMI-1、p16^INK4a和p14^ARF蛋白在EJ细胞中表达情况及定位。Real-time RT-PCR检测EJ细胞及膀胱正常移行上皮细胞中3种基因的表达水平,Western blotting检测蛋白水平。构建干扰 BMI-1 基因siRNA,通过脂质体转染导入EJ细胞中,设立空白对照和阴性干扰对照组,检测 BMI-1 及下游 p16、p14 基因表达水平及蛋白表达水平的变化;以CCK-8检测细胞生长观察siRNA干扰 BMI-1 表达对EJ细胞增殖的抑制作用;用流式细胞术分析细胞凋亡的改变。结果: BMI-1mRNA及蛋白水平在EJ细胞表达高于膀胱移行上皮细胞,而p16^INK4a和p14^ARFmRNA及蛋白在EJ细胞表达水平稍低于膀胱移行上皮细胞。siRNA干扰 BMI-1 后可以上调EJ细胞中其下游p16和p14 mRNA及蛋白水平,使EJ细胞增殖能力下降,细胞凋亡增多。结论: siRNA干扰 BMI-1 基因表达对EJ细胞的体外生长具有明显的抑制作用,其作用机制与上调其下游 p16^INK4a、p14^ARF 基因的表达有关。     

前列腺癌p21CIP1/WAF1、Rb及PCNA的表达及意义

目的研究p21^CIP1/WAF1、Rb及PCNA在人前列腺癌标本中的表达及三者相关性，阐述它们与前列腺癌病理分级及临床分期的关系。方法收集36例确诊前列腺癌石蜡包埋存档标本作为研究对象，采用免疫组化SABC法对其p21^CIP1/WAF1、Rb及PCNA进行检测，并应用图象分析仪判定，统计学处理，对前列腺癌的病理分级及临床分期进行了对比分析及相关性研究。结果p21^CIP1/WAF1、Rb及PCNA的免疫组化阳性染色为棕黄色和／或棕褐色，定位于细胞浆或细胞核。所得数据均经统计学处理。在不同病理分级、临床分期之间差异均有显著性，同时还发现PCNA与p21^CIP1/WAF1及Rb之间存在显著负相关性。但未发现p21^CIP1/WAF1、与Rb有显著相关性。结论p21^CIP1/WAF1、Rb表达与前列腺癌组织的病理分级、临床分期呈负相关性，在发病机制中可能涉及到p21^CIP1/WAF1、Rb和PCNA凋节通路的异常。同时，作为一种检测方法，可用于判定前列腺癌恶性程度及进程的有价值的指标，对诊治康复也可提供有意义的帮助。     

p21调控胃癌POLD1基因的初步机制探究

目的 分析p21调控胃癌POLD1基因表达的初步机制,以探索基于降低胃癌POLD1基因表达并阻断癌细胞恶性增殖的分子靶点。方法 利用生物信息学软件Cytoscape、String分析p21与POLD1基因的相互关系;干扰胃癌细胞中p21基因的表达,采用荧光定量PCR及Western blot法检测POLD1基因及细胞周期调控因子CDK2、CDK4、p53、PCNA的表达变化,采用免疫共沉淀实验分析p21与POLD1基因编码的蛋白p125之间的相互作用。结果 生物信息学分析发现,p21通过CDK2、PCNA与POLD1直接关联,并与CDK4等细胞周期因子间接相关。干扰胃癌细胞中p21的表达后,POLD1、CDK2、CDK4表达上调,而p53表达下调。免疫共沉淀实验未检测到p21与p125直接相互作用。结论 p21能负调控胃癌中POLD1基因的表达,这种调控作用与细胞周期调控因子CDK2、CDK4、p53、PCNA等密切相关。     

nm23—H1与p21、p53蛋白在人卵巢癌中表达的相关性研究

目的：研究人卵巢癌组织中肿瘤转移抑制基因nm23-H1、抑癌基因p21^WAFI及p53蛋白的表达,探讨它们在卵巢癌发生、发展中的作用。方法：采用免疫印迹技术,对74例卵巢癌组织及21例卵巢非癌组织中nm23-H1p21^WAFI及p53蛋白进行检测。结果：在卵巢癌中nm23-H1、p53蛋白的表达高于卵巢非癌组织,p21^WAFI蛋白的表达呈下调;肿瘤发生转移时卵巢癌组织中nm23-H1和p21WAF蛋白表达显著低于未发生肿瘤转移的癌组织。p53蛋白表达与肿瘤转移无关。nm23-H1 \p21^WAFI 蛋白与卵巢癌组织类型无关,但与卵巢癌的临床分期相关。p53蛋白的表达与卵巢癌组织类型及卵巢癌的临床分期无关。nm23-H1与p53、p21^WAFI蛋白间表达在卵巢癌中呈相关性。结论：nm23-H1、p53、p21^WAFI 基因在卵巢癌发生、发展中起一定的作用,nm23-H1与p53、p21^WAFI基因在卵巢癌发生、发展中可能起协同作用。     

p53与肿瘤的形成,治疗和预后

p53基因作为抑制基因在约50％的人类肿瘤中被检测出来,其蛋白产物p53蛋白与特异性DNA序列结合并激活转录。转录激活导致p53增加,进而诱导蛋白p21、WAF1／CIP1产生,通过p21与。cyclin－cdk复合物结合来抑制cdk活性,从而达到控制细胞从GI期进入S期的目的．也可通过p21与PCNA结合抑制DNA复制。p53在肿瘤形成中的作用50－55％的人类肿瘤中发现有p53突变。这些突变完全淘汰不能与特异DNA序列结合的P53蛋白。P53的细胞周期抑制功能需要p53转录活性,至少有些p53的凋亡活动不需要有赖于p53的基因产物。这可能意味着,被选p53靶基因的…     

乳腺癌中p16INK4a和视网膜母细胞瘤基因甲基化状况及其表达

目的 研究乳腺癌及癌旁增生组织中p16INK4a和视网膜母细胞瘤(RB)基因启动子区域的甲基化状况,并探讨基因异常甲基化与蛋白表达及其临床意义.方法 采用甲基化特异性PCR方法 对46例乳腺癌、22例癌旁增生组织及7例正常乳腺组织中p16INK4a和RB基因启动子区域甲基化状况进行检测,并采用免疫组织化学SP法对p16INK4a蛋白表达情况进行相应检测.结果 乳腺癌、癌旁增生组织和正常乳腺组织中p16INK4a基因的甲基化率分别为23.9%(11/46)、18.2%(4/22)、1/7;RB基因的甲基化率分别为10.8%(5/46)、9.1%(2/22)、0(0/7);肿瘤组织、癌旁增生组织和正常乳腺组织中p16INK4a基因、RB基因甲基化率差异均无统计学意义(P>0.05).正常乳腺组织、癌旁增生组织、乳腺癌中p16INK4a蛋白表达阳性率分别为7/7、60.8%(28/46)和81.8%(18/22),三者之间差异无统计学意义(P>0.05);肿瘤组织中p16INK4a蛋白表达与肿瘤分级相关(P<0.05);肿瘤组织中p16INK4a甲基化状况与其蛋白表达、肿瘤分级、ER表达阴性具有相关性(P<0.05),与肿瘤大小、淋巴结转移、年龄均不相关;RB基因甲基化状态与肿瘤分级、肿瘤大小、ER表达及年龄均无相关性,但与淋巴结转移相关(P<0.05).结论 p16INK4a基因异常甲基化可能在乳腺癌发生过程中作用有限,但在肿瘤的演进中发挥作用;RB基因甲基化检测对于分析乳腺癌进展及预后情况可能有一定参考价值;p16INK4a基因甲基化是p16INK4a蛋白失表达的机制之一.     

Frequent p16ink4a inactivation is an early and frequent event of intraductal papillary neoplasm of the liver arising in hepatolithiasis

Intraductal papillary neoplasm of the liver (IPNL) is a precursor lesion of intrahepatic cholangiocarcinoma (ICC) arising in hepatolithiasis. In this study, 98 foci of IPNL identified in 39 surgically resected hepatolithiatic livers were investigated for expression of p16INK4a, cyclin D1, p21WAF1/CIP1, p53, mouse double-minute 2 (MDM2), and pRb. In addition, methylation-specific polymerase chain reaction (MSP) for p16 INK4a promoter region was performed in these foci. Nonneoplastic bile ducts from 11 hepatolithiatic livers, 5 histologically normal livers, and 9 cases of nonpapillary conventional ICC were used as controls. Decreased expression of p16INK4A was seen in IPNL group 1 with mild dysplasia and continued along the progression of IPNL to ICC. The expression of cyclin D1, p21WAF1/CIP1,and pRb gradually increased along the progression of IPNL to ICC and became significantly high in IPNL of group 3 (carcinoma in situ). The expression of p53 and MDM2 was increased in IPNL group 3 and group 4 with evident invasive carcinoma. MSP revealed that 54.6% of 44 IPNL foci harbored p16INK4a promoter hypermethylation, and such foci were significantly correlated with decreased expression of p16INK4a protein. Ki-67 labeling index exhibited a stepwise increase from IPNL group 1 to group 4. We conclude that p16INK4a inactivation, due mainly to its promoter hypermethylation, is a frequent and early event of IPNL and may be responsible for genetic and epigenetic alterations of other cell cycle regulators in IPNL.     

8-Br-cAMP对人视网膜母细胞瘤HXO-Rb44细胞抑癌基因表达的效应

目的 探讨８－Ｂr－CＡＭＰ对人视网膜母细胞瘤之ＨＸＯ－Ｒb４４细胞抑癌基因表达的 效庆及其对细胞生长的影响。方法 应用原位杂交、ＲＮＡ斑点印迹检测Ｐ１６＾ＩＮＫ４mＲＮＡ、p２１＾ＷＡＦ１mＲＮＡ、wp５３mＲＮＡ、mp５３mＲＮＡ和ＲｂｍＲＮＡ,应用免疫组织和化学和蛋白质斑点印迹技术检测ＰＣＮＡ－ＩＲ、p２１＾ＷＡＦ１－ＩＲ、 ｐ１６－ＩＲ、ｐＲｂ－ＩＲ、ｃｄｋ２、ＩＲ和ｃｄｋ４－ＩＲ。结果 在人ＨＸＯ－Ｒ     

Cell cycle regulators in bladder cancer: a multivariate survival study with emphasis on p27Kip1

Cyclin-dependent kinase inhibitors (CKIs) prevent cyclin-dependent kinases from phosphorylating critical substrates such as retinoblastoma gene protein (pRb), hence blocking the cascade of events leading to cell proliferation. Currently, the list of CKIs includes p21WAF1/Cip1, p27Kip1, p57Kip2 (the Cip/Kip family), p15/ INK4b, p16/INK4a, p18/INK4c, and p19/INK4d (the INK4 family). Among them, p27 plays a crucial role linking extracellular growth-regulatory signals to progression to or exit from the cell cycle. Unlike p53, p16, and Rb, mutations in Kip1 and WAF1 genes are distinctly rare in bladder cancer. We analyzed immunohistochemically the expression of p27 and other interacting G1 proteins (ie, p21, p16, pRb, p53) in 120 consecutive cases of transitional cell carcinomas (TCCs) and related it to proliferation rate, clinicopathologic parameters, and survival. p27 levels were significantly higher in low-grade (P = .001), superficial (Ta-T1) (P = .001), papillary (P < .001), and slowly proliferating TCCs (rs = -0.235, P = .05). p27 also positively correlated with p16 expression (rs = 0.212, P = .05). In univariate analysis, decreased p27 expression was associated with poor overall (P = .0109) and postrelapse (P = .0344) survival, especially if combined to increased Ki-67 expression (P = .0004 and P = .036, respectively). Furthermore, in multivariate analysis, Ki-67/p27 status had the strongest bearing on the overall survival of muscle-invasive TCCs (P = .0019). Our results indicate that low p27 expression is more common in poorly differentiated muscle-invasive TCCs and is a major player in cell cycle control in these neoplasms. More importantly, the combined Ki-67/p27 expression provides prognostic information beyond that provided by conventional parameters or other cell cycle-related proteins, concerning overall survival in muscle-invasive TCCs.     

p53、p21~(WAF1)蛋白在非小细胞肺癌中的表达及其临床意义

目的　探讨原发性非小细胞肺癌中p5 3、p2 1WAF1蛋白表达与临床病理及预后的关系。方法　应用免疫组织化学 (SP法 )方法。共检测非小细胞肺癌 147例 ,其中腺癌 6 6例 ,鳞癌 6 3例 ,腺鳞癌 14例 ,大细胞癌 4例。结果　p5 3蛋白总阳性率为 6 1.2 % (90 / 147) ,腺癌为 5 7.6 % (38/ 6 6 ) ,鳞癌阳性率为 6 3.5 % (4 0 / 6 3) ,腺鳞癌为 71.4% (10 / 14) ,大细胞癌 2例阳性。p2 1WAF1蛋白总阳性率为40 1% (5 9/ 147) ,腺癌为 42 .4% (2 8/ 6 6 ) ,鳞癌为 41.3% (2 6 / 6 3) ,腺鳞癌 2 8.6 % (4 / 14) ,大细胞癌 1例阳性。肺腺癌p5 3蛋白阳性表达与其预后相关 ,6 6例腺癌中 ,生存率低于 3年组和高于 3年组的p5 3蛋白阳性率分别为 75 % (2 1/ 2 8)和 44 .7% (17/ 38) ,差异有显著性意义 (P <0 .0 2 5 )。p2 1WAF1阳性表达与肺癌预后有关 ,p2 1WAF1阳性表达者 3年生存率 (6 4.4% )高于阴性表达者 (4 6 .6 % ) (P <0 .0 5 )。p5 3阳性而p2 1WAF1阴性的非小细胞肺癌患者的预后比p5 3阴性而p2 1WAF1阳性者差 (P <0 .0 1)。结论　检测p5 3蛋白表达可作为判断肺腺癌预后的指标之一 ;检测p2 1WAF1蛋白表达有利于对非小细胞肺癌预后的判断 ;联合检测p5 3、p2 1WAF1蛋白对判断非小细胞肺癌的预后有重要的意义 ,似可作     

p21WAF1／CIPI基因导入对p53突变人肺癌细胞系生长特性的影响

目的 探讨含突变ｐ５３基因癌细胞系ｐ２１基因的抗肿瘤作用。方法 构建人ｐ２１表达重组子,导入ｐ５３基因突变的人肺癌ＰＧ细胞每当增产同表达ｐ２１的细胞系;然后观察其形态太生长特性的改变;ＣＤＫ４,ＰＣＮＡ水平;对基因毒性物的反应性。结果 在含ｐ５３基因突变的ＰＧ细胞内导入的性ｐ２１基因,其高表达ｐ２１约是ＰＧ细胞的６倍,转谬为薄等异型性降低;生长速度下降（５０％）,叠落生长不明显;在０．５％血甭条件     

p21 WAF1/CIP1基因导入对p53突变人肺癌细胞系生长特性的影响

目的　探讨含突变ｐ５３ 基因癌细胞系表达ｐ２１ 基因的抗肿瘤作用。方法　构建人ｐ２１表达重组子,导入ｐ５３ 基因突变的人肺癌ＰＧ细胞系,建立稳定高表达ｐ２１ 的细胞系;然后观察其形态及生长特性的改变;ＣＤＫ４ ,ＰＣＮＡ水平;对基因毒性物的反应性。结果　在含ｐ５３ 基因突变的ＰＧ 细胞内导入外源性ｐ２１ 基因,其高表达ｐ２１ 约是ＰＧ 细胞的６ 倍;转染细胞出现核规则、核膜变薄等异型性降低;生长速度下降（５０％ ） ,叠落生长不明显;在０ ．５％ 血清条件下生长显著低于对照组;血清依赖性升高;软琼脂集落实验：转染细胞集落形成率降低为１ ％ （ 对照组为２８％ ） 。ｗｅｓｔｅｒｎ ｂｌｏｔ 显示,ｐ２１ 转染细胞的ＣＤＫ４ 和核仁组成区相关蛋白水平显著降低。但顺铂诱导下转染细胞凋亡发生延缓至４８ 小时以后（ 对照组２４ 小时）。结论　在有ｐ５３ 基因突变的肿瘤细胞ｐ２１ 的高表达仍能抑制癌细胞的生长,降低恶性表型;其作用可能与降低细胞ＣＤＫ４ 和ＰＣＮＡ 水平有关,而不依赖细胞凋亡机制。表达ｐ２１ 基因可作为恢复ｐ５３ 基因功能的旁路途径。     

Immunohistochemical markers of cell cycle control applied to ovarian and primary peritoneal surface epithelial neoplasms: p21(WAF1/CIP1) predicts survival and good response to platinin-based chemotherapy.

Immunohistochemistry for p53, p21(WAF1/CIP1), and Ki-67 provides insight into the molecular events controlling the cell cycle. We tested the hypothesis that these cell cycle markers will aid in the clinical evaluation of ovarian and primary peritoneal surface epithelial neoplasms (SENs). Paraffin sections from a retrospective surgical series of 117 SENs were immunostained with anti-p53 (clone DO7, Novacastra Laboratories, UK), anti-p21(WAF1/CIP1) (clone EA10, Oncogene Science, Cambridge, MA), and anti-Ki-67 (clone MIB-1, Immunotech, Westbrook, ME). The Ki-67 proliferation index (Ki-67PI) and immunoreactivity were evaluated. One hundred seventeen SENs reacted as follows: p53 50%+ and p21(WAF1/CIP1) 65%+. Ki-67PI ranged from 4% to 88% (mean/median = 44/46%). p53 reactivity associated with transitional cell histology, decreased p21(WAF1/CIP1) staining, increased Ki-67PI, architectural/nuclear grade, and stage (P < .05, 1 x 10(-7), .01, .05/.0001, .001,). p21(WAF1/CIP1) staining was associated with endometrioid/clear cell histology, decreased Ki-67PI, architectural/nuclear grade, and stage (P < 05/.05, .05, .01/1 x 10(-8), 1 x 10(-5)). Ki-67PI associated with increased architectural/nuclear grade but not mucinous histology (P < 1 x 10(-5)/1 x 10(-6), .01). Sixty-seven patients had disease at last follow-up; 53 were dead of disease at 0 to 67 months (mean/median, 21/18), and 14 were alive with disease at 12 to 224 months (mean/median, 56/40). Fifty patients were disease free at 5 to 214 months (mean/median, 59/41). Predictors of survival include decreased Ki-67PI, stage, architectural/nuclear grade (P < 1 x 10(-6), 1 x 10(-10), 1 x 10(-10)/.005) and p21(WAF1/CIP1) IMS (multivariate P < 1 x 10(-6)). p21(WAF1/CIP1), a potent inhibitor of cyclin-dependent kinases necessary for cell cycle progression, functions as a key checkpoint in cell cycle control. Immunoreactivity for p21(WAF1/CIP1) provides prognostic information independent of other histological and clinical predictors, p53 IMS, and Ki-67PI in this series of 117 PTs with SENs. Our preliminary data suggest an interrelationship between p21(WAF1/CIP1) expression and an effective clinical response to platinin-based chemotherapy, both associated with apoptosis. Further investigation seems warranted.     

Reduced p21(WAF1/CIP1) expression is an early event in gallbladder carcinogenesis and is of prognostic significance for patients with carcinomas of the gallbladder

The molecular basis underlying the development and progression of gallbladder carcinoma (GBC) remains poorly understood. To evaluate the roles of p21(WAF1/CIP1) and p53 in gallbladder carcinogenesis and to assess their prognostic significance for patients with GBC, we used immunohistochemistry to examine the expression of p21(WAF1/CIP1) and p53 protein in a series of surgically resected specimens, including normal epithelia, precancerous lesions adenoma, and dysplasia, and carcinomas of the gallbladder. Reduced p21(WAF1/CIP1) expression was frequently observed in carcinomas (18 of 37 lesions; 49%), and even in precancerous lesions adenomas (3 of 7; 43%) and dysplasias (5 of 5; 100%). p53 overexpression was detected in 43% of the adenomas, 60% of the dysplasias and 57% of the carcinomas. There was an inverse relationship between p21(WAF1/CIP1) and p53 expression in GBCs (P =.01). Survival analysis indicated that reduced p21(WAF1/CIP1) expression was significantly associated with shortened disease-free and overall survival (P =.04 and.03, respectively) for patients with stages II to IV GBCs. These observations suggest that reduced p21(WAF1/CIP1) expression and p53 overexpression contribute to GBC from an early stage and that determination of p21(WAF1/CIP1) expression in surgically resected specimens would add prognostic information to conventional pathologic examinations for patients with advanced-stage GBC.