目的　探讨老年人膀胱癌组织 ｐ５３ 基因突变与临床分期、病理分级及预后的关系。方法　利用 Ｐ Ｃ Ｒ Ｓ Ｓ Ｃ Ｐ 及 Ｐ Ｃ Ｒ 直接循环测序技术，分析 ７０ 例 ６０ 岁以上老年人膀胱癌组织 ｐ５３ 基因突变。结果　７０ 例中 ２４ 例（３４３％ ）发生 ｐ５３ 基因突变。侵润性 膀胱癌（ｐ Ｔ２ ～ｐ Ｔ ４ ）组比浅表性性膀胱癌（ｐ Ｔ ａ～ｐ Ｔ１ ）组、Ⅱ～Ⅲ级组比Ⅰ级组 ｐ５３ 基因突变率明显增高（ Ｐ ＝ ００２０ 和 Ｐ ＝００２３）。突变阳性组与突变阴性组的 １ 年、３ 年、５ 年生存率分别为 ６３６％ 、４０１％ 、４０１％ 及 ９１８％ 、７６４％ 、５６４％ ，阳性组较阴性组明显预后不良（ Ｐ＝ ００２３）。结论　ｐ５３ 基因突变可作为预测老年人膀胱癌恶性进展及鉴别浸润性与浅表性膀胱癌、预后判断有用的分子生物学指标。 Objective To investigate the relationship between p53 gene mutation and clinical stage, pathological grade and prognosis of bladder cancer in the elderly. Methods P C R S S C P and P C R  direct cycle sequencing were used to analyze p53 gene mutation in 70 cases of bladder cancer aged over 60 years old. Results Of 70 cases, 24 cases (343%) had p53 gene mutation. The mutation rate of p53 gene in invasive bladder cancer (pT2-pT4) group was significantly higher than that in superficial bladder cancer (pTa-pT1) group, and grade Ⅱ ~ Ⅲ group than in grade Ⅰ group (P = 0 ˙020 and P = 0023). The 1-year, 3-year and 5-year survival rates were 63.6%, 40.1%, 40.1% and 918%, 764% and 564% in the mutant positive group and the mutant negative group respectively. The positive group than the negative group was significantly poor prognosis (P = 0  023). Conclusion The mutation of p53 gene can be used as a molecular biological indicator to predict malignant progression of bladder cancer in elderly patients and to distinguish invasive and superficial bladder cancer and prognosis.