Transitional Cell Tumor and p53
19 March 2008 (online)
It is now believed that about 50 % of all human cancers contain a mutation in p53, so hopes are high that molecular analysis will provide new insights into treating the disease. Several recent studies using PCR techniques have shown that p53 gene mutations are closely associated with high grade and/or stage urothelial cancers. The existence of p53 protein alterations in urothelial cancer, detected by imunohistochemistry seems to be one of the most promising prognostic markers. We have analysed the p53 tumor suppressor gene in 3 cases with bladder tumors developing after treatment for a renal pelvic or ureteral tumor and in 1 case with a ureteral tumor after treatment for a bladder tumor. For each case, identical p53 gene mutations were detected in all primary and recurrent tumors. It is suggested that heterotopic recurrence by intraluminal seeding from the original tumor is common in urothelial cancer. A better understanding of the molecular mechanisms underlying urothelial cancers is likely to be helpful in the design of diagnostic procedures with predictive value for the course of the disease.
Urothelial cancer - p53 tumor suppressor gene - Prognostic marker - Recurrence