Objecetive: Surgically positive lymph node in invasive bladder cancer generally imply distant micrometastasis, thus preoperative identification of lymph node status is important. Various antioncoproteins were evaluated for their validity of predicting lymph node metastasis. Subjects and Method: 57 cases who had invasive, grade III(WHO) transitonal cell carcinoma at transurethral resection of bladder(TURB), and then confirmed to have stage T2, T3a, and T3b tumor after radical cystectomy from 1985 to 1994 were selected. Tissues acquired from transurethral resection were immunostained with tumor suppressor gene p53(DO7 and PAb1801) and antimetastatic gene nm23-Hl(NM301). Results of staining and pathological stagings were compared with the status of lymph node metastasis. Reault: Expression of p53 was 42.1% (24/57) for DO7 and 22.8% (13/57) for PAbl801, DO7 exhibiting superiority over PAbl801. Expresion of nm23-Hl was seen in 50.9% (29/57). Combined analysis of p53 and nm23-Hl expression and nodal status(N stage) was not significant. However pathological nodal status was statistically significantly correlated with pathological tumor(T) stage and p53 expression. Conclnsion: ¨c High risk of lymph node metastasis can be predicted when Grade III, muscle invasive tumor and p53 expression is seen from TURB specimen.¨e Lymph node metastasis is correlated with the degree of invasion in Grade III muscle invasive tumor, and especially in T3b tumors, where there is highest probability of node involvement.
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