OVER-EXPRESSION OF P53 NUCLEAR ONCOPROTEIN IN TRANSITIONAL-CELL BLADDER-CANCER AND ITS PROGNOSTIC VALUE

Two hundred and twelve archival bladder-cancer biopsy specimens were analyzed immunohistochemically to detect over-expression of p53 protein. The results of immunohistochemical analysis were correlated to established histological and quantitative prognostic factors and survival of patients during a mean follow-up period of more than 10 years. Twenty-nine percent of tumours were positive for p53 protein, and over-expression was associated with high histological grade, non-papillary growth architecture, dense inflammatory cell reaction, DNA aneuploidy, high S-phase fraction, high mitotic frequency and high SD of nuclear area. Progression in T, N and M categories was significantly related to over-expression of p53 protein. In univariate survival analysis, over-expression of p53 predicted poor outcome in the entire cohort, in papillary tumours and in muscle-invasive tumours but not in superficial tumours. In a multivariate survival analysis, over-expression of p53 oncoprotein had no independent prognostic value over clinical stage and mitotic index. The results confirm that p53 is involved in the growth regulation of bladder cancer and is certainly a subject for detailed analysis of specific mutations.