Co-overexpression of p21 and Ki-67 in head and neck squamous cell carcinoma relative to a significantly poor prognosis.

Abstract

Head and neck squamous cell carcinomas (HNSCC) are treated by surgery or radiotherapy. Tumor cell death-related markers, such as p21 and Ki-67, may predict response to therapy and improve treatment choice. We evaluated and compared the effect of their coexpression between patients treated by surgery or radiotherapy. Immunohistochemistry for p21 and Ki-67 expression in 144 pharyngeal and laryngeal HNSCC samples was analyzed and correlated with follow-up parameters. p21 expression correlated significantly with positive cN classification (p < .001), locoregional relapse (p = .031), and poor overall survival (p = .016), and Ki-67 positivity with poor survival only (p = .025). Coexpressing tumor phenotypes showed the worst survival (p = .009), observed primarily in patients treated by radiotherapy (p = .077). Coexpression of p21/Ki-67 is a strong negative prognostic factor in HNSCC and could be of particular relevance in tumors treated by primary radiotherapy.