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目的：以免疫组织化学染色的方法，研究p53和bcl－2蛋白在膀胱癌中的表达，以及与病理和临床表现之间的关系。方法：应用抗p53和bcl-2的单克隆抗体，以标准的LSAB方法，共分析了131例患者的肿瘤标本。结果：p53染色阳性的肿瘤为86例（65．6％），G3级阳性的比例（84．1％）明显高于G1-2级（56.3％，P＝0．0012）；浸润型（T2－4）肿瘤阳性的比例（75．8％）明显高于表浅型（Ta－1）肿瘤（55．4％，P＜0．0001）。p53阳性患者的生存率明显低于阴性患者（P＝0．0070）。bcl-2染色阳性的肿瘤有35例（26．7％），但bcl-2染色在不同的细胞分级和不同临床分期之间无统计学差异，对是否复发及生存率也无影响。两种蛋白表达之间也无相关性。经多因素分析，仅浸润型肿瘤（相对于表浅型）为独立的预后因素。结论：p53和bcl-2免疫染色对膀胱癌的预后无重要预示价值。
OBJECTIVE: To study the expression of p53 and bcl-2 protein in bladder cancer by immunohistochemical staining and their relationship with pathology and clinical manifestations. METHODS: Tumor specimens from 131 patients were analyzed by the standard LSAB method using monoclonal antibodies against p53 and bcl-2. Results: There were 86 cases (65.6%) with positive p53 staining, the positive rate of G3 (84.1%) was significantly higher than that of G1-2 (56.3%, P = 0.0012) -4) was significantly higher in tumors (75.8%) than in superficial (Ta-1) tumors (55.4%, P <0.0001). The survival rate of p53-positive patients was significantly lower than that of negative patients (P = 0.0070). There were 35 cases (26.7%) of bcl-2 positive tumors, but there was no significant difference in bcl-2 staining between different cell grades and different clinical stages, and had no effect on the recurrence and survival rate. There was also no correlation between the two protein expressions. By multivariate analysis, only infiltrating tumors (as opposed to superficial) were independent prognostic factors. Conclusion: p53 and bcl-2 immunostaining have no significant predictive value for the prognosis of bladder cancer.