Correlation of immunohistochemical molecular staging of bladder biopsies and radical cystectomy specimens.
OBJECTIVE
To determine the relationship of p53, retinoblastoma (RB), and p16 expression between precystectomy transurethral resection bladder (TURB) biopsy and matched cystectomy specimens; and to determine the value of p53 immunoreactivity for predicting progression and survival in patients undergoing radical cystectomy.


METHODS
We performed p53 immunohistochemical staining on matched archival TURB and cystectomy specimens taken from 40 patients. Twenty-seven and 26 of these patients were also evaluated for RB and p16 expression, respectively.


RESULTS
Twenty-eight (70%) of the TURB and 22 (55%) of the cystectomy specimens stained positive for p53. RB and p16 protein expression were altered in 19 (70%) and 19 (73%) of the TURB specimens, respectively, and 19 (70%) and 19 (73%) of the cystectomy specimens, respectively. There was a strong correlation between p53, RB, and p16 expression and TURB and cystectomy specimens (all p < 0.001). In preoperative and postoperative multivariate analyses, biopsy p53 and cystectomy p53 were independently associated with disease progression (p = 0.049 and p = 0.034, respectively) and bladder cancer-related death (p = 0.044 and p = 0.037, respectively).


CONCLUSIONS
p53, RB, and p16 expression patterns on TURB specimens correlate with cystectomy specimens. p53 immunoreactivity is an independent predictor of disease progression and bladder cancer survival. These data support the potential of prognostic staging using immunohistochemical analysis on bladder biopsy specimens prior to neoadjuvant or definitive therapy.
Tokunaga
H
H
Scott Department of Urology, Baylor College of Medicine and the Methodist Hospital, Houston, TX 77030, USA.
Shariat
S F
SF
Green
A E
AE
Brown
R M
RM
Zhou
J H
JH
Benedict
W F
WF
Lerner
S P
SP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001706:Biopsy; D002295:Carcinoma, Transitional Cell / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D015653:Cystectomy; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D009946:Organothiophosphorus Compounds; D011379:Prognosis; D016016:Proportional Hazards Models; D016160:Retinoblastoma Protein / Q000032:analysis*; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*; D001743:Urinary Bladder / Q000737:chemistry* / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology
D019941:Cyclin-Dependent Kinase Inhibitor p16; D009363:Neoplasm Proteins; D009946:Organothiophosphorus Compounds; D016160:Retinoblastoma Protein; D016159:Tumor Suppressor Protein p53; C009680:VX-agent