title: The prognostic significance of p53, p63 and her2 expression in non-muscle-invasive bladder cancer in relation to treatment with bacille Calmette-Guerin.
abstract: OBJECTIVE
  To investigate whether the immunohistochemical expression of p53, p63 and her2/neu is correlated with the prognosis of tumour recurrence and progression in patients with non-muscle invasive (NMI) bladder cancer.
  
  
  METHODS
  In all, 88 patients diagnosed with NMI transitional cell carcinoma of the bladder in a Urology Department from May 2009 to April 2014 were included in the study. Paraffin-embedded specimens were obtained by transurethral resection of the bladder tumours. Sections on haematoxylin and eosin-stained slides were examined histologically and tumour grade was classified according to the World Health Organisation system (2004) Mostofi classification. The sections were evaluated using p63, p53 and her2/neu immunohistochemical staining before and after immunotherapy with bacille Calmette-Guerin (BCG), and patients were followed up for 36 months in the Urology Department.
  
  
  RESULTS
  For tumour grade there was a significant relationship with the overexpression of p53 (P = 0.010), her2 (P = 0.025) and negativity of p63 (P = 0.025). There was no significant relationship between p53 or her2/neu overexpression and tumour stage. However, there was a significant correlation (P = 0.005) between p63 negativity and tumour stage. There was a significant relationship between p53 (P = 0.01), her2/neu (P = 0.025) overexpression and p63 negativity (P = 0.005) and tumour recurrence and progression.
  
  
  CONCLUSIONS
  Patients with transitional cell carcinoma who are selected for BCG treatment should preferably be positively immunoreactive for p63, but negative for both p53 and her2/neu. These patients were less susceptible to recurrence and/or progression after BCG adjuvant therapy. Further studies are needed to investigate the relationship between these three markers and treatment with anti-her2/neu therapies.
authors.affiliation: Department of Pathology, Faculty of medicine, Zagazig University, Cairo, Egypt.
authors.forename: Raafat
authors.initials: R
authors.lastname: Hegazy
authors.affiliation: Department of Anatomy, Faculty of medicine, Zagazig University, Cairo, Egypt.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Kamel
authors.affiliation: Department of Anatomy, Faculty of medicine, Zagazig University, Cairo, Egypt.
authors.forename: Emad A
authors.initials: EA
authors.lastname: Salem
authors.affiliation: National Research Centre, Cairo, Egypt.
authors.forename: Neveen A
authors.initials: NA
authors.lastname: Salem
authors.affiliation: Department of Anatomy, Faculty of medicine, Zagazig University, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Fawzy
authors.affiliation: Department of Anatomy, Faculty of medicine, Zagazig University, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Sakr
authors.affiliation: Department of Urology, Faculty of medicine, Zagazig University, Cairo, Egypt.
authors.forename: Ola
authors.initials: O
authors.lastname: El-Farargy
authors.affiliation: Department of Radiotherapy, Faculty of medicine, Zagazig University, Cairo, Egypt.
authors.forename: Nashwa
authors.initials: N
authors.lastname: Nawar
authors.affiliation: Department of Radiotherapy, Faculty of medicine, Zagazig University, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Atar
authors.affiliation: Department of Anatomy, Faculty of medicine, Zagazig University, Cairo, Egypt.
authors.forename: Ashraf M S
authors.initials: AM
authors.lastname: Shahin
authors.affiliation: Department of Medical Oncology, Faculty of medicine, Zagazig University, Cairo, Egypt.
authors.forename: Abdelmonem
authors.initials: A
authors.lastname: Hegazy
keywords: BCG; Bladder cancer; Cis, carcinoma in situ; H&E, haematoxylin and eosin; NMI, non-muscle invasive; P53, P63, Her2; TURBT, transurethral resection of the bladder tumour