Rodríguez-Alonso Andrés, Pita-Fernández Salvador, González-Carreró Joaquín, Nogueira-March José Luis
Urology Service, Xeral-Cíes Hospital, Vigo, Spain.
Eur Urol. 2002 Feb;41(2):182-8; discussion 188-9. doi: 10.1016/s0302-2838(01)00038-0.
OBJECTIVE: To determine prognostic factors for survival in bladder transitional cell carcinoma (TCC), and the prognostic value of p53 and ki67. MATERIAL AND METHODS: A study was made of patients with stage T1 primary bladder TCC (n = 175). The immunohistochemical study was carried out using DO7 and MIB-1 monoclonal antibodies, for p53 and ki67, respectively. Kaplan-Meier methodology was used for the survival analysis, and the log-rank test was applied in order to determine accumulated probability rates of survival. Moreover, Cox's multivariate regression analysis was also used to establish the variables associated with survival. Receiver operating characteristic (ROC) curves were also drawn, with the aim of determining the prognostic capacity of p53 and ki67. RESULTS: The average follow-up period was 7.3 years. Cancer-related survival rates at 5 and 10 years were 89.51 and 80.68%, respectively. The increase in p53 and ki67 expressions paralleled the histological grade, both markers showing significant inter-group differences (P = 0.0000). The variables which modified cancer-related survival significantly in the univariate analysis were the following: tumour multifocality, solid microscopic morphology, large cell nucleus and a high expression of p53 and ki67. Independent cancer-related survival variables were: age, tumour size of >3 cm, a solid microscopic growth pattern and expression of p53. CONCLUSIONS: The expression of p53, increase in age, tumour size of >3 cm and microscopic growth pattern are independent predictors for cancer-related survival. A positive correlation was observed, indicating that, the higher the expression of p53, the greater the probability of death.
目的:确定膀胱移行细胞癌(TCC)生存的预后因素,以及p53和ki67的预后价值。 材料与方法:对175例T1期原发性膀胱TCC患者进行了研究。分别使用DO7和MIB-1单克隆抗体对p53和ki67进行免疫组化研究。采用Kaplan-Meier方法进行生存分析,并应用对数秩检验来确定累积生存率。此外,还使用Cox多因素回归分析来确定与生存相关的变量。绘制受试者工作特征(ROC)曲线,以确定p53和ki67的预后能力。 结果:平均随访期为7.3年。5年和10年的癌症相关生存率分别为89.51%和80.68%。p53和ki67表达的增加与组织学分级平行,两种标志物在组间均显示出显著差异(P = 0.0000)。单因素分析中显著改变癌症相关生存的变量如下:肿瘤多灶性、实体显微镜形态、大细胞核以及p53和ki67的高表达。独立的癌症相关生存变量为:年龄、肿瘤大小>3 cm、实体显微镜生长模式和p53表达。 结论:p53表达、年龄增加、肿瘤大小>3 cm和显微镜下生长模式是癌症相关生存的独立预测因素。观察到正相关,表明p53表达越高,死亡概率越大。
J Cancer Res Clin Oncol. 2018-6-29
Cent European J Urol. 2015