MDM2和p53共同染色可成为膀胱癌独立的预后指标

目的：以免疫组织化学染色的方法，研究 MDM2 和 p53 蛋白在膀胱癌中的表达，以及与病理和临床表现之间的关系。方法:应用抗 MDM2 和 p53 的单克隆抗体，以标准的 LSAB 方法，共分析了 131 例组织学确诊的膀胱癌标本。结果:MDM2染色阳性的肿瘤为 39 例（29.8%），阴性的肿瘤为 92 例（70.2%）。MDM2 染色在不同细胞分级和不同临床分期之间无统计学差异，对是否复发及生存率也无影响。p53 染色阳性的肿瘤为 86 例(65.6%)，G3级阳性的比例(84.1%)明显高于 G1-2 级（56.3%，P=0.0012）；浸润型（T2-4）肿瘤阳性的比例（75.8%）明显高于表浅型（Ta-1）肿瘤（55.4%，P<0.001）。p53 阳性患者的生存率明显低于阴性患者（P=0.007）。两种蛋白表达之间无明显关系。P53+/MDM2－的患者生存率最低，且在多因素分析中，成为独立的预后因素（P=0.0046）。结论:P53+/MDM2－患者的生存率最低，并且是独立的预后因素。MDM2和p53共同染色，可为预后判断提供更准确的资料。

MDM2 and p53stain simultaneously has independent prognostic significance in human bladder cancer

Objective:To detect the prognostic value of the expression of MDM2 and p53 protein, as well as the relationship of these two proteins as determined by immunohistochemistry in bladder cancer. Methods: Bladder tumor samples from 131 patients were assessed immunohistochemically using the specific monoclonal antibody and labeled streptavidin biotin staining against MDM2 and p53 protein. Results:MDM2 and p53 positive stains were 39 cases (29.8%) and 87 cases (65.6%), respectively There was no significant correlation of MDM2 staining with the histological grade, clinical stage and prognoses p53 accumulation were significantly correlated with high histologic grade (P=0.0012), high clinical stage (P<0.0001) and reduced survival (P=0.007) No relationship was observed between MDM2 and p53 in staining status or intensity. The lowest survival rate was seen in p53+/MDM2, pattern Multivariate analysis demonstrated that p53+/MDM2 has significant statistical correlation with unfavorable outcome (P=0.0046) Conclusion:p53+/MDM2 pattern is independent prognostic impact for tumor progression in bladder cancer. The simultaneous immunostaining for MDM2 and p53 could be important prognostic factor in patients affected by bladder cancer.