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Urological Research

, Volume 28, Issue 5, pp 285–292 | Cite as

Evaluation of p21WAF1/CIP1 and cyclin D1 expression in the progression of superficial bladder cancer

  • T. Liukkonen
  • P. Lipponen
  • M. Raitanen
  • E. Kaasinen
  • M. Ala-Opas
  • P. Rajala
  • V.-M. Kosma
  • Finnbladder Group
ORIGINAL PAPER

Abstract

Immunoreactivity of p21WAF1/CIP1 and cyclin D1 proteins was assessed in a cohort of 207 patients with superficial (pTa-pT1) bladder cancer followed up for a mean of 4.9 years. The results of the immunostainings were compared with T category, WHO grade, tumor cell proliferation rate (MIB-1 score), the expressions of p53 and bcl-2 as well as survival. Sixty-eight percent and 75% of the tumors were p21WAF1/CIP1 positive (≥5% of cells positive) and cyclin D1 positive (≥10% of cells positive), respectively. The p21WAF1/CIP1 expression was related to cyclin D1 immunolabelling (P < 0.001) but not to the other variables studied. The expression of cyclin D1 was inversely associated with T category (P=0.001), WHO grade (P=0.006), MIB-1 score (P=0.014), p53 expression (P=0.001), and bcl-2 (P=0.011) immunoreactivity. In univariate analysis, T category (P=0.0001), WHO grade (P < 0.0001), MIB-1 score (P < 0.0001), bcl-2 (P=0.0092), p53 (P=0.0016) and p21WAF1/CIP1 (P=0.009) expressions were significant prognostic factors with regard to tumor progression, whereas cyclin D1 was without any prognostic significance (P=0.1). Out of 123 p21 positive tumors 21 progressed, whereas only 2 out of 58 p21 negative tumors progressed. In multivariate analysis, the MIB-1 score was the only independent predictor of cancer-specific survival (P=0.03), whereas tumor grade (P=0.002) and cyclin D1 expression (P=0.04) were independent predictors of tumor recurrence. Only the WHO grade (P=0.04) retained its prognostic value indicating the risk of progression. We suggest that in superficial bladder cancer p21WAF1/CIP1 and cyclin D1 immunohistochemistry provide no additional prognostic information compared with already established prognostic factors for predicting the risk of progressive disease.

Key words Superficial bladder cancer p21WAF1/CIP1 Prognosis Cyclin D1 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • T. Liukkonen
    • 1
  • P. Lipponen
    • 2
  • M. Raitanen
    • 3
  • E. Kaasinen
    • 4
  • M. Ala-Opas
    • 5
  • P. Rajala
    • 6
  • V.-M. Kosma
    • 7
  • Finnbladder Group
  1. 1.Department of Surgery, Mikkeli Central Hospital, Porrassalmenkatu 35-37, Fin-50100 Mikkeli, Finland Tel.: +358 (0)15 3511; Fax: +358 (0)15 3512200FI
  2. 2.Department of Pathology and Forensic Medicine, University of Kuopio, FinlandFI
  3. 3.Department of Surgery, Tampere University Hospital, FinlandFI
  4. 4.Department of Surgery, Hyvinkää District Hospital, FinlandFI
  5. 5.Department of Urology, Kuopio University Hospital, FinlandFI
  6. 6.Department of Surgery, Turku University Hospital, FinlandFI
  7. 7.Department of Pathology and Forensic Medicine, Kuopio University Hospital, FinlandFI

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