title: The role of p53, MDM2 and c-erb B-2 oncoproteins, epidermal growth factor receptor and proliferation markers in the prognosis of urinary bladder cancer.
abstract: The immunohistological expression of p53 and MDM2 oncoproteins was examined in paraffin embedded tissue from 106 patients with transitional cell carcinoma of the urinary bladder and was related to various clinicopathological features, the expression of proliferation associated markers (proliferating cell nuclear antigen - PCNA - and Ki-67), c-erb B-2 oncoprotein and epidermal growth factor receptor (EGFR), as well as to survival. MDM2 immunoreactivity was seen in 38% of our cases, and in 14% was accompanied by p53 positive immunohistochemistry. The rate of p53 positivity was associated with grade, stage and papillary status, whereas MDM2 immunopositivity increased with grade and stage (Ta VS T1), and MDM2 labeling index (LI) with stage. MDM2 expression was related to p53 expression and less strongly to proliferation rate (Ki-67 LI). The simultaneous p53 and MDM2 expression was more frequently observed in higher grade and stage tumours. C-erb B-2, EGFR and proliferation marker expression increased with grade, stage and non-papillary configuration. In univariate analysis high grade, solid growth pattern, advanced T-category, cystectomy, EGFR and Ki-67 expression were linked to shorter overall survival but only Ki-67 LI, along with T-category and type of therapy, had independent prognostic value. C-erb B-2 expression and stage were the two independent predictors of disease-free survival and Ki-67 LI and EGFR LI the independent predictors of post-relapse survival. For patients with superficial tumors PCNA LI emerged as the single independent determinator of survival. p53 and MDM2 expression did not appear to have any significant impact on survival, although the simultaneous expression of p53 and MDM2 turned out to be a highly significant parameter of shortened overall survival in univariate analysis.
authors.affiliation: Department of Pathology, Asklepeion Hospital, Voula, Athens, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Korkolopoulou
authors.forename: P
authors.initials: P
authors.lastname: Christodoulou
authors.forename: P
authors.initials: P
authors.lastname: Kapralos
authors.forename: M
authors.initials: M
authors.lastname: Exarchakos
authors.forename: A
authors.initials: A
authors.lastname: Bisbiroula
authors.forename: M
authors.initials: M
authors.lastname: Hadjiyannakis
authors.forename: C
authors.initials: C
authors.lastname: Georgountzos
authors.forename: E
authors.initials: E
authors.lastname: Thomas-Tsagli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000502:physiology; D002295:Carcinoma, Transitional Cell / Q000737:chemistry* / Q000175:diagnosis; D003627:Data Interpretation, Statistical; D066246:ErbB Receptors / Q000032:analysis* / Q000502:physiology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis / Q000502:physiology; D011518:Proto-Oncogene Proteins / Q000032:analysis* / Q000502:physiology; D051736:Proto-Oncogene Proteins c-mdm2; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis* / Q000502:physiology; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis* / Q000502:physiology; D001749:Urinary Bladder Neoplasms / Q000737:chemistry* / Q000175:diagnosis
chemical_list: D014408:Biomarkers, Tumor; D066246:ErbB Receptors; D019394:Ki-67 Antigen; D009687:Nuclear Proteins; D018809:Proliferating Cell Nuclear Antigen; D011518:Proto-Oncogene Proteins; D051736:Proto-Oncogene Proteins c-mdm2; D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53; C497206:MDM2 protein, human