Soini Y, Turpeenniemi-Hujanen T, Kamel D, Autio-Harmainen H, Risteli J, Risteli L, Nuorva K, Pääkkö P, Vähäkangas K
Department of Pathology, University of Oulu, Finland.
Br J Cancer. 1993 Nov;68(5):1029-35. doi: 10.1038/bjc.1993.475.
Immunohistochemically detectable p53 protein using a polyclonal antibody (CM-1) was studied in 42 carcinomas of which 11 were grade I, 22 grade II and nine grade III carcinomas. Additionally 14 urothelial dysplasias were studied. In 11 of these a diagnosis of transitional cell carcinoma was established before and in one after the dysplasia diagnosis. Twenty-one out of 42 (50%) cases of transitional cell carcinoma were positive for the p53 protein. Eleven out of 14 (78%) dysplasias and 10/12 (83%) related carcinomas were p53 positive. One out of 11 grade I (9%), 12/22 grade II (55%) and 8/9 grade III (89%) tumours showed positivity for p53. There were significantly more p53 positive cases in grade II-III tumours than in grade I tumours (P = 0.004). There were significantly more p53 positive cases in stage T2-T4 tumours than in stage T1 tumours (P = 0.035). In only one case among the 11 dysplastic lesions following the treatment of a carcinoma the dysplastic lesion was p53 negative while the preceding carcinoma was p53 positive. All dysplasias and 28 carcinomas were also immunostained for laminin and type IV collagen to evaluate the continuity of basement membranes (BMs). Clearly disrupted BMs were observed only in grade III carcinomas. These cases showed the most p53 immunopositivity. The results show a strong association of p53 staining between dysplasias and transitional cell carcinomas of the urinary bladder indicating that these lesions might share similar p53 changes. The correlation to grade, clinical stage and to disrupted BM suggests that p53 mutations may be associated with the evolution of aggressive growth characteristics in transitional cell carcinomas or, alternatively, that p53 positive tumours of a more aggressive type from the start. Whether p53 staining can be used as an adjunct in the assessment and follow-up of epithelial changes of patients treated for a p53 positive bladder carcinoma deserves to be studied.
使用多克隆抗体（CM - 1）通过免疫组织化学方法检测p53蛋白，研究对象为42例癌，其中11例为I级癌，22例为II级癌，9例为III级癌。另外还研究了14例尿路上皮发育异常。其中11例在发育异常诊断之前确诊为移行细胞癌，1例在发育异常诊断之后确诊。42例移行细胞癌中有21例（50%）p53蛋白呈阳性。14例发育异常中有11例（78%）以及12例相关癌中的10例（83%）p53呈阳性。11例I级肿瘤中有1例（9%）、22例II级肿瘤中有12例（55%）以及9例III级肿瘤中有8例（89%）p53呈阳性。II - III级肿瘤中p53阳性病例显著多于I级肿瘤（P = 0.004）。T2 - T4期肿瘤中p53阳性病例显著多于T1期肿瘤（P = 0.035）。在11例癌治疗后的发育异常病变中，仅1例发育异常病变p53呈阴性，而之前的癌p53呈阳性。对所有发育异常和28例癌也进行了层粘连蛋白和IV型胶原免疫染色，以评估基底膜（BM）的连续性。仅在III级癌中观察到基底膜明显破坏。这些病例p53免疫阳性程度最高。结果显示膀胱发育异常与移行细胞癌之间p53染色存在强关联，表明这些病变可能具有相似的p53变化。与分级、临床分期以及基底膜破坏的相关性表明，p53突变可能与移行细胞癌侵袭性生长特征的演变相关，或者说，p53阳性肿瘤从一开始就是更具侵袭性的类型。p53染色能否作为p53阳性膀胱癌患者上皮变化评估及随访的辅助手段值得研究。
