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为探讨基因的改变在膀胱移行细胞癌发生过程中的意义，应用免疫组织化学及聚合酶链反应－限制性片段长度多肽性法，检测１５０例膀胱移行细胞癌Ｐ２１、Ｐ１８５、ｐ５３蛋白表达以及５０例ｒａｓ、ｐ５３基因突变。结果表明：膀胱移行细胞癌Ｐ２１、Ｐ１８５、ｐ５３蛋白表达阳性率分别为５９．３％（８９例）、５５．３％（８３例）、２９．３％（４４例）。Ｐ２１、ｐ１８５蛋白表达阳性率与膀胱移行细胞癌分级呈负相关（Ｐ＜０．０５），ｐ５３蛋白表达与膀胱移行细胞癌分级呈正相关（Ｐ＜０．０１）。Ｐ２１、ｐ５３蛋白表达阳性率与预后呈显著相关，Ｐ２１与预后呈负相关。７３例膀胱移行细胞癌存在两种以上蛋白共同表达。膀胱移行细胞癌Ｈａ－ｒａｓ癌基因第１２位密码子突变１６例（３２％），ｐ５３基因突变９例（１８％），均为２４８位点突变。Ｈａ－ｒａｓ第１２位点突变随病理分级增高而增高，与膀胱移行细胞癌分级显著相关（Ｐ＜０．０５）。ｒａｓ基因、ｐ５３基因突变与预后显著相关（Ｐ＜０．０５）。ｒａｓ基因、ｐ５３基因突变患者死亡率高于无突变患者。４例膀胱移行细胞癌存在ｒａｓ基因及ｐ５３基因共同突变。
To investigate the significance of gene changes in transitional cell carcinoma of the bladder (BTCC), immunohistochemistry and polymerase chain reaction-restriction fragment length polymorphism were used to detect the expression of P21, P185 and p53 in bladder transitional cell carcinoma Cases of ras, p53 gene mutation. The results showed that the positive rates of P21, P185 and p53 in transitional cell carcinoma of the bladder were 59.3% (89 cases), 55.3% (83 cases) and 29.3% (44 cases) respectively. The positive rates of P21 and p185 protein were negatively correlated with the grade of transitional cell carcinoma of the bladder (P <0.05), and the expression of p53 protein was positively correlated with the grade of transitional cell carcinoma of bladder (P <0.01). P21, p53 protein expression was positively correlated with prognosis, P21 and prognosis was negatively correlated. 73 cases of bladder transitional cell carcinoma there are two or more proteins co-expression. In codon 12 of Ha-ras oncogene in bladder transitional cell carcinoma, 16 cases (32%) and 9 cases (18%) of p53 gene mutations were mutations of 248 loci. The mutation of Ha-ras site 12 increased with the pathological grade and was significantly associated with the grade of bladder transitional cell carcinoma (P <0.05). The ras gene and p53 gene mutations were significantly associated with prognosis (P <0.05). ras gene, p53 mutations in patients with higher mortality than non-mutant patients. Four cases of bladder transitional cell carcinoma ras gene and p53 gene co-mutation.