Kuczyk M A, Serth J, Bokemeyer C, Hervatin C, Oelke M, Oelert F, Höfner K, Jonas U
Klinik für Urologie, Medizinische Hochschule Hannover.
Urologe A. 1995 Mar;34(2):146-52.
Although patients with superficial bladder cancer (Ta, T1) have a generally good prognosis, those of them who have tumours invading muscle or metastatic disease will have a poor clinical prognosis. In the current study, 41 patients undergoing complete transurethral resection for superficial transitional cell cancer of the bladder were investigated for different clinical and biological characteristics as possible prognostic factors: age, sex, previous instillation therapy, immunohistochemical determination of mutational inactivation of p53 tumour suppressor gene (monoclonal antibody pAb 1801) and proliferation rate determined immunohistochemically by staining for PCNA (proliferating cell nuclear antigen; monoclonal antibody PC 10). After a median follow-up of 54 months 7 of 8 patients (87.5%) with more than 20% of cells positive for p53 had disease recurrence, as against only 1 of 33 patients (3%) negative for p53 detection (P < 0.01; Chi-square test). During univariate analysis histological grade (G1 vs G2; P = 0.007), positivity for PCNA (> 60% of cells; P = 0.003) and positivity for p53 (P = 0.001) were significant prognostic factors for disease progression (log rank test), while during multivariate analysis only positivity for p53 was a significant predictor for relapse of bladder cancer (P = 0.0035; multivariate Cox regression analysis).
虽然浅表性膀胱癌（Ta、T1）患者的总体预后通常较好，但其中肿瘤侵犯肌肉或有转移性疾病的患者临床预后较差。在本研究中，对41例行膀胱浅表性移行细胞癌完全经尿道切除术的患者进行了调查，以了解不同的临床和生物学特征作为可能的预后因素：年龄、性别、既往灌注治疗、p53肿瘤抑制基因突变失活的免疫组化测定（单克隆抗体pAb 1801）以及通过PCNA（增殖细胞核抗原；单克隆抗体PC 10）染色免疫组化测定的增殖率。中位随访54个月后，p53阳性细胞超过20%的8例患者中有7例（87.5%）疾病复发，而p53检测阴性的33例患者中只有1例（3%）复发（P<0.01；卡方检验）。单因素分析期间，组织学分级（G1 vs G2；P = 0.007）、PCNA阳性（细胞>60%；P = 0.003）和p53阳性（P = 0.001）是疾病进展的显著预后因素（对数秩检验），而多因素分析期间，只有p53阳性是膀胱癌复发的显著预测因素（P = 0.0035；多因素Cox回归分析）。
