title: Evaluation of p53 nuclear accumulation in low- and high-grade (WHO/ISUP classification) transitional papillary carcinomas of the bladder for tumor recurrence and progression.
abstract: OBJECTIVE
  To evaluate the association of p53 nuclear accumulation with recurrence and progression in transitional cell carcinomas of the bladder and to examine the distribution of p53 in low-grade and high-grade transitional cell carcinomas according to the World Health Organization/International Society of Urological Pathology classification.
  
  
  METHODS
  Nuclear accumulations of p53 were examined in a total of 99 patients with transitional cell carcinoma between May 1995 and October 1999. The mean age was 64 years. There were 94 (95%) men and 5 (5%) women. Following resection, surgical specimens were examined, and p53 accumulation with a 20% cutoff value was accepted as positive staining. Of the 99 patients, 52 (53%) had histologically superficial bladder tumors, and 47 (47%) had invasive tumors. Data concerning grade, stage, number of recurrences, and disease progression were available for each patient.
  
  
  RESULTS
  The median follow-up period was 55 months. 60 of the 99 patients (61%) had p53 overexpression. The difference for p53 overexpression between low-grade and high-grade tumors was significant (p < 0.05). In low- and high-grade tumors, there was no significant relationship for recurrence between p53-positive and p53-negative groups. But there was a statistically significant relationship between progression and histological grade of the tumors. p53 had no significant relationship with tumor recurrences (p > 0.05), but its relationship with progression was statistically significant (p < 0.05).
  
  
  CONCLUSIONS
  We did not find a correlation between tumor recurrence and p53 overexpression, but p53 overexpression has a predictive value in determining tumor progression. High-grade tumors had higher p53-positive values than low-grade tumors. This group of patients should be considered for radical therapies on the basis of other prognostic parameters.
authors.affiliation: Department of Pathology, SSK Izmir Teaching Hospital, Bornova, Turkey. envervardar@ttnet.net.tr
authors.forename: Enver
authors.initials: E
authors.lastname: Vardar
authors.forename: Bulent
authors.initials: B
authors.lastname: Gunlusoy
authors.forename: Süleyman
authors.initials: S
authors.lastname: Minareci
authors.forename: Hakan
authors.initials: H
authors.lastname: Postaci
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Ayder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000145:classification* / Q000378:metabolism*; D002295:Carcinoma, Transitional Cell / Q000145:classification* / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011446:Prospective Studies; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*; D001749:Urinary Bladder Neoplasms / Q000145:classification* / Q000378:metabolism*; D014944:World Health Organization
chemical_list: D016159:Tumor Suppressor Protein p53