Prognostic factors in renal‐cell carcinoma: Immunohistochemical detection of p53 protein versus clinico‐pathological parameters

Immunoreactivity forp53 protein was assessed in 100 cases of primary renal‐cell carcinoma (RCC). The results were correlated with clinical survival data (follow‐up 24 to 84 months: mean: 39 months) and with clinico‐pathological parameters, including nuclear grade, tumour stage, cell type, tumour architecture and tumour diameter. In all, 32% of the tumours were p53‐positive; there was no difference in survival between p53‐positive and ‐negative cases. Similarly, p53 expression did not correlate with any of the clinico‐pathological parameters mentioned. Nuclear grade (grade 1 + 2 vs. grade 3 + 4) had a striking impact on prognosis and so, to a lesser extent, did tumour stage and the occurrence of a spindle‐cell component. The immunohistochemical detection of p53 in RCC is not of prognostic value. The estimation of nuclear grade, however is a major predictor of prognosis.