bcl-2和p53的表达在膀胱癌预后判断中的意义

The prognostic significance of bcl-2 and p53 expression in bladder cancer

目的：以免疫组织化学染色的方法，研究p53和bcl－2蛋白在膀胱癌中的表达，以及与病理和临床表现之间的关系。方法：应用抗p53和bcl-2的单克隆抗体，以标准的LSAB方法，共分析了131例患者的肿瘤标本。结果：p53染色阳性的肿瘤为86例（65．6％），G3级阳性的比例（84．1％）明显高于G1-2级（56.3％，P＝0．0012）；浸润型（T2－4）肿瘤阳性的比例（75．8％）明显高于表浅型（Ta－1）肿瘤（55．4％，P＜0．0001）。p53阳性患者的生存率明显低于阴性患者（P＝0．0070）。bcl-2染色阳性的肿瘤有35例（26．7％），但bcl-2染色在不同的细胞分级和不同临床分期之间无统计学差异，对是否复发及生存率也无影响。两种蛋白表达之间也无相关性。经多因素分析，仅浸润型肿瘤（相对于表浅型）为独立的预后因素。结论：p53和bcl-2免疫染色对膀胱癌的预后无重要预示价值。

Objective: To detect the prognosis value of the expression of p53 and bcl-2 protein, as well as then relationship of these two proteins as determined by immunohistochemistry in bladder cancer. Methods: Tumor samplesb from 131 patients with bladder cancer were assessed immunohistoc hemically usi ng the clone DO - 7 and 124 monoclonal antibody and labeled streptavidin biotin staining for p53 and bcl-2 protein. Results : 65. 6% tumors were positive for p53 and 26. 7% for bcl-2, respectively. A statistically significant differences of p53 staining were observed between grade 3 and grade 1-2 (P = 0. 0012), invasive and supefficial stage (P < 0. 000l ), as well as overall survival (P =0. 007). while p53 positive was not independent predictor for overall survival by multivariate analysis. There was no correlation of bcl-2 staining with the histological grade, clinical stage or outcome. Conclusion: Immunostaining of p53 and bcl-2 has no important value for prognosis in bladder cancer.