Expressions of p53, KAI1, PTEN and their use as prognostic markers in urothelial carcinoma of the bladder

Objectives: To determine the expression levels of p53, KAI1, PTEN and their relations with the clinicopathologic parameters in patients with urothelial carcinoma of the bladder Design: Retrospective study Setting: Department of Pathology, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey Subjects: Seventy-eight patients with a diagnosis of urothelial carcinoma of the bladder at the Pathology Department of Ankara Diskapi Yildirim Beyazit Education and Research Hospital and who were followed up for two years Intervention: Archived pathology materials of all patients were reviewed and clinical data were collected from medical database records retrospectively. Main outcome measures: We considered the following parameters: age, gender, survivals and disease-free survivals of the patients, tumor-stage, lymphovascular-angiovascular invasions, expressions of KAI1, PTEN and p53 in tumorous tissues. Results: In non-metastatic-patients, 55.2% were p53 negative; however, 45.8% of the metastatic-patients had diffuse-strong p53-expressions. Hence, p53 positivity indicates that the tumor will metastase. In transurethral resection (TUR) materials, patients with positive KAI1-expression had better survival (p=0.0285). The tumor seemed to be more aggressive and invasive in patients with decreased KAI1-expressions because there was no KAI1 expression in 50% of the metastatic-patients, although it wasn't statistically significant (p=0.550). For PTEN expression, no statistically-significant relation was found with the tumor-stage (p=0.34) and survival/ disease-free-survival (TUR:p=0.9599/0.7576, radical cystectomy :p=0.8219/0.5790). Conclusions: The presence of metastasis dramatically decreases the overall survival in patients with urothelial carcinoma. Identification of these patients as early as possible would effect their therapies, follow-up intervals and surveys. p53 and KAI1 seem to be especially better indicators of the prognosis than PTEN.