Prognostic factors in survival of patients with stage Ta and T1 bladder urothelial tumors -: The role of G1-S modulators (p53, p21Waf1, p27Kip1, cyclin D1, and cyclin D3), proliferation index, and clinicopathologic parameters
Prognostic factors in survival of patients with stage Ta and T1 bladder urothelial tumors -: The role of G1-S modulators (p53, p21Waf1, p27Kip1, cyclin D1, and cyclin D3), proliferation index, and clinicopathologic parameters
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DOI：
10.1309/ltfu3uumby095hum
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发表时间：
2004-09-01
影响因子：
3.5
通讯作者：
Montironi, R
中科院分区：
文献类型：
--
作者：
Lopez-Beltran, A;Luque, RJ;Montironi, R
我们研究了159例浅表性（Ta或T1期）膀胱肿瘤，以确定细胞周期从G期到S期的转变（p53，p21 Waf 1，p27 Kip 1，cyclin D1，cyclin D3）和肿瘤增殖（Ki-67 [MIB-1]）的调节因子子集对生存的意义。分析中包括临床结果（患者年龄、性别、肿瘤大小、级别、分期[Ta或T1]）。单变量分析显示肿瘤大小（P = 0.0353），Ta期肿瘤分级（P=.0074），细胞周期蛋白D1表达（P = 0.0182）和Ki-67指数（P = 0.0033）与无病生存率的关系，肿瘤大小（P= 0.0005）、分期（P = 0.0494）、细胞周期蛋白D3表达（P= 0.0105）和Ki-67指数（P = 0.0272）与总生存率的关系。考克斯多变量分析显示细胞周期蛋白D1表达和高增殖指数（无病）和肿瘤大小、细胞周期蛋白D3表达和高增殖指数（总生存期）是独立预测因子。结果表明，细胞周期从G（1）期到S期的进程的改变在乳头状膀胱尿路上皮肿瘤中是常见的。高肿瘤增殖，细胞周期蛋白D1和D3的表达，和肿瘤大小在诊断可能是相关的预测生存期Ta和T1期膀胱尿路上皮肿瘤患者。
We studied 159 cases of superficial (stage Ta or T1) bladder tumors to determine the significance on survival of a subset of regulators of transition from G, to S phase of the cell cycle (p53, p21Waf1, p27Kip1, cyclin D1, cyclin D3) and tumor proliferation (Ki-67 [MIB-1]). Clinical findings (patient age, sex, tumor size, grade, stage [Ta or T1]) were included in the analysis. Univariate analysis revealed association of tumor size (P =.0353), grade in stage Ta tumors (P=.0074), cyclin D1 expression (P =.0182), and Ki-67 index (P =.0033) with disease-free survival and of tumor size (P=.0005), stage (P =.0494), cyclin D3 expression (P=.0105), and Ki-67 index (P =.0272) with overall survival. Cox multivariate analysis revealed cyclin D1 expression and high proliferation index (disease-free) and tumor size, cyclin D3 expression, and high proliferation index (overall survival) as independent predictors. Results suggest that alterations of the progression from the G(1) to S phase of the cell cycle are common in papillary urothelial bladder tumors. High tumor proliferation, expression of cyclins D1 and D3, and tumor size at diagnosis might be relevant predictors of survival in patients with stage Ta and T1 bladder urothelial tumors.