Correlation Between TGF-β1 and p21 (WAF1/CIP1) Expression and Prognosis in Resectable Invasive Ductal Carcinoma of the Pancreas

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Summary:Transforming growth factor-β1 (TGF-β1) inhibits the growth of a variety of epithelial cells; however, in many types of tumors it loses its inhibitory effect. p21(WAF1/CIP1), one of the cyclin-dependent kinase (Cdk) inhibitors induced by TGF-β1, is considered a downstream effector of the growth-inhibitory function of TGF-β1. We assessed the clinicopathologic significance of TGF-β1 and p21 expression in resectable invasive ductal carcinoma (IDC) of the pancreas. Immunohistochemical examination of the expression of TGF-β1 and p21 in 62 patients revealed positive expression of TGF-β1 in 28 (45%) and of p21 in 25 (40%) of the 62 patients, and a significant correlation between the two expressions. The survival curve of patients with TGF-β1(+) tumors was significantly higher than that of patients with TGF-β1(−) tumors; p21(+) patients showed a higher survival curve than did p21(−) patients, but the difference was not statistically significant. Simultaneous analysis of TGF-β1 and p21 expression showed that the patients with TGF-β1(+)/p21(+) tumors had a significantly better prognosis than the others. Multivariate analysis showed that TGF-β1 was a significantly low risk factor for death due to IDC. The concurrent evaluation of TGF-β1 and p21 expression would be an effective tool in the prediction of the prognosis of patients with pancreatic cancer.

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