The tumor suppressor p16 is a negative regulator of the cell cycle, commonly believed to act in the nucleus. We recently found that p16 protein is expressed in the cytoplasm of gastric cancer cells, concomitantly with anion exchanger 1 (AE1). The aim of this study was to analyze the significance of cytoplasmic p16 and its relationship to AE1 in the progression of gastric cancer. Expression of p16 and AE1 was examined by immunohistochemical analysis in 196 patients; 98 with early gastric cancer and 98 with advanced gastric cancer. The relationship between cytoplasmic p16 and clinicopathological features, and the relationship between cytoplasmic p16 and AE1, were analyzed statistically. Expression of p16 was observed in the nucleus in early stage gastric cancer, but was located mainly in the cytoplasm in advanced cancer cells. Furthermore, cytoplasmic expression of p16 was correlated with AE1 expression, and both were associated with the absence of lymph metastasis in gastric cancer. In conclusion, cytoplasmic immunoreactivity of p16 appears to be a good prognostic indicator in advanced gastric cancer. Co-localization of p16 and AE1 predicts a lack of metastasis in gastric cancer. The role of cytoplasmic p16 and AE1, and the mechanisms involved in the progression of gastric cancer, warrant further investigation.

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