High cyclin E/low p27Kip1 expression is associated with poor prognosis in astrocytomas

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Abstract
Cyclin E and p27Kip1 are co-regulators of the G1-to S-phase transition and closely related to tumor behavior. The purpose of this study was to examine expression of cyclin E and p27Kip1 in astrocytomas and to evaluate the relationships between expression of these cell-cycle regulators and prognosis of patients with astrocytoma. Tissue samples from 130 astrocytomas (WHO grade 1 n=5, grade 2 n=23, grade 3 n=64, grade 4 n=38) were examined immunohistochemically for cyclin E and p27Kip1 expression. Patient charts were reviewed for clinical presentation, and survival was followed. The cyclin E labeling index (LI) tended to increase with tumor grade (Kruskal-Wallis, P=0.0104). For patients with primary astrocytomas, the 50% survival times for the low cyclin E LI (Kip1 expression, the low cyclin E/high p27Kip1 LI (≥50%) group had the best survival (50% survival time: 103.2 months), the low cyclin E/low p27Kip1 LI (≥50%) and the high cyclin E/high p27Kip1 LI groups moderate survival (24.1 and 27.5 months), and the high cyclin E/low p27Kip1 LI group the worst survival (13.1 months). Multivariate analysis identified the combined factor, high cyclin E/low p27Kip1, as a novel independent prognostic factor for survival time (P=0.0037, relative risk=2.4). This study suggested that combined analysis of cyclin E and p27Kip1 expression was considered to be potentially useful in predicting the prognosis of patients with astrocytoma.

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