Shiina H, Igawa M, Yagi H, Urakami S, Shirakawa H, Ishibe T
Department of Urology, Shimane Medical University, Izumo, Japan.
Eur Urol. 1996;30(1):80-8. doi: 10.1159/000474150.
To elucidate the relationship between genetic instability and tumor development in transitional cell carcinoma (TCC) of the bladder.
The genetic instability as assessed by 2c deviation index (2cDI) and 5c exceeding rate (5cER) was compared with immunoreactivities for p53 protein and proliferating cell nuclear antigen (PCNA) in specimens obtained from 65 patients with primary untreated TCCs.
Both p53 and PCNA immunoreactivities significantly correlated with histological grade as well as stage. The immunoreactivity of p53 significantly correlated with that of PCNA, while a dissociation of the positive correlation between p53 immunoreactivity and PCNA expression was noted in the TCCs with high 2cDI value (> or = 2.0) and/or high 5cER (> or = 10%). In addition, PCNA expression became higher as the genetic instability increased, however, the p53 immunoreactivity was not parallel with the change of genetic instability. Moreover, some TCCs with high genetic instability (2cDI > or = 2.0 and 5cER > or = 10%) showed concomitant expression of high PCNA and low p53 protein, whose clinical outcome was poor in general.
The inactivation of p53 may represent a rather early event in the development of TCC of the bladder. However, the proliferative activity in itself rather than the effect due to a specific alteration in p53 plays an important role in the development and progression in TCC of the bladder.
阐明膀胱移行细胞癌（TCC）中基因不稳定与肿瘤发生发展之间的关系。
对65例未经治疗的原发性TCC患者的标本，比较通过2c偏差指数（2cDI）和5c超标率（5cER）评估的基因不稳定情况与p53蛋白和增殖细胞核抗原（PCNA）的免疫反应性。
p53和PCNA的免疫反应性均与组织学分级及分期显著相关。p53的免疫反应性与PCNA的免疫反应性显著相关，然而，在2cDI值高（≥2.0）和/或5cER高（≥10%）的TCC中，p53免疫反应性与PCNA表达之间的正相关出现解离。此外，随着基因不稳定增加，PCNA表达升高，但是，p53免疫反应性与基因不稳定的变化并不平行。而且，一些基因不稳定高（2cDI≥2.0且5cER≥10%）的TCC同时表现为PCNA高表达和p53蛋白低表达，总体临床预后较差。
p53失活可能是膀胱TCC发生发展过程中相当早期的事件。然而，增殖活性本身而非p53特定改变所产生的效应在膀胱TCC的发生发展中起重要作用。
