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THE VALUE OF P53 NUCLEAR PROTEIN EXPRESSION IN PREDICTING RESPONSE TO INTRAVESICAL MITOMYCIN C CHEMOTHERAPY | ||
| IRAQI JOURNAL OF MEDICAL SCIENCES | ||
| Article 1, Volume 6, Issue 1, 2008, Pages 3-14 | ||
| Authors | ||
| Usama Al-Nasiri; Muhannad Muhsin; Ahmad Abdul-Hameed | ||
| Abstract | ||
| Background: Alterations of p53 gene are the most common mutations in human cancers. In bladder cancer, p53 mutations have been associated with high tumor grades and advanced stages, as well as progression of superficial disease to muscle invasive disease. Moreover, p53 nuclear over expression appears to be an independent predictor of disease progression and decreased survival after cystectomy. Objective: The objective of the study is to evaluate the P53 expression percentage in patients with transitional cell carcinoma of the bladder and the relation of this expression to superficial cancer, muscle invasive disease, and carcinoma in situ as far as the tumor grade, clinical stage and response to intravesical mitomycin chemotherapy is concerned. The expression of P53 in normal bladder mucosa, taken from patients admitted for ureteral endoscopic procedures, was used as a control group Method: The expression of p53 protein was studied by immunohistochemical analysis in paraffin embedded specimens from 58 patients with transitional cell carcinoma of the bladder and 20 patients with normal urinary bladder (control group), these patients were admitted for insertion or removal of double J ureteric stents. Patients with superficial tumors (stage T1, Ta) were treated with intravesical chemotherapy with mitomycin C (20-40mg). once weekly for 6 weeks and cystoscopy repeated after 3 months , 6 months and 9 months. Patients with superficial muscle invasive disease were subjected to extended transurethral resection followed by intravesical chemotherapy and cystoscopy repeated at 6 weeks, 3 months and 6 months. No treatment other than MMC was given. Results: P53 over expression was observed in 29 (50%) out of 58 patients with transitional cell carcinoma of the bladder, with no case of p53 over expression observed in the control group. A statistically significant relation was noticed between p53 over expression and clinical stage, with p53 over expression was more common in muscle invasive tumors. P53 over expression was also more common in high grade tumors; however, no statistically significant relation between p53 expression and tumor grades and response to intravesical chemotherapy with mitomycin C was noticed. Conclusions: P53 over expression was noticed in half of the patients with transitional cell carcinomas of the bladder, it was much more common in muscle invasive tumors and more frequent in high grade tumors, however, it seems that p53 status did not predict response to intravesical mitomycin C chemotherapy. | ||
| Keywords | ||
| Bladder Tumor; over expression; response to Mitomycin C | ||
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