Dept. of Pathology, University of Texas Southwestern, 5323 Harry Hines Blvd., Dallas, TX 75390-9110, USA.
Am J Clin Pathol. 2011 Jun;135(6):822-30. doi: 10.1309/AJCP76KUVOTBKQRY.
Primary adenocarcinomas of the urinary bladder are uncommon, and the molecular pathways are currently not well defined. In this study, we assessed the association between biologic markers and clinicopathologic characteristics in a cohort of 21 patients with primary urinary bladder adenocarcinoma. Immunohistochemical staining for cell cycle-specific markers, including p53, p21, p27, Ki-67, and cyclin E, were performed on sections of a tissue microarray construct. The tumors were high grade in 12 (57%) and pT2 or higher in 18 (86%); lymph nodes were involved in 6 cases (29%); and there was pathologic evidence of schistosomiasis in 14 (67%). The best prognostic combination of markers was combined alterations in p27 and Ki-67 and was associated with stage (P = .012), grade (P = .005), DNA ploidy (P = .005), and lymph node involvement (P = .04). Stage, lymph node involvement, combined alterations of p27 and Ki-67, and combined alterations of all 5 biomarkers were associated with increased probability of disease recurrence and cancer-specific mortality (P < .05).
原发性膀胱腺癌并不常见，其分子途径目前尚未明确。在这项研究中，我们评估了 21 例原发性膀胱腺癌患者队列中生物学标志物与临床病理特征之间的关联。在组织微阵列构建的切片上进行细胞周期特异性标志物（包括 p53、p21、p27、Ki-67 和细胞周期蛋白 E）的免疫组织化学染色。12 例（57%）肿瘤为高级别，18 例（86%）为 pT2 或更高分期；6 例（29%）淋巴结受累；14 例（67%）有血吸虫病的病理证据。标志物的最佳预后组合是 p27 和 Ki-67 的联合改变，与分期（P =.012）、分级（P =.005）、DNA 倍体（P =.005）和淋巴结受累（P =.04）相关。分期、淋巴结受累、p27 和 Ki-67 的联合改变以及所有 5 种生物标志物的联合改变与疾病复发和癌症特异性死亡率的增加相关（P <.05）。
