浅表型膀胱癌P53过度表达的预后价值

The prognostic value of P53 over-expression in superficial urinary bladder cancer

用抗Ｐ５３单克隆抗体ＤＯ－７检测４９例浅表型膀胱癌病理蜡块，获总阳性率２８．６％（１４／４９）。其中血管浸润组阳性率６０．０％（６／１０）．显著高于无血管浸润组的２０．５％（８／３９，Ｐ＜０．０５）。病理分级Ｇ１阳性率１３．６％（３／２２），Ｇ２３８．９％（８／２１），Ｇ３５０．０％（３／６），总体构成比无统计学意义。初步随访结果表明，除病理分级外，Ｐ５３阳性及血管浸润与否均与疾病进展无相关性。但Ｐ５３状况与病理分级和（或）血管浸润结合，则明显提高预后预测的准确性（６３．６％～１００％）。本研究结论不支持Ｐ５３表达状况作为浅表型膀胱癌的独立预后指标。不过，Ｐ５３与其它指标结合进行预后监测可能有一定价值。

It has been repoted that P53 inactivity probably predicts a poor prognosis of diease. Using monoclonal antibody Do-7,immunohistochemical expression of P53 oncoprotein was detected in tumour sections of 49 superficial bladder cancers (pTa～pT1), and 14 positive nuclear staining acquaired(28.6%). The analysis demonstrated that the P53 positive rate of patients with vasular invasion was much higher than those of opposite one(60.0% to 20.5%,P<0.05),while there was no statistical differense in grade category(G1 13.6%,G2 38.1%,G3 50.0%,P>0.05).The tentative follow-up data indicated that,however,the factors of P53 expression and vas cular invasion,not of grade.had no relationship to disease progression. When the P 53 status com bined with either of two markers,A elevated predictable specificity was found (63.6%～100%).The results of present study didn't support the immunohistochemical P53 overexpression as an in dependent prognostic indicator in superficial bladder cancer,but integrated with grade or/and vas cular invasion,it may be somewhat valuable.