Abstract
Tumor markers Ki67, TP53, and TP63 are common labels in the diagnosis of bladder cancer (BCa) around the world. The combination of those biomarkers may have advantages in predicting BCa prognosis and non-muscle-invasive bladder cancer (NMIBC) postoperative recurrence. We investigated the immunohistochemical profiles of 313 bladder cancer samples classified under the WHO/ISUP (2004) grading scale and the UICC-TNM (2002) classification. Then we investigated their predictive value in the tumor recurrence of 270 NMIBC patients after TURBT. Expression of Ki67 correlates with grade, stage, tumor size, and tumor numbers. Semiquantitative evaluation of TP53 correlates with grade and invasive conditions. The positive expression rate of TP63 correlated with tumor grade and stage. The combined effect of TP53 and Ki67 revealed a predictive value in NMIBC recurrence. However, the positive TP63 expression did not show any protective effect in NMIBC recurrence. The expression of TP53 and Ki67 could be used to predict the risk of NMIBC recurrence postoperatively.
Similar content being viewed by others
References
Cordon-Cardo C et al. Molecular alterations associated with bladder cancer initiation and progression. Scand J Urol Nephrol Suppl. 2008;8:154–65.
Epstein JI, Amin VR, Reuter FK, et al. The World Health Organization/International Society of Urological Pathology Consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. The Bladder Consensus Conference Committee. Am J Surg Pathol. 1998;22:1435–48.
Larsson P, Wijkstrom H, Thorstenson A, et al. A population-based study of 538 patients with newly detected urinary bladder neoplasms followed during 5 years. Scand J Urol Nephrol. 2003;37:195–201.
Fernandez-Gomez J, Madero R, Solsona E, et al. Predicting nonmuscle invasive bladder cancer recurrence and progression in patients treated with bacillus Calmette-Guerin: the CUETO scoring model. J Urol. 2009;182(5):2195–203.
Madersbacher S, Hochreiter W, Burkhard F, et al. Radical cystectomy for bladder cancer today—a homogeneous series without neoadjuvant therapy. J Clin Oncol. 2003;21(4):690–6.
Bassi P, Ferrante GD, Piazza N, et al. Prognostic factors of outcome after radical cystectomy for bladder cancer: a retrospective study of a homogeneous patient cohort. J Urol. 1999;161(5):1494–7.
Evans CP, Debruyne F, Payne H, et al. Bladder cancer: management and future directions. Eur Urol Suppl. 2007;6:365–73.
Millan-Rodriguez F, Chechile-Toniolo G, Salvador-Bayarri J, et al. Multivariate analysis of the prognostic factors of primary superficial bladder cancer. J Urol. 2000;163:73–8.
Pruthi RS, Baldwin N, Bhalani V, et al. Conservative management of low risk superficial bladder tumors. J Urol. 2008;179(1):87–90.
Sylvester R, Oosterlinck W, van der Meijden A, et al. Treatment of superficial bladder tumors: achievements and needs. The EORTC Genitourinary Group. Eur Urol. 2000;37 Suppl 3:1–9.
Evans C, Debruyne F, Payne H, et al. Bladder cancer: management and future directions. Eur Urol Suppl. 2006;6:365–73.
Bryan RT, Zeegers MP, James ND, et al. Biomarkers in bladder cancer. BJU Int. 2010;105:608–13.
Sauter G, Algaba F, Amin M., et al. Tumours of the urinary system: non-invasive urothelial neoplasias. In: Eble JN, Sauter G, Epstein Jl, Sesterhenn I, eds. WHO classification of classification of tumours of the urinary system and male genital organs. Lyon: IARCC Press, 2004, pp. 29–34.
Sobin LH, Gospodariwicz M, Wittekind C. (eds). TNM classification of malignant tumors. UICC International Union Against Cancer. 7th edn. Wiley-Blackwell, 2009; pp. 262–265.
Wang L, Feng C, Ding G, et al. Relationship of TP53 and Ki67 expression in bladder cancer under WHO 2004 classification. J BUON. 2013;18(2):420–4.
Feng CC, Wang PH, Ding Q, Guan M, Zhang YF, Jiang HW, et al. Expression of pigment epithelium-derived factor and tumor necrosis factor-α is correlated in bladder tumor and is related to tumor angiogenesis. Urol Oncol. 2013;31(2):241–6.
Feng C, Wu Z, Guo T, Jiang H, Guan M, Zhang Y, et al. BLCA-4 expression is related to MMP-9, VEGF, IL-1α and IL-8 in bladder cancer but not to PEDF. TNF-α or angiogenesis. Pathol Biol (Paris). 2012;60:e36–40.
Feng CC, Wang PH, Guan M, Jiang HW, Wen H, Ding Q, et al. Urinary BLCA-4 is highly specific for detection of bladder cancer in Chinese Han population and is related to tumour invasiveness. Folia Biol (Praha). 2011;57:242–7.
Sylvester RJ, van der Meijden AP, Oosterlinck W, et al. Predicting recurrence and progression in individual patients with stage TaT1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006;49(3):466–5.
Montironi R, Mazzucchelli R, Colanzi P, et al. Improving interobserver agreement and certainly level in diagnosing and grading papillary urothelial neoplasms. Usefulness of a Bayesian belief network. Eur Urol. 2002;41:449–57.
Yurakh A, Ramos D, Calabuig-Frinas S, et al. Molecular and immunohistochemical analysis of the prognostic value of cell-cycle regulators in urothelial neoplasms of the bladder. Eur Urol. 2006;50:506–15.
Oosterhuis J, Schapers R, Janssen-Heijnen M, et al. MIB-1 as a proliferative marker in transitional cell carcinoma of the bladder. Clinical significance and comparison with other prognostic factors. Cancer. 2000;88:2598–605.
Wu T, Chen J, Lee Y, et al. The role of BCL-2, TP53 and Ki67 index in predicting tumor recurrence for low grade superficial transitional cell bladder carcinoma. J Urol. 2000;163:758–60.
Gonzalez-Campora R, Davalos-Casanova A, et al. Apoptotic and proliferation indexes in primary superficial bladder tumors. Cancer Lett. 2006;242:266–72.
Santos L, Amaro T, Pereira S, et al. Expression of cell-cycle regulatory proteins and their prognostic value in superficial low-grade urothelial cell carcinoma of the bladder. EJSO. 2003;29:74–80.
Mulder A, Van Hootegem J, Sylvester R, et al. Prognostic factors in bladder carcinoma: histological parameters and expression of a cell cycle related nuclear antigen (Ki67). J Pathol. 1992;166:37–43.
Vet JA, Bringuier PJ, Poddighe HF, et al. TP53 mutations have no additional prognostic value over stage in bladder cancer. Br J Cancer. 1994;70:496–500.
Erill N, Colomer A, Verdú M, et al. Genetic and immunophenotype analyses of TP53 in bladder cancer: TP53 alterations are associated with tumor progression. Diagn Mol Pathol. 2004;13(4):217–23.
Comperat E, Camparo P, Haus R, et al. Immunohistochemical expression of p63, p53 and MIB-1in urinary bladder carcinoma. A tissue microarray study of 158 cases. Virchows Arch. 2006;448:319–24.
Liukkonen T, Rajala P, Raitanen M, et al. Prognostic value of MIB-1 score, TP53, EGFr, mitotic index and papillary status in primary superficial (stage pTa/pT1) bladder cancer: a prospective comparative study. Eur Urol. 1999;36:393–400.
Shariat S, Kim J, Raptidis G, et al. Association of p63 and p21 expression with clinical outcome in patients with carcinoma in situ of the urinary bladder. Urology. 2003;61:1140–5.
Friedrich M, Riethdorf S, Erbersdobler A, et al. Relevance of p53 gene alterations for tumor recurrence in patients with superficial transitional cell carcinoma of the bladder. J Urol. 1996;155:1754–7.
Gontero P, Casetta G, Zitella A, et al. Evaluation of TP53 protein over expression, Ki67 proliferative activity and mitotic index as markers of tumor recurrence in superficial transitional cell carcinoma of the bladder. Eur Urol. 2000;38:287–96.
Yang A, McKeon F, et al. P63 and P73: p53 mimics, menaces and more. Nat Rev Mol Cell Biol. 2000;1:100–207.
Park B, Lee S, Kim J, et al. Frequent alteration of p63 expression in human primary carcinomas. Cancer Res. 2000;60:3370–4.
Urist M, Di Como C, Lu M, et al. Loss of p63 expression is associated with tumor progression in bladder. Am J Patho. 2002;161:1199–206.
Author information
Authors and Affiliations
Corresponding author
Additional information
Lujia Wang and Chenchen Feng are equal contributors.
Rights and permissions
About this article
Cite this article
Wang, L., Feng, C., Ding, G. et al. Ki67 and TP53 expressions predict recurrence of non-muscle-invasive bladder cancer. Tumor Biol. 35, 2989–2995 (2014). https://doi.org/10.1007/s13277-013-1384-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13277-013-1384-9