Wu T T, Chen J H, Lee Y H, Huang J K
Department of Surgery, Veterans General Hospital-Kaohsiung and Yang-Ming University, School of Medicine, Taipei, Taiwan.
J Urol. 2000 Mar;163(3):758-60. doi: 10.1016/s0022-5347(05)67798-1.
We assess the prognostic significance of bcl-2 expression, p53 mutation and ki-67 index for low grade, superficial transitional cell bladder carcinoma.
The medical records of 93 cases of primary, low grade (24 G1, 69 G2), superficial (70 pTa, 23 pT1) transitional cell carcinoma of the bladder were reviewed. Association of bcl-2, p53 and ki-67 index immunoreactivity with tumor grade and stage was examined. Prognostic significance of tumor grade, pathological stage, bcl-2 expression, p53 mutation and ki-67 index in predicting tumor recurrence was assessed.
Of the tumors 60 (70%) had p53 mutation and 9 (10.5%) expressed bcl-2. These 2 markers did not relate to tumor grade or pathological stage. Median ki-67 index was 10.9% and positively correlated with tumor grade. Recurrence was noted in 34.9% of patients with a median followup of 26 months (range 1 to 84). The ki-67 index was the only significant prognostic indicator in univariate and multivariate analyses. This marker can further distinguish grade 2 tumors with a favorable prognosis from those with an unfavorable outcome.
The ki-67 labeling index is an independent predictor of tumor recurrence for patients with primary superficial, low grade bladder cancers.
我们评估bcl-2表达、p53突变和ki-67指数对低级别浅表性移行细胞膀胱癌的预后意义。
回顾了93例原发性低级别（24例G1，69例G2）浅表性（70例pTa，23例pT1）膀胱移行细胞癌的病历。研究了bcl-2、p53和ki-67指数免疫反应性与肿瘤分级和分期的相关性。评估了肿瘤分级、病理分期、bcl-2表达、p53突变和ki-67指数在预测肿瘤复发方面的预后意义。
在这些肿瘤中，60例（70%）有p53突变，9例（10.5%）表达bcl-2。这两个标志物与肿瘤分级或病理分期无关。ki-67指数中位数为10.9%，与肿瘤分级呈正相关。中位随访26个月（范围1至84个月），34.9%的患者出现复发。在单因素和多因素分析中，ki-67指数是唯一显著的预后指标。该标志物可以进一步区分预后良好和不良的2级肿瘤。
ki-67标记指数是原发性浅表性低级别膀胱癌患者肿瘤复发的独立预测指标。
