浅表型膀胱癌p53基因过度表达的预后价值

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286％（14／49）。其中血管浸润组阳性率60％（6／10），显著高于无血管浸润组的20．30％（8／29，P＜0.05）。病理分级G1阳性率13.6％（3／22），G238.9％（8／21），G350％（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表达结合病理分级和／或血管浸润情况，有助于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。p53与其它指标结合进行预后监测可能有一定价值。

The prognostic value of p53 inactivity probably predicts a poor prognosis of disease. Using monoclonal antibody Do-7,immunohistochemical expression of p53 oncoprotein was detected in pathological sections of 49 superficial bladder cancers (pTa - pT1 ), and 14 positive nuclear staining acquired (28.6% ). The P53 positive rates of patients with vasular invasionwere much higher than those of opposite one (60 % to 20. 5 %,P< 0. 05 ), while there was no statistical difference in grade category (Gl 13.6%, G2 38.1 %, G3 50%, P>0.05). Thetentative follow - up data indicated that, however, the factors of p53 expression and vascular invasion, not of grade, had no relationship to disease progression. When the p53 status combined 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 independent prognostic indicator in superficial bladder cancer, but integrated with grade or/and vascular invasion, it may be somewhat valuable.