Altered p21WAF1/CIP1 expression is associated with poor prognosis in extrahepatic bile duct carcinoma

This study was designed to determine the clinical implications of p21WAF1/CIP1 expression and the relationship between p21WAF1/CIP1 expression and p53 status in extrahepatic bile duct carcinoma (EBDC). Low p21WAF1/CIP1 expression was immunohistochemically detected in 23 (67.6%) of 34 EBDCs, moderate in six (17.7%), and high in five (14.7%). Kaplan–Meier curves showed that low and high p21WAF1/CIP1 expressions were significantly associated with shortened disease-free survival (low vs. moderate, P=0.02; high vs. moderate, P=0.01). There was no correlation between p21WAF1/CIP1 and p53 expression. These findings suggest that altered p21WAF1/CIP1 expression exerts an adverse influence on the prognosis of EBDC.