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p21: prognostic marker in pleural mesothelioma

Mesothelioma stained with monoclonal antibody to p21. (A) Mixed mesothelioma with 10% of positive cells; (B) sarcomatoid mesothelioma with >10% positive cells. Original magnification x400.

Expression of p21—an inhibitor of the cell cycle—may hold an important clue to events leading to malignant mesothelioma. Normally p21 expression is upregulated by the binding of p53 to the p21 promoter, but in malignant mesothelioma—an important cancer of the pleura—it may be silenced by the binding and inactivation of p53 by simian virus 40 large T antigen (SV40Tag). This preliminary study supports the hypothysis.

Expression of p21 in specimens of malignant mesothelioma was not significantly related to histological type in the study. However, median survival in the patients was significantly greater for specimens expressing p21 in more than 10% of cells (median difference in survival 7 months, 95% confidence interval 4.8 to 9.9 months), and Kaplan-Meier analysis confirmed the relation.

Twenty nine specimens . . . [Full text of this article]