Soukup V, Babjuk M, Dusková J, Pesl M, Szakácsova M, Zámefnik L, Dvorácek J
Urologická klinika 1. LF UK a VFN, Praha.
Cas Lek Cesk. 2007;146(1):63-7.
The aim of the study is to assess the prognostic value of p53 positivity in the non-tumor mucosa of urinary bladder in patients with superficial urinary bladder carcinoma.
In 45 patients cold cup non-tumor mucosa samples were taken at the same time with the TUR of superficial urinary bladder carcinoma prospectively. Monoclonal antibody BP53-12-1 was used for the detection of p53 protein. When identifying positive colouring only the nuclear immunoreactivity was being evaluated. 200 nuclei at minimum were examined in several representative fields. The McCarthy method in Bacus modification was used to analyse the findings. It is a semiquantitative method which detects not only the percentage of p53 positive cells but also the intensity of positivity classified into four degrees (0 - negative, 1 - slightly positive, 2 - distinctly positive, 3 - strongly positive). The intensity of p53 positivity was quantified as HSCORE, where HSCORE = 7Pi (i + 1), in which i is one of the four see above degrees and Pi fluctuates from 0 % to 100 %. The result is a numerical figure from 100-400. A negative finding is of HSCORE 100, HSCORE of 400 is the highest possible. The samples were analysed in the analytical system LUCIA. The borderline value was quantified to HSCORE 200. All patients were carefully followed up and treated using usual schemes. The results were evaluated by the use of SAS system (Cary, USA). Thirty patients recurred during the follow-up and 7 of them progressed. The average HSCORE in those who did not recur was 130.2, in patients with the recurrence of tumor it was 162.5 and in patients with progression it was 169.2. We have found a correlation between the HSCORE and the risk of recurrence, which was statistically significant.
The p53 positivity in non-tumor mucosa of urinary bladder in patients with superficial bladder cancer may bring additional information when predicting the risk of recurrence. More extensive studies need to be carried out.
本研究旨在评估浅表性膀胱癌患者膀胱非肿瘤黏膜中p53阳性的预后价值。
前瞻性地对45例浅表性膀胱癌经尿道切除术（TUR）患者同时采集冷杯法非肿瘤黏膜样本。使用单克隆抗体BP53 - 12 - 1检测p53蛋白。在鉴定阳性染色时，仅评估细胞核免疫反应性。在几个代表性视野中至少检查200个细胞核。采用巴库斯改良的麦卡锡方法分析结果。这是一种半定量方法，不仅检测p53阳性细胞的百分比，还将阳性强度分为四个等级（0 - 阴性，1 - 弱阳性，2 - 明显阳性，3 - 强阳性）。p53阳性强度量化为HSCORE，其中HSCORE = 7Pi（i + 1），i为上述四个等级之一，Pi从0%到100%波动。结果是一个100 - 400的数值。阴性结果为HSCORE 100，HSCORE 400为最高可能值。样本在LUCIA分析系统中进行分析。临界值量化为HSCORE 200。所有患者均接受仔细随访并采用常规方案治疗。结果使用SAS系统（美国卡里）进行评估。30例患者在随访期间复发，其中7例进展。未复发患者的平均HSCORE为130.2，肿瘤复发患者为162.5，进展患者为169.2。我们发现HSCORE与复发风险之间存在相关性，具有统计学意义。
浅表性膀胱癌患者膀胱非肿瘤黏膜中的p53阳性在预测复发风险时可能提供额外信息。需要进行更广泛的研究。
