Prognostic significance of p16/cdkn2a loss in pleural malignant mesotheliomas

Sanja Dacic, Hannelore Kothmaier, Stephanie Land, Yongli Shuai, Iris Halbwedl, Patrizia Morbini, Bruno Murer, Camilla Comin, Françoise Galateau-Salle, Funda Demirag, Handan Zeren, Richard Attanoos, Alan Gibbs, Philip Cagle, Helmut Popper

Research output: Contribution to journalArticlepeer-review

105 Scopus citations


Homozygous deletion of p16/CDKN2A is the most common genetic abnormality in malignant mesotheliomas. The aim of this study was to determine prognostic significance of p16/CDKN2A loss in malignant pleural mesotheliomas (MPM) as defined by immunohistochemistry and fluorescence in situ hybridization (FISH). High-density tissue microarrays were constructed from archival formalin-fixed paraffin-embedded samples of 48 MPM. Long survival (LS) was defined as survival greater than 3 years from the time of diagnosis, and short survival was defined as less than 3 years from the time of diagnosis. Both loss of p16 protein expression by immunohistochemistry and homozygous deletion of p16 by FISH were associated with adverse prognosis. Female gender, positive p16 immunoexpression, and lack of p16/CDKN2A deletion significantly predicted the survival for the LS group. Statistical analysis showed a very strong correlation of immunohistochemistry and FISH data. Cases positive for p16 immunoexpression and negative for 9p21 deletion showed the best survival time. Our study is the first to demonstrate decreased frequency of homozygous deletion of 9p21 and loss of p16 immunoreactivity in pleural mesotheliomas from patients with long-term survival of greater than 3 years in contrast to patients with rapidly fatal mesotheliomas. A possible implementation of these tests into preoperative prognostication of MPM and therapeutic decisions should be considered.

Original languageEnglish (US)
Pages (from-to)627-635
Number of pages9
JournalVirchows Archiv
Issue number6
StatePublished - Dec 2008


  • FISH
  • Immunohistochemistry
  • p16
  • Pleural mesothelioma
  • Prognosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Cell Biology
  • Molecular Biology


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