Prognostic value of Ki‐67 antigen and p53 protein in urinary bladder cancer: immunohistochemical analysis of radical cystectomy specimens

Abstract

Objective To investigate the role of tumour proliferation and p53 expression as a marker of survival in patients with urinary bladder cancer who undergo radical cystectomy. Patients and methods Samples were obtained from 31 patients (29 men and two women, mean age 66.0 years, range 46–80) with transitional cell carcinoma of the bladder who underwent radical cystectomy. The 31 formalin‐fixed radical cystectomy specimens were stained immunohistochemically for Ki‐67 antigen and p53 protein using MIB1 and p53 antibodies, respectively, and the results correlated with tumour grade, stages and prognosis. Results The Ki‐67 index was significantly greater in high‐grade tumours and in those overexpressing p53 (>20% positive nuclei). Patients whose tumour samples had a high Ki‐67 index (>32%) had a significantly worse prognosis than those with a lower index (P<0.01). There was a similar correlation between Ki‐67 index and prognosis in high‐risk patients (grade 3 and pT3–4; P<0.05). Although the associations between tumour grade, stage and p53 expression were not statistically significant, patients whose tumour samples overexpressed p53 had a lower survival rate (P<0.05). No patients with tumours having a low Ki‐67 and low p53 index (n=14) died of urinary bladder cancer during the follow‐up. Conclusion These results suggest that immunohistochemical analyses for Ki‐67 and p53 are useful prognostic indicators in patients with urinary bladder cancer who undergo radical cystectomy; the prognostic role of these markers was particularly important in high‐risk (grade 3 and pT3–4) patients.

Immunohistochemical Expression of CK20, p53, and Ki-67 as Objective Markers of Urothelial Dysplasia

“…CK20 has been proposed as a marker of neoplastic change as well as a predictor for progression of urothelial carcinoma (18 -21). Ki-67 is a proliferation marker, with demonstrated usefulness in many neoplasms in determining their progression (7)(8)(9)(10)(11).…”

“…The Ki-67 antigen recognized by the MIB-1 monoclonal antibody is a useful proliferation marker (7)(8)(9)(10). Overexpression of the p53 gene product has been reported to be a marker of progression in urothelial carcinoma (11)(12)(13)(14).…”

Multivariate analysis of survival, recurrence, progression and development of mestastasis in T1 and T2a transitional cell bladder carcinoma

“…Esrig et al 19 and Tsuji et al 20 point to a significant link between the expression of p53 and survival, although the latter study included only a univariate analysis. However, in the studies by Jahnson et al 6 and Liukkonen et al 21 the expression of p53 does not appear as an independent variable of survival.…”

Survivin nuclear labeling index: a superior biomarker in superficial urothelial carcinoma of human urinary bladder

“…34 However, systematic evaluation of the expression profile and biologic significance of these apoptosis regulators in urothelial carcinomas is lacking. In addition, although tumor cell proliferation (as assessed by the immunomarker MIB1/Ki67) has been correlated with urothelial carcinoma progression and patient survival, 4,11,14,17,21,25 the relationship of proliferation activity with caspase and IAP expression in urothelial carcinomas is not clear.…”