Abstract
The expression of Skp2, the ubiquitin ligase subunit that targets p27^Kip1^ for degradation, is commonly overexpressed in human cancers. p27^Kip1^ is a negative regulator of the cell cycle that plays an important role in tumor suppression. Loss of p27^Kip1^ secondary to enhanced ubiquitinโmediated degradation results in uncontrolled proliferation and promotes tumor progression. In the present study the prognostic implications of Skp2 are reviewed and the mechanisms that regulate its expression in different human cancers. A review and analysis of the English literature was undertaken. Overexpression of Skp2 mRNA and protein levels was observed in many aggressive cancers and was commonly associated with downโregulation of p27^Kip1^ levels and loss of tumor differentiation. Skp2 is an independent prognostic marker for diseaseโfree and overall survival and may provide additional predictive information to that provided by p27^Kip1^ alone. Targeting Skp2 in experimental models resulted in upโregulation of p27^Kip1^ and arrested cellular proliferation. Alterations in Skp2 expression have profound effects on cancer progression and may serve as an accurate and independent prognostic marker. Thus, determination of levels of Skp2 and p27^Kip1^ by readily available immunohistochemical studies may be a useful tool in the assessment of prognosis, especially in patients with intermediate disease, and may potentially assist in the planning of adjuvant therapy. Skp2 may be an attractive target for the development of novel interventional therapy. Cancer 2008. ยฉ 2008 American Cancer Society.