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

• Published in: Pathology oncology research Vol. 26; no. 2; pp. 1211 - 1219
• Main Authors: Stec, Rafał, Cierniak, Szczepan, Lubas, Arkadiusz, Brzóskowska, Urszula, Syryło, Tomasz, Zieliński, Henryk, Semeniuk-Wojtaś, Aleksandra
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.04.2020; Springer Nature B.V
• Subjects: Bacillus Calmette-Guerin vaccine; BCG; Biomarkers, Tumor - analysis; Biomedical and Life Sciences; Biomedicine; Bladder cancer; Cancer Research; Carcinoma, Papillary - mortality; Carcinoma, Papillary - pathology; Carcinoma, Transitional Cell - mortality; Carcinoma, Transitional Cell - pathology; Disease-Free Survival; E-cadherin; Female; Humans; Immunohistochemistry; Immunology; Invasiveness; Ki-67 Antigen - analysis; Male; Multivariate analysis; Muscles; N-Cadherin; Nuclear reactions; Oncology; Original; Original Article; p53 Protein; Pathology; Prognosis; Proteins; Staining; Survivin; Tumor Suppressor Protein p53 - analysis; Urinary Bladder Neoplasms - mortality; Urinary Bladder Neoplasms - pathology; β-Catenin; Ki-67; Survivin; NMIBC; Bladder cancer; p53
• ISSN: 1219-4956; 1532-2807
• DOI: 10.1007/s12253-019-00678-1

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.