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为探讨癌基因及抑癌基因改变与膀胱癌生物学行为的关系，采用免疫组织化学方法及分子生物学技术，检测了８２例膀胱移行细胞癌Ｐ２１、Ｐ１８５、Ｐ５３蛋白表达及３８例ｒａｓ、Ｐ５３基因突变。结果表明：Ｐ２１、Ｐ１８５、Ｐ５３蛋白表达阳性分别为５１例（６２．２％）、４８例（５８．５％）、２６例（３１．７％）。Ｐ２１、Ｐ５３蛋白表达阳性率与膀胱移行细胞癌病理分级及临床分期呈正相关（Ｐ＜０．０１）；Ｐ１８５蛋白阳性率与膀胱移行细胞癌分级、分期呈负相关（Ｐ＜０．０５）。膀胱移行细胞癌组织中１５例（３９．５％）有Ｈａｒａｓ癌基因第１２位密码子突变；１２例（３１．６％）有Ｐ５３抑癌基因突变，其中全部有第２８０位密码子ＧＣ突变；３例合并有２４８密码子突变；１例有２４９密码子点突变。Ｈａｒａｓ癌基因及Ｐ５３抑癌基因点突变与膀胱癌病理分级和临床分期呈显著正相关（Ｐ＜０．０５）；与预后显著相关（Ｐ＜０．０５）；且死亡率高于点突变阴性者。６例既有Ｈａｒａｓ基因突变，又有Ｐ５３基因突变的病例中４例死亡。
In order to investigate the relationship between oncogene and tumor suppressor gene changes and biological behavior of bladder cancer, immunohistochemistry and molecular biological techniques were used to detect the expression of P21, P185 and P53 in 82 cases of bladder transitional cell carcinoma and 38 cases of ras and p53 Gene mutation. The results showed that the positive expression rates of P21, P185 and P53 were 51 (62.2%), 48 (58.5%) and 26 (31.7%) respectively. The positive rates of P21 and P53 were positively correlated with the pathological grading and clinical stage (P <0.01). The positive rate of P185 protein was negatively correlated with the grade and stage of bladder transitional cell carcinoma (P <0.05). Fifteen patients (39.5%) with transitional cell carcinoma of the bladder had the 12th codon mutation of Ha-ras oncogene and 12 (31.6%) had mutations of p53 suppressor gene, all of which had 280th codon G C mutations; 3 cases merged with 248 codon mutations; 1 case of 249 codon point mutations. There was a significant positive correlation between point mutation of Haras oncogene and P53 tumor suppressor gene and pathological grade and clinical stage of bladder cancer (P <0.05), and prognosis (P <0.05), and the mortality was higher than that of point Mutant negative person. In 6 cases of both Ha-ras mutations and P53 mutations, 4 died.