The expression of p53 and Bcl-2 in superficial bladder transitional cell carcinoma and its role in the outcome of postoperative intravesical chemotherapy

Background: We evaluated whether p53 and bcl-2 expression has any predictiv e value on the outcome of postoperative adjuvant intravesical chemotherapy for superficial bladder transitional cell carcinoma (TCC). Materials and Me thods: Immunostaining for p53 and bcl-2 was performed on paraffin-embedded armor tissues obtained from 100 patients with superficial bladder TCC. 56 h ad solitary and 44 had multiple tumors; 36 were grade I, 53 grade II and II grade III; 50 were stage pTa and 50 stage pT1. They all received transuret hral resection (TUR) and weekly intravesical instillation chemotherapy with either Thiotepa (70 patients)or Epirubicin(30 patients) for consecutive 8 doses postoperatively. Results: Overall, 7 (7%) tumors were p53(+) and 12 ( 12%) tumors were bcl-2(+). Of these, only one armor was combined p53(+) and bcl-2(+). The status of tumor p53 and bcl-2 positivity was found to be not significantly correlated with either armor grade or stage. After adjuvant intravesical chemotherapy, tumor recurrence is significantly correlated wit h tumor multifocality (p=0.0002) but not with armor grade and stage. Compar ed 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 p atients was also not significantly different in p53(+) versus p53(-) tumors , bcl-2(+) versus bcl-2(-) tumors. Six (6%) patients eventually developed d isease progression, and none stained positively for either p53 or bcl-2. Co nclusions: We conclude that in superficial bladder TCC the status of tumor p53 and bcl-2 expression is not correlated with stage and grade. Their expr ession, either alone or combined, has no predictive role on the outcome of post-TUR intravesical chemotherapy on tumor recurrence.