The expression of p53 in urothelial carcinoma of bladder: An immunohistochemical study

Urinary bladder cancers are the ninth most frequently diagnosed cancers worldwide. More than 90% of bladder cancers are urothelial carcinomas (UC). The Higher incidence is observed in men than in women. Higher p53 expression is associated with a higher grade, stage of the tumor. The objectives of the present study included determining the histological grade of UC, immunohistochemical expression of p53 in UC, and correlating expression of p53 with various clinicopathological variables like age, gender, grade, and invasion of the tumor.

The present study was conducted between 1 st January 2023 and 31 st March 2024 (60 cases) on UC in TURBT specimens of patients in a tertiary care center in India. Ethical clearance was obtained.

The peak incidence of UC was seen in the 5 th to 6 th decades (51.7%). Most patients (78.3%) were males. Painless hematuria (80%) was the most common presenting complaint. On histology, 75% were high-grade and 25% low-grade. p53 positivity was seen in 81.7% of cases. A statistically significant correlation was observed between p53 expression and size ( P -value = 0.015), grade ( P -value = 0.003), lamina propria invasion ( P -value < 0.001), and stage of the tumor ( P -value < 0.001). p53 percentage positivity and intensity both were significantly correlated with tumor grade ( P -value = 0.002 in both), lamina propria invasion ( P -values = 0.007, <0.001 respectively), and tumor stage ( P -values = 0.024, <0.001 respectively).

p53 is a bad prognostic marker and its expression has a direct and positive correlation with size, stage, and overall grade. Also, p53 can be used in targeted drug therapy in these cases.