The clinical value of p21(WAF1/CIP1) expression in superficial bladder cancer

The clinical value of p21(WAF1/CIP1) in superficial bladder cancer remains controversial. To address the question, we examined the expression patterns of p21 and p53 gene products and compared for their significance in a tota l of 89 cases of superficial (pTa/pTl) bladder cancer. Over-expression of p 21 was detected in 32 of 89 (36%) rumors. But, the expression status did no t correlate with biological indicators or clinical outcome (p > 0.1, respec tively). Factors predicting clinical outcome were multiplicity for tumor re currence (p = 0.0002) or patient survival (p = 0.03), and the histological grading for disease progression (p = 0.02) or patient survival (p = 0.05). Taking into account the p53 status, a trend approaching better prognosis fo r p53+p21+ tumors was observed compared with that of p53+p21- bladder cance r (p = 0.08). Our data indicate that evaluation of p21 status does not prov ide better prognostic information compared with conventional biological ind icators of superficial bladder cancer. Maintenance of p21 appears to abroga te the deleterious effects of p53 alterations in the tumorigenesis of human bladder.