Department of Urology, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam, Korea.
Oncology. 2010;79(5-6):440-6. doi: 10.1159/000327214. Epub 2011 Apr 11.
To determine the impact of p53 overexpression on tumor recurrence after bacillus Calmette-Guérin (BCG) intravesical therapy in patients with nonmuscle invasive bladder cancer (NMIBC).
Between January 1999 and December 2008, 275 patients who received six BCG intravesical instillations for NMIBC (transitional cell carcinoma) after transurethral resection were assessed for differences in outcomes according to the level of p53 overexpression. A multivariate logistic regression model was applied to assess the predictive capacity of variables for recurrence. Overexpression of p53 was determined using monoclonal p53-DO7 antibody.
In 275 subjects, the recurrence rate was higher based on the level of p53 expression (p = 0.019). Based on multivariate analysis, a strong-positive p53 >60% (p = 0.031) and tumor grade (p = 0.015) were significant predictors for recurrence. Patients with a strong-positive p53 >60% had a much lower 5-year biochemical recurrence-free survival rate than patients with p53 ≤60% (72.1 vs. 31.5%, p < 0.001).
Strong overexpression of p53 was predictive of recurrence in patients with NMIBC undergoing intravesical BCG treatment. A 6-week induction course of BCG alone is not sufficient to prevent recurrence in patients with NMIBC with high p53 expression; additional prophylactic strategies are needed for these patients.
确定 p53 过表达对卡介苗（BCG）膀胱内治疗非肌肉浸润性膀胱癌（NMIBC）患者肿瘤复发的影响。
1999 年 1 月至 2008 年 12 月，对 275 例接受经尿道切除术后接受 6 次 BCG 膀胱内灌注治疗的 NMIBC（移行细胞癌）患者进行评估，根据 p53 过表达水平评估结局差异。采用多变量 logistic 回归模型评估变量对复发的预测能力。使用单克隆 p53-DO7 抗体确定 p53 过表达。
在 275 例患者中，p53 表达水平越高，复发率越高（p = 0.019）。基于多变量分析，强阳性 p53 >60%（p = 0.031）和肿瘤分级（p = 0.015）是复发的显著预测因子。p53 >60%的强阳性患者的 5 年生化无复发生存率明显低于 p53 ≤60%的患者（72.1%比 31.5%，p < 0.001）。
p53 过表达强烈预示着接受 BCG 膀胱内治疗的 NMIBC 患者复发。单独使用 6 周诱导期的 BCG 不足以预防高 p53 表达的 NMIBC 患者复发；这些患者需要额外的预防策略。
