Expression of p21 (WAF1/CIP1) protein in clinical thyroid tissues.

p21 (WAF1/CIP1) protein expression in various thyroid tissues, including thyroid carcinoma, was studied by means of immunohistochemistry using anti-p21 monoclonal antibody. Normal follicles and hyperplasias rarely expressed p21, whereas immunohistochemically positive cells were also too rarely found in follicular adenomas to justify these cases being classified as positive. Twenty eight of the 93 carcinomas examined (30.1%), however, were positive for p21. Of the p21-positive cases, 80% of the undifferentiated and 28.6% of the poorly differentiated carcinomas showed lesions co-expressing p21 and p53. If diffuse immunoreactivity of p53 reflects the p53 mutation, our results indicate that p21 in these carcinomas can be induced by p53-independent as well as by p53-dependent pathways. On the other hand, well-differentiated carcinomas did not co-express these two proteins and it therefore remains unclear whether p53-independent or p53-dependent pathways are predominant in this type of carcinoma. The incidence of expression of p21 was very similar in undifferentiated (26.3%), poorly (28.0%) and well-differentiated carcinomas (32.7%), even though they are characterised by different degree of malignancy. Furthermore, no correlation between p21 expression and either clinical parameters or patient's prognosis could be established. These results suggest that p21 is only marginally related to the characteristics of thyroid carcinoma and can play only an adjuvant role in regulating the progression of this carcinoma.