Moyano Calvo J L, De Miguel Rodríguez M, Poyato Galán J M, Ortíz Gamiz A, Molina Carranza A, Zerpa Railey J J, Toro Cepeda H, Sánchez-Barriga Peña D, Galera Davidson H, Castiñeiras Fernández J
Servicio de Urología, Hospital Universitario Virgen Macarena, Sevilla.
Actas Urol Esp. 2001 Jan;25(1):32-45. doi: 10.1016/s0210-4806(01)72564-8.
Evaluate the utility of Ki-67 label index, p53 expression and flow cytometry-DNA ploidy in the selection of groups to be treated with prophylactic BCG and the prognostic value compared with the classic variables (grade, lymphatic permeation, multiplicity, volume, primary).
MATERIAL & METHOD: 121 superficial bladder tumors T1. 10% Cut-off level for Ki-67 and p53. Aneuplody is defined as a tumor with DNA index different of 1 or more than 20% in G2-M phase. 71 (58.7%) received BCG.
In uni and multivariate analysis positivity to Ki-67 is correlated with recurrence. Progression is correlated with lymphatic permeation (p .0003), volume (p .016), ploidy (p .022) and positivity to p53 (p .007). In multivariate analysis, volume and positivity to p53 are independent variables. None were of utility to prevent recurrence, but Ki-67 positive or aneuploid treated tumors had less progression (p .025 and p .009 respectively). The p53 negative treated tumors had less progression too.
Only Ki-67 is correlated with tumoral recurrence. P53 and tumor volume are correlated with stage progression. If the results are confirmed with bigger series, the Ki-67 positive and/or aneuploid tumors would obtain benefits of prophylactic treatment with BCG.
评估Ki-67标记指数、p53表达及流式细胞术-DNA倍体在选择接受预防性卡介苗治疗的患者组中的效用，以及与经典变量（分级、淋巴管浸润、多发性、体积、原发灶）相比的预后价值。
121例T1期浅表性膀胱肿瘤。Ki-67和p53的截断水平为10%。非整倍体定义为DNA指数在G2-M期不同于1或超过20%的肿瘤。71例（58.7%）接受了卡介苗治疗。
在单因素和多因素分析中，Ki-67阳性与复发相关。进展与淋巴管浸润（p = 0.0003）、体积（p = 0.016）、倍体（p = 0.022）和p53阳性（p = 0.007）相关。在多因素分析中，体积和p53阳性是独立变量。这些因素均无助于预防复发，但Ki-67阳性或非整倍体的肿瘤进展较少（分别为p = 0.025和p = 0.009）。p53阴性的肿瘤进展也较少。
只有Ki-67与肿瘤复发相关。p53和肿瘤体积与分期进展相关。如果这些结果在更大的系列研究中得到证实，Ki-67阳性和/或非整倍体肿瘤将从卡介苗预防性治疗中获益。
