Surgical specimens from 30 patients with transitional cell carcinoma of the bladder were examined for the presence of mutation of the p53 tumor suppressor gene using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis. All of the specimens were superficial, low grade cancer, and 10 patients had recurrences during an observation period of 24 months following the initial surgical treatment. Among the 30 patients with superficial bladder cancer, 4 were found to have the mutated p53 gene and 3 of them had recurrences, which involved either invasive or high grade tumors. Two of these recurrent tumors with the p53 gene mutation showed identical mutations with those primary tumors, whereas the other one did not have the same mutation. The data suggest that bladder cancers with a mutation of the p53 gene have a greater probability of poor prognosis than those which do not, even if the primary lesion was a superficial, low grade tumor. Therefore, the presence of the p53 gene mutation may provide important clues to the factors involved in bladder cancer.
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