Objectives: Histological grade (G) is the only parameter proved to have pro
gnostic value for progression in T1 transitional cell carcinoma (TCC) of th
e bladder, although it is considered inaccurate to make clinical decisions
on individuals. The aim of the present study was to evaluate the prognostic
relevance of p53 expression in T1 TCC of the bladder.
Methods: Clinical records of 207 patients with T1 TCC of the bladder were r
eviewed for clinical parameters reported to influence the evolution of supe
rficial bladder cancer. Among these 207 patients, 40 developed muscle-invas
ive disease (20 G2 and 20 G3). A retrospective case-control study was then
carried out comparing the latter 40 tumours with 40 control tumours matched
by grade, sex, age, number and size of the tumours, chemical exposure and
presence of carcinoma in situ. p53 immunostaining with monoclonal antibody
was performed in these two groups.
Results: Histological grade was the only clinical parameter that influenced
evolution, p53 expression correlated with tumour progression, since it was
observed in 21 out of 24 p53-positive tumours and in only 20 of 56 p53-neg
ative tumours (p<0.0001), showing a specificity of 93.5% and a sensitivity
of 53%. p53 expression correlated as well with patient survival, being 39%
in patients with p53-positive tumours and 80% in patients with p53-negative
tumours at 60 months (p<0.0001).
Conclusions: p53 protein expression has prognostic value for survival and p
rogression in T1 bladder tumours and can be used for early detection of poo
r-prognosis T1 bladder tumours. Copyright (C) 2000 S. Karger AG, Basel.