Tzai T S, Chow N H, Lin J S, Yang W H, Tong Y C
Department of Urology, Medical College, National Cheng Kung University, Tainan, Taiwan, Republic of China.
Anticancer Res. 1998 Nov-Dec;18(6B):4717-21.
We evaluated whether p53 and bcl-2 expression has any predictive value on the outcome of postoperative adjuvant intravesical chemotherapy for superficial bladder transitional cell carcinoma (TCC).
Immunostaining for p53 and bcl-2 was performed on paraffin-embedded tumor tissues obtained from 100 patients with superficial bladder TCC. 56 had solitary and 44 had multiple tumors; 36 were grade I, 53 grade II and 11 grade III; 50 were stage pTa and 50 stage pT1. They all received transurethral resection (TUR) and weekly intravesical instillation chemotherapy with either Thiotepa (70 patients) or Epirubicin (30 patients) for consecutive 8 doses postoperatively.
Overall, 7 (7%) tumors were p53+ and 12 (12%) tumors were bcl-2+. Of these, only one tumor was combined p53+ and bcl-2+. The status of tumor p53 and bcl-2 positivity was found to be not significantly correlated with either tumor grade or stage. After adjuvant intravesical chemotherapy, tumor recurrence is significantly correlated with tumor multifocality (p = 0.0002) but not with tumor grade and stage. Compared with p53- or bcl-2- tumors, patients with p53+ or bcl-2+ tumors do not show a higher tumor recurrence rate. The number of recurrence-free patients was also not significantly different in p53+ versus p53- tumors, bcl-2+ versus bcl-2- tumors. Six (6%) patients eventually developed disease progression, and none stained positively for either p53 or bcl-2.
We conclude that in superficial bladder TCC the status of tumor p53 and bcl-2 expression is not correlated with stage and grade. Their expression, either alone or combined, has no predictive role on the outcome of post-TUR intravesical chemotherapy on tumor recurrence.
我们评估了p53和bcl-2表达对浅表性膀胱移行细胞癌（TCC）术后辅助膀胱内化疗结果是否具有预测价值。
对100例浅表性膀胱TCC患者石蜡包埋的肿瘤组织进行p53和bcl-2免疫染色。56例为单发肿瘤，44例为多发肿瘤；36例为I级，53例为II级，11例为III级；50例为pTa期，50例为pT1期。他们均接受了经尿道切除术（TUR），并在术后连续8周每周接受噻替哌（70例患者）或表柔比星（30例患者）膀胱内灌注化疗。
总体而言，7例（7%）肿瘤为p53阳性，12例（12%）肿瘤为bcl-2阳性。其中，只有1例肿瘤同时为p53阳性和bcl-2阳性。发现肿瘤p53和bcl-2阳性状态与肿瘤分级或分期均无显著相关性。辅助膀胱内化疗后，肿瘤复发与肿瘤多灶性显著相关（p = 0.0002），但与肿瘤分级和分期无关。与p53阴性或bcl-2阴性肿瘤相比，p53阳性或bcl-2阳性肿瘤患者的肿瘤复发率并未更高。p53阳性与p53阴性肿瘤、bcl-2阳性与bcl-2阴性肿瘤中无复发生存患者数量也无显著差异。6例（6%）患者最终出现疾病进展，且均无p53或bcl-2阳性染色。
我们得出结论，在浅表性膀胱TCC中，肿瘤p53和bcl-2表达状态与分期和分级无关。它们单独或联合表达对TUR术后膀胱内化疗对肿瘤复发的结果均无预测作用。
