EXPRESSION OF P53 AND BCL-2 IN PRIMARY LOCALLY CONFINED RENAL-CELL CARCINOMAS - NO EVIDENCE FOR PROGNOSTIC-SIGNIFICANCE

p53 tumor suppressor gene mutations are present in a wide variety of h uman cancers, and the bcl-2 gene product is considered to prevent apop tosis. However, the significance of these gene products for the aggres siveness of the tumor. and correspondingly for the prognosis of patien ts with renal cell carcinoma (RCC) is unclear. The expression of p53 a nd bcl-2 gene products was studied immunohistochemically using formali n-fixed paraffinembedded tumor samples of 31 locally confined RCC of p atients treated with radical nephrectomy. The significance of these 2 parameters, in addition to tumor stage and malignancy grade, was teste d with regard to survival and time of no recurrence using Kaplan-Meier -plots by the log rank test or Tarone's test and the Cox multiple haza rd regression analysis (mean follow-up 5.4 years). Only 5 of the 31 RC Cs stained positively for p53 and only 2 showed positive bcl-2 stainin g of tumor cells. Tumor stage (P <0.002) and malignancy grade (P <0.00 7) were statistically significant prognostic parameters for both survi val and disease-fr ee period by univariate analysis. In contrast, the defection of either p53 (P >0.67) or bcl-2 gene product (P >0.28) had no prognostic impact. Also in the multivariate statistical analysis, n either of the 2 parameters ie. p53 and bcl-2 expression significantly improved the prognostic impact of the conventional prognosticators sta ge and grade, if applied in addition. The expression of p53 and bcl-2 seems unimportant as a prognostic factor in locally confined RCCs.