Relación Entre Las Recidivas Tumorales Y La Expresión Del Gen P53 En Los Carcinomas Transicionales Superficiales Primarios De Vejiga

Servicio de Urología. Hospital General Universitario de Elche. Universidad Miguel Hernández. Elche (Alicante).
Actas urologicas españolas (Impact Factor: 1.15). 07/2013; 24(7):530–535. DOI: 10.1016/S0210-4806(00)72499-5

ABSTRACT Contribution of 60 patients with primary surface transitional cell tumours of the bladder where nuclear expression of p53 protein was prospectively studied and compared to known prognostic factors in an attempt to find out its role in the development of relapses. An statistically significant relationship was found between the protein expression and cytology, tumoral multifocality, stage, relapse development and tumoral progression. It can be concluded that expression of this protein can be of use as relapse predictor.

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    ABSTRACT: DNA ploidy and S-phase fraction (SPF), determined by flow cytometry were studied in 118 patients with muscle-invasive transitional cell carcinoma (TCC) of the urinary bladder, scheduled for cystectomy after pre-operative radiotherapy (20 Gy/1 week) with or without systemic cisplatin-based neo-adjuvant chemotherapy. The correlation between these parameters and immunohistochemically demonstrated p53, c-erbB-2 and HCG was also investigated. There were 16 DNA diploid and 102 DNA non-diploid tumours. DNA ploidy was not related to the T (all 118 patients) or pN (58 patients) category, occurrence of stage reduction or cancer-related 5 years survival. Patients with high SPF tumours tended, however, to have a better prognosis than those with low SPF TCC reaching the level of significance (P < 0.05) for those patients who had high SPF tumours and received neo-adjuvant chemotherapy. Fifty-one of the tumours were p53 positive. p53 positive tumours were significantly more often found in TCC with low SPFs than in those with high SPFs. Respectively 12 and 9% of the tumours were HCG and c-erbB-2 positive, without correlation to DNA ploidy or SPF. We conclude that DNA ploidy does not represent a prognostic parameter in muscle-invasive operable bladder carcinomas. A high SPF, determined by FCM, may be helpful to identify patients with chemotherapy-sensitive TCC of the urinary bladder.
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    ABSTRACT: The expression of c-erbB-2, p53 and proliferating cell nuclear antigen (PCNA) was studied using immunocytochemical techniques in paraffin-embedded biopsy specimens (consecutive 5-microns sections) from 104 transitional cell bladder tumours. 46/104 (44%) of the tumours were positive for c-erbB-2, 29/104 (28%) for p53 and 88/104 (85%) for PCNA. The expression of these antigens was independent of T-category, whereas the expression was significantly related to histological differentiation and papillary status so that non-papillary high-grade tumours were usually positive for all the antigens. The expression of c-erbB-2 and p53 was intense in 8/104 (8%) of cases and weak or absent in 76/104 (73%) of cases (p = 0.0003). The expression of p53 and PCNA was intense in 22/104 (21%) and weak or absent in 76/104 (73%) of tumours (p = 0.0003). Intense expression of c-erbB-2 and PCNA was also interrelated significantly (p = 0.0202). All three antigens were simultaneously expressed in 16-29% of T2-T4 tumours, in 22-35% of grade 2-3 tumours and in 35% of non-papillary tumours.
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    ABSTRACT: This study aimed to immunohistochemically examine the expression of proliferating cell nuclear antigens (PCNA) and p53 protein in transitional cell carcinomas (TCC) of the urinary bladder, and to investigate possible correlations of this expression with the tumor grade or stage, tumor recurrence, and prognosis of the disease. The immunohistochemical status of the PCNA and p53 proteins were determined on paraffin-embedded sections from 128 patients with TCC of the urinary bladder, using PC-10 and DO7 as the primary antibodies. Positive stainings were represented by scores (Labeling Index; LI, %) calculated as the percent of positive cells among all neoplastic cells counted. The findings were compared to the patients' histopathological features. Patients who underwent transurethral resection were divided into groups with "low" and "high" scores for PCNA and p53, respectively, and the tumor recurrence rate was compared among the groups. Patients who underwent total cystectomy were similarly divided into "low" and "high" score groups, and survival rates of the groups were compared. PCNA expression was observed in 66 of 128 patients (51.6%), with a mean labeling index of 26.6%. Overexpression of p53 was observed in 65 of 128 patients (50.8%), with a mean labeling index of 35.3%. There were significant correlations of the PCNA and p53 indices with both histological grade and stage of the tumor. In the TUR group, there were no statistically significant differences in recurrence rate between the groups with high or low scores for either PCNA or p53. In the total cystectomy group, there was a significant correlation between survival rate and positive staining for PCNA, but not for p53. The relationship between 2 parameters, PCNA and p53 scores, was not significant (linear correlation coefficient, r = 0.67). PCNA and p53 status in transitional cell carcinomas of the urinary bladder is related to the histopathological findings. We also suggest that immunohistochemical staining for PCNA provides significant clinical information which may be useful in the initial selection of therapy. However, overexpression of p53 does not appear to represent an independent prognostic marker in bladder tumors.
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