PROGNOSTIC VALUE OF HISTOLOGICAL AND MOLECULAR-BIOLOGICAL CHARACTERISTICS IN TRANSITIONAL-CELL NON-MUSCLE INVASIVE BLADDER CANCER

The prediction of disease progression in patients with high-risk transitional-cell non-muscle invasive bladder cancer (NMIBC) can help in the decision-making for patients eligible to early cystectomy. In this study we evaluated the association of different immunohistochemical tissue markers in patients with NMIBC at a high risk of disease progression. 179 patients with NMIBC that underwent complete TUR ± intravesical therapy between 2004 and 2007 and available follow-up were selected. Microscopic slides were reviewed: tumour stage, grade (WHO 1973 and 2004), the presence of carcinoma in situ and lymphovascular invasion was determined. Additionally, the expression of Ki67, р53, р63, CK 20, СK 18, CK 10/13 and CK 5/6 was determined after immunohistochemical staining of paraffin embedded tissue samples. The pathology results were correlated with the progression-free survival (PFS defined as the development of the muscle invasive disease, metastases or the death from cancer). 5-year PFS in patients with positive nuclear staining (≥50 %) with р53 antibodies and/or positive cytoplasm staining with CK 5/6 (≥50 %) was 55 % (95 % CI 39–70) compared to 84 % (95 % CI 77–90) in patients without the expression of these markers (HR 4.0, 95 % CI 2.2–7.0 (p < 0.001).

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