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Value of p53 expression, cellular proliferation, and DNA content as prognostic indicators in renal cell carcinoma.

OBJECTIVE
In renal cell carcinoma (RCC) little is known about the basic mechanisms of cell proliferation and differentiation leading to growth, invasion, and eventual metastasis. In the present study, the prognostic significance of proliferative activity, p53 activity, and ploidy is analyzed.


METHODS
In 90 patients with RCC overexpression of the p53 protein. DNA ploidy and proliferation status as determined by the monoclonal antibodies Ki-67 and Ki-S5 were analyzed in addition to tumor malignancy grade and stage and correlated with the clinical course.


RESULTS
During the follow-up period (average 38 months) 23% of the patients had a progressive course. Only the Ki-S5 index correlated with stage, grade, and clinical course. Ploidy, p53, and Ki-67 correlated neither with tumor stage and grade nor with the clinical course.


CONCLUSION
The proliferation activity determined with the monoclonal antibody Ki-S5 represents the most promising prognostic factor of the pathological indicators considered for the clinical course of RCC.