Korean J Urol.  2009 Jan;50(1):12-17. 10.4111/kju.2009.50.1.12.

Clinical Implications of the Expression of Survivin and p53 in Superficial Transitional Cell Carcinoma of the Bladder

• Kwak DY
• Ha JY
• Chang HS
• Choi MS
• Park CH
• Kim CI

• KMID: 2140107
• DOI: http://doi.org/10.4111/kju.2009.50.1.12

Abstract

PURPOSE: The prognostic value of p53 remains controversial in transitional cell carcinomas of the bladder. Survivin, an inhibitor of apoptosis, is expressed in many human cancers. Recent studies have reported increased expression of survivin in superficial transitional cell carcinomas of the bladder. We investigated the expression of survivin and p53 and the clinical implications of this expression in superficial transitional cell carcinomas of the bladder.
MATERIALS AND METHODS
Immunohistochemical staining of paraffin sections using a monoclonal antibody for survivin and p53 was performed in 82 cases of superficial transitional cell carcinomas of the bladder. Correlations between the expression of survivin and p53 and clinicopathological features, such as age, multiplicity of tumor, size, recurrence, and progression, were examined.
RESULTS
Among 82 cases, positive survivin expression (greater than 20%) was observed in 59 cases. Positive p53 expression (greater than 20%) was observed in 46 cases. There were no significant differences in age, gender, multiplicity, tumor size, tumor grade, pT stage, recurrence, or progression-free survival between p53-positive and p53-negative groups (p>0.05). Also, there were no significant differences in age, gender, multiplicity, tumor size, tumor grade, or pT stage between survivin-positive and survivin-negative groups (p>0.05). However, recurrent-free and progression-free survivals were significantly lower in the survivin-positive group than in the survivin-negative group (p<0.05).
CONCLUSIONS
The expression of survivin can be recommended as a useful marker for predicting disease recurrence and progression. Survivin may be superior to p53 as a prognostic factor in superficial transitional cell carcinoma of bladder.

Keyword

Urinary bladder neoplasms; Human BIRC5 protein; p53 genes

MeSH Terms

Apoptosis
Carcinoma, Transitional Cell
Disease-Free Survival
Genes, p53
Humans
Paraffin
Recurrence
Urinary Bladder
Urinary Bladder Neoplasms
Paraffin

Figure

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  Fig. 1 Immunohistochemical staining of survivin in tissue sections obtained from superficial bladder tumor. (A) Survivin was observed diffusely in bladder tumor tissue. Reduced from ×40 (brown staining). (B) Reduced from ×200 (brown staining).

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  Fig. 2 Immunohistochemical staining of p53 in tissue sections obtained from superficial bladder tumor. (A) p53 was observed diffusely in bladder tumor tissue. Reduced from ×40 (brown staining). (B) Reduced from ×200 (brown staining).

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  Fig. 3 Kaplan-Meier cumulative recurrence-free and progression-free curves of patients with superficial bladder tumor according to the survivin immunoreactivity. There were significant differences in recurrence-free (p=0.015) and progression-free survival (p=0.046) between the surviving-positive and survivin-negative groups.

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  Fig. 4 Kaplan-Meier cumulative recurrence-free and progression-free curves of patients with superficial bladder tumor according to p53 immunoreactivity. There were no significant differences in recurrence-free (p=0.081) and progression-free survival (p=0.793) between the p53-positive and p53-negative groups.

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