Overexpression of p53 protein in a high-risk population of patients with superficial bladder cancer before and after Bacillus Calmette-Guerin therapy: Correlation to clinical outcome
Overexpression of p53 protein in a high-risk population of patients with superficial bladder cancer before and after Bacillus Calmette-Guerin therapy: Correlation to clinical outcome
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DOI：
10.1200/jco.1996.14.10.2646
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发表时间：
1996-10-01
影响因子：
45.3
通讯作者：
Reuter, VE
中科院分区：
文献类型：
--
作者：
Lacombe, L;Dalbagni, G;Reuter, VE
目的：我们之前已经证明p53过表达可预测Ta、Tis和T1肿瘤的疾病进展和生存。卡介苗是目前公认的浅表性膀胱癌最有效的辅助治疗方法。本研究的目的是确定在膀胱内卡介苗治疗前后评估p53状态是否可以预测浅表性膀胱癌高危人群的临床结局。材料和方法：我们检查了98例患者在膀胱内卡介苗治疗前后立即获得的196份组织标本，治疗前人群包括22例To， 57例Tis和19例T1肿瘤。卡介苗治疗后，66例T0, 32例有残余转体，分析核p53过表达与疾病进展时间和疾病特异性生存的关系。结果：中位随访时间为44个月。在卡介苗治疗前检测核p53过表达并不能预测对卡介苗治疗的反应，卡介苗前p53蛋白过表达、对卡介苗治疗的反应和卡介苗前分期都是疾病进展的独立标志物，在卡介苗治疗后残留疾病（无反应）的患者中，多因素分析证实，治疗后p53过表达是疾病进展的唯一独立标志物。结论：在这一浅表性膀胱肿瘤高危人群中，BCG治疗前肿瘤及T1期肿瘤中p53核过表达的患者存在疾病进展的高风险，且在BCG治疗后残留病变组中，p53状态比BCG治疗后病变更能预测疾病进展。
Purpose: We have previously demonstrated that p53 overexpression is predictive of disease progression and survival in Ta, Tis, and T1 tumors. instillation of Bacillus Calmette-Guerin (BCG) is now accepted to be the most efficient adjuvant therapy far superficial bladder carcinoma. The aim of this study was to determine if p53 status, assessed before and after intravesical BCG therapy, can predict clinical outcome in a high-risk population of patients with superficial bladder carcinoma.Materials and Methods: We examined 196 tissue specimens from 98 patients, obtained immediately before and after intravesical BCG therapy, The pretherapy population was composed of 22 To, 57 Tis, and 19 T1 tumors. After BCG, 66 specimens were T0 and 32 had residual turners, Nuclear p53 overexpression was analyzed in relation to time to disease progression and disease-specific survival.Results: The median follow-up duration was 44 months. The detection of nuclear p53 overexpression before BCG therapy did not predict response to BCG therapy, Pre-BCG p53 protein overexpression, response to BCG therapy, and pre-BCG stage were ail independent markers of disease progression, In patients with residual disease after BCG therapy (nonresponders), multivariate analysis confirmed that posttherapy p53 overexpression was the only independent marker of disease progression.Conclusion: In this high-risk population of patients with superficial bladder tumors, patients who have p53 nuclear overexpression in the tumor and stage T1 disease before BCG therapy are at high risk of disease progression, Furthermore, in the group of patients with residual disease after BCG therapy, p53 status is a better predictor of disease progression than post-BCG stage.