p53, p21/WAF1, pRb的表达与T1G3膀胱癌预后的关系

目的　探讨p5 3,p2 1/WAF1和pRb的异常表达在T1G3 膀胱癌预后判断中的价值。　方法　对 4 7例T1G3 膀胱癌患者进行术后随访 ,采用p5 3,p2 1/WAF1和pRb单克隆抗体对手术标本行免疫组化染色。将肿瘤进展情况与染色结果和与预后相关的临床指标进行分析。　结果　 39例手术保留膀胱的患者总进展率为 5 9% ,其中 9例发生远处转移。 8例行膀胱全切术的患者 1例于术后 2年发现肺转移。肿瘤细胞核p5 3,p2 1/WAF1和pRb蛋白的异常表达率分别为 6 6 .7%、5 1.4 %和 71.8%。多因素分析显示 ,p5 3、pRb同时异常表达 (P <0 .0 5 )和p5 3、p2 1/WAF1、pRb三者同时异常表达(P <0 .0 1)与肿瘤进展显著相关。　结论　p5 3,p2 1/WAF1和pRb的表达与T1G3 膀胱癌患者的预后密切相关

Expressions of p53, p21/WAF1 and pRb in the prognosis of T1G3 bladder cancer

Objective To evaluate the prognostic significance of p53, p21/WAF1 and pRb in T 1G 3 transitional cell carcinoma (TCC) of the urinary bladder. Methods Paraffin embedded sections from 47 patients with T 1G 3 TCC of the bladder were studied by immunohistochemistry, using monoclonal antibodies of p53, p21/WAF1 and pRb. The immunostaining results were analyzed in relation to the tumor progression, and compared with the clinical parameters on prognostic significance. Results Of the 39 patients treated by TURBT or partial cystectomy, the total progression rate of the tumor has been 59%.Of the 8 patients treated by cystectomy,one had pulmonary metastasis 2 years after the operation.The abnormal expression rates of p53, p21/WAF1 and pRb were 66.7%, 51.4% and 71.8% respectively. Multivariate analysis indicated that only the combined abnormal expressions of p53, p21/WAF1 and pRb provided prognostic information in T 1G 3 TCC of the bladder. Conclusions Immunohistochemical evaluation of p53, p21/WAF1 and pRb nuclear expressions would help the prognostic evaluation cases of T 1G 3 TCC of the bladder.