Immunoreactivity of p53 in Urothelial Carcinomas of the Urinary Bladder
Introduction: Urothelial Carcinomas (UC) are heterogenous disease with unpredictable outcome. Risk stratification plays an important role in the management as 70% tumours are NonMuscle Invasive (NMI) at the time of diagnosis. It is difficult to make prognosis for individual patients due to high r...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2018-10-01
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| Series: | National Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | http://www.njlm.net/articles/PDF/2324/39790_CE[Ra1]_F(SHU)_PF1(A_SHU)_PFA(A_SHU)_PN(SHU).pdf |
| Summary: | Introduction: Urothelial Carcinomas (UC) are heterogenous
disease with unpredictable outcome. Risk stratification plays
an important role in the management as 70% tumours are NonMuscle Invasive (NMI) at the time of diagnosis. It is difficult to
make prognosis for individual patients due to high rates of
recurrence and progression. Over-expression of p53 cell cycle
regulator protein is associated with high grade, high stage of
bladder cancer and important in the multistep progression with
an unfavourable prognosis. The p53 immunohistochemical
staining intensity and score status identifies patients needing
early cystectomy for treatment of NMI or aggressive adjuvant
therapy after cystectomy.
Aim: To assess the immunohistochemical expression patterns
of p53 in UC of the urinary bladder and to find out the relationship
between p53 over expression with clinicopathological
parameters like grading and pathological staging.
Materials and Methods: The study was conducted in
JSS Medical College and Hospital, JSS Academy of Higher
Education & Research, Mysuru. A total of 50 cases of UC
of the bladder were included in the study (2 years each of
retrospective-October 2012 to September 2014 and prospective
study-October 2014 to September 2016) over a duration of two
years.
The over expression of p53 antigen was evaluated by
Immunohistochemistry (IHC) as intensity and a score based on
the percentage of tumour cells staining positive after counting
at least 500 cells in each case using high power objective of the
microscope (x400).
RESULTS: Among 50 cases, 39 (78%) tumours were high
grade and 11 were low grade. A 49 (98%) were positive for p53
over expression and 01 (2%) high grade non papillary tumour
was negative. Higher intensity (3+) and score (4+) of p53 over
expression was seen with higher grade than lower grade with
statistically significant p-value (intensity - < 0.001, score -
0.006).
Also, when evaluated separately this correlation was found
significant in high grade NMI (p-value: intensity- 0.021, score –
0.025) rather than muscle invasive tumours. No relationship was
established between p53 over expression with pathological
stage of tumour and other clinicopathological parameters.
CONCLUSION: Higher p53 over expression is associated
with higher grade, particularly in NMI tumours which may
go for progression and recurrence. Therefore, p53 over
expression by IHC can provide important prognostic
information in risk stratification of UC of the bladder. It aid in
appropriate modification of treatment management and better
understanding biological behaviour of UC. |
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| ISSN: | 2277-8551 2455-6882 |