Clinical Significance Of Spontaneous Apoptosis And The Expression Of Bcl-2, PCNA, P27kip1 In Transitional Cell Carcinoma Of Bladder

Objective: The aim of our study is to investigate the rate of spontaneous apoptosis and the expression of bcl-2, p27kipl, PCNA in chronic cystitis epithelium tissue of bladder and transitional cell carcinoma of bladder (TCC), in order to assess their relationship with pathological grade, clinical stage and their significance and to improve our understanding of the pathogenesis of TCC.Methods: Immunohistochemical analysis of PCNA, p27kipl, bcl-2 were performed on paraffin embedded tissue sections in 50 cases of TCC , 12 cases of chronic cystitis epithelium tissue of bladder by Immunohistochemical method S-P. The terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) was used to examined the level of apoptotic cells.Results: UK The positive rate of bcl-2, p27kipl were 36.0%(18/50), 41.7%(5/12) and58.0% (29/50) , 33.3% (4/12) , respectively, in TCC and chronic cystitis epithelium of bladder. There was no significant difference in two groups (P>0.05). While in TCC, they were45.0%(9/20), 33.3%(6/18), 25.0%(3/12), and 85.0% (17/20) , 55.6%(10/18),16.7%(2/12),respectively, ingrade Ⅰ, Ⅱ and Ⅲ. The bcl-2 positivity was 44.8%(13/29), 23.8%(5/21), respectively, in Tis-T1 and T2-T4 . Bcl-2 expression was not correlated with clinicopathologic grade or stage(P>0.05). The positive rate of p27kipl was significant higher in grade Ⅰ + Ⅱ than grade Ⅲ( P <0.05), it was 72.4%(21/29), 38.1%(8/21), respectively, in Tis-T1 and T2-T4, (P<0.05). The expressions of bcl-2 , p27kipl were not related to patient's age ,sex, size or number of tumor(P>0.05).(2), The spontaneous apoptosis index AI was (3.0±1.5)%, (2.9±1.4)%, (mean±std) in TCC and in chronic cystitis epithelium of bladder .The means of AI of two groups were compared with t Test (P>0.05). In TCC, the means of AI was (3.8±1.3)%, (2.7±1.4)%, (2.1±1.1)%, respectively, in grade Ⅰ ,Ⅱ and Ⅲ, it was significantly higher in grade Ⅰ than in grade Ⅱ and Ⅲ(P<0.05). In Tis-T1 and T2-T4, it was (3.4±1.5)%, (2.4±1.1)%( P<0.05).(3), The index PI of PCNA was(48.9±21.6)%, (19.4±5.1)%, (meant std) in TCC and in chronic cystitis epithelium of bladder, it was significantly different in two groups ( P<0.05). In TCC, the positive cell rate of PCNA increased with the escalation of the tumor grade (rs=0.535, P 0.05) .It was (37.0±22.0)%, (50.6±17.3)% and (66.2±13.6)%, respectively, in grade Ⅰ, Ⅱ, Ⅲ, and was significantly different in grades( P <0.05). The means of PI was (41.6±21.5)% in Tis-T1 and (58.9±17.6)% in T2-T4 (P<0.05). The expression of PCNA was not associated with patient's age ,sex, size or number of tumor( P >0.05).(4), The positive expression of p27kipl protein were significantlyassociated with higher spontaneous apoptosis and lower expression of PCNA compared with the negative expression of p27kipl protein (P<0.05).The negative or positive expression of bcl-2 gene was not significantly related to spontaneous apoptosis and the expression of PCNA.Conclusion: The results of this study show that cell proliferations apoptosis .apoptosis suppressing protein bcl-2 and cyclin-dependent kinase inhibitor p27kipl play an important role in the genesis and progression in TCC. Evaluating these factors contributes to our understanding of the biological behaviors of TCC.