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PROGNOSTIC VALUE OF p53, Ki-67 EXPRESSION IN THE UROTHELIAL CARCINOMA TISSUE AND URINARY BLADDER NONTUMOR MUCOSA


Authors: Viktor Soukup 1;  Marko Babjuk 1;  Jaroslava Dušková 2;  Michael Pešl 1;  Monika Szakácsová 1;  Libor Zámečník 1;  Jan Dvořáček 1;  Ctibor Povýšil 2
Authors‘ workplace: Katedra urologie IPVZ, Urologická klinika 1. LF UK a VFN, Praha 1;  Patologický ústav 1. LF UK a VFN, Praha 2
Published in: Ces Urol 2009; 13(2): 161-167
Category: Original article

Overview

Aim:
The aim of the prospective study was to assess the prognostic value of p53, Ki-67 expression level in the urothelial carcinoma tissue and in the samples of urinary bladder non-tumor mucosa.

Material and methods:
Forty eight patients with first history of Ta, T1 urinary bladder carcinoma were enrolled into the study. They were all followed for 31,3 month at average. Primary antibodies (Imunotech/ DAKO) were used to detect p53 and Ki-67 positivity. The expression was evaluated semi quantitatively and expressed as HSCORE, where HSCORE = Σpi (i + 1), in which I is one of the four positivity grades, Pi stands for the positive nuclei percentage. All patients were included into the follow-up program. The results were evaluated in the statistical system SAS (Cary, USA).

Results:
The tumor recurrence was detected in 21 patients, and tumor progression in four patients. The average p53 expression value in the tumor samples was 139.3, in the samples of non-tumor mucosa was 118.2. The average Ki-67 values were 126.2 in the tumor samples and 107.6 in the non tumor mucosa. P53 positivity in the tumor and non-tumor mucosa correlated significantly (p = 0.0019), nevertheless, not the same relation was found for Ki-67. The level of expression Ki-67 in non tumor musoca correlated significantly with recurrence-free interval (p = 0.023), the cut-off level was calculated 127.66. Ki-67 and p53 expression in the tumor tissue were significantly related to the tumor grade (p = 0.003 and p = 0.004, resp.). The level of Ki-67 expression in non-tumor mucosa and tumor multiplicity had independent prognostic value in the relation to the cancer recurrence.

Conclusion:
The level of p53, Ki-67 expression in tumor tissue correlated with those levels in non-tumor mucosa. The level of Ki-67 expression in nontumor mucosa brings independent prognostic information in relation to the cancer recurrence and could be the cause of urinary bladder urothelial carcinoma multiplicity. Further research has to be done for the final assessment.

Key words:
urinary bladder urothelial carcinoma, nontumor mucosa, p53, Ki-67.


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