CYCLIN D1, p53, AND Ki-67, THEIR ROLES IN UROTHELIAL CARCINOMA OF BLADDER IN DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA DURING 2010–2019

Bladder cancer is a malignancy of the genitourinary system, which is ninth cancer globally with 430,000 new cases estimated in 2012. More than 50% of all bladder cancer incidents globally. Urothelial cell carcinoma is that commonest histological type. There are no good therapeutic options to date. Cancer occurs through various pathways, through disruption of tumor suppressor genes that inhibit apoptosis, the cell cycle continues so that cell proliferation occurs continuously and uncontrollably. Apoptosis can be seen from the p53 protein expressed by tumor cells as a mechanism for cell suicide, to remove cells that are not functioning. This p53 expression can assess tumor size and assess tumor cell proliferation, including urothelial bladder cancer cells. A nuclear protein called Ki-67 represents cell proliferation that highly active tumors. Ki-67 overexpression is related with worse oncologic outcomes in urothelial tumors. An increased level of cyclin D1 expression identified by immunohistochemistry is related to good progression and survival in bladder cancer. The analytical observation was conducted on 53 Urothelial Carcinoma of bladder patients who underwent cystectomy in Dr. Soetomo General Academic Hospital during 2010–2019. Immunohistochemistry on paraffin blocks was performed using p53, Ki-67, and cyclin D1 antibodies in the pathology laboratory. Expression of p53, Ki-67 and cyclin D1 were semiquantitative measured then statistically analyzed. In the Spearman correlation test, the grade of bladder urothelial cell carcinoma correlated strongly with p53 expression. There was also a correlation between Ki-67 and T stage of bladder urothelial cell carcinoma. Still, p53 and Ki-67 are promising biomarkers for urothelial tumors.