Intensity of Nuclear Staining for Ki-67, p53 and Survivin as a New Prognostic Factor in Non-muscle Invasive Bladder Cancer

Pathol Oncol Res. 2020 Apr;26(2):1211-1219. doi: 10.1007/s12253-019-00678-1. Epub 2019 Jun 19.

Abstract

The aim of the study was to determine the prognostic value of expression levels of biomarkers selected on the basis of the literature: p53, Ki-67, survivin, β-catenin, E-cadherin and N-cadherin in patients with non-muscle invasive bladder cancer. Immunohistochemistry was performed on sections of primary papillary carcinoma of the bladder removed during transurethral resection of the tumor in 134 patients. The expression of β-catenin and E-cadherin was found in all analyzed cases and N-cadherin expression was demonstrated in 3.73% of the tissues examined. The expression of the p53 protein was confirmed in 96.27% of tissues examined. The expression of the Ki-67 protein was demonstrated in all analyzed cases. Survivin expression was found in 95.52% of the study group. Multivariate analysis confirmed the relationship between the recurrence-free survival (RFS) and the intensity of the nuclear reaction for p53 (HR 1417, 95% CI 1.001-2.007, p = 0.049) and survivin (HR 1.451; 95% CI 1.078-1.955; p = 0.014), the expression level of the Ki-67 protein expressed by the TS index (HR 1.146, 95% CI 1.116-1.823, p = 0.005) and the use of adjuvant BCG therapy (HR 0.218, 95% CI 0.097-0.489, p = 0.0002). The evaluation of Ki-67 expression and the intensity of nuclear staining for survivin and p53 may provide additional information that will allow more accurate stratification of the risk of NMIBC recurrence after TURBT.

Keywords: Bladder cancer; Ki-67; NMIBC; Survivin; p53.

MeSH terms

  • Biomarkers, Tumor / analysis*
  • Carcinoma, Papillary / mortality
  • Carcinoma, Papillary / pathology*
  • Carcinoma, Transitional Cell / mortality
  • Carcinoma, Transitional Cell / pathology*
  • Disease-Free Survival
  • Female
  • Humans
  • Ki-67 Antigen / analysis
  • Male
  • Prognosis
  • Survivin
  • Tumor Suppressor Protein p53 / analysis
  • Urinary Bladder Neoplasms / mortality
  • Urinary Bladder Neoplasms / pathology*

Substances

  • BIRC5 protein, human
  • Biomarkers, Tumor
  • Ki-67 Antigen
  • Survivin
  • TP53 protein, human
  • Tumor Suppressor Protein p53