[DNA ploidy determination with flow cytometry, Ki-67 index and overexpression of p53 protein in 121 T1 superficial bladder carcinomas. Retrospective studies. Part II: Prognostic value and usefulness in the indication for prophylactic treatment with BCG].
OBJECTIVE
Evaluate the utility of Ki-67 label index, p53 expression and flow cytometry-DNA ploidy in the selection of groups to be treated with prophylactic BCG and the prognostic value compared with the classic variables (grade, lymphatic permeation, multiplicity, volume, primary).


METHODS
121 superficial bladder tumors T1. 10% Cut-off level for Ki-67 and p53. Aneuplody is defined as a tumor with DNA index different of 1 or more than 20% in G2-M phase. 71 (58.7%) received BCG.


RESULTS
In uni and multivariate analysis positivity to Ki-67 is correlated with recurrence. Progression is correlated with lymphatic permeation (p .0003), volume (p .016), ploidy (p .022) and positivity to p53 (p .007). In multivariate analysis, volume and positivity to p53 are independent variables. None were of utility to prevent recurrence, but Ki-67 positive or aneuploid treated tumors had less progression (p .025 and p .009 respectively). The p53 negative treated tumors had less progression too.


CONCLUSIONS
Only Ki-67 is correlated with tumoral recurrence. P53 and tumor volume are correlated with stage progression. If the results are confirmed with bigger series, the Ki-67 positive and/or aneuploid tumors would obtain benefits of prophylactic treatment with BCG.
Servicio de Urología, Hospital Universitario Virgen Macarena, Sevilla.
J L
JL
Moyano Calvo
M
M
De Miguel Rodríguez
J M
JM
Poyato Galán
A
A
Ortíz Gamiz
A
A
Molina Carranza
J J
JJ
Zerpa Railey
H
H
Toro Cepeda
D
D
Sánchez-Barriga Peña
H
H
Galera Davidson
J
J
Castiñeiras Fernández
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000368:Aged; D001500:BCG Vaccine / Q000627:therapeutic use*; D005260:Female; D005434:Flow Cytometry; D015972:Gene Expression Regulation, Neoplastic / Q000235:genetics*; D006801:Humans; D019394:Ki-67 Antigen / Q000235:genetics*; D008297:Male; D009367:Neoplasm Staging; D011003:Ploidies; D011379:Prognosis; D012189:Retrospective Studies; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis* / Q000235:genetics; D001749:Urinary Bladder Neoplasms / Q000235:genetics* / Q000473:pathology / Q000517:prevention & control*
D000276:Adjuvants, Immunologic; D001500:BCG Vaccine; D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53