Purpose: To determine the expressions of bcl-2, p53, Ki-67 and PTEN on the basis of immunohistochemistry methods in upper urinary transitional cell carcinoma (TCC), and to correlate their presentations in specimens with clinical tumor stage, grade and patient survival. Material and Method: Paraffin-embedded primary upper urinary TCC specimens were divided into 2 groups for immunohistochemical study: Group 1 including 91 cases were treated with bcl-2, p53 and Ki-67 antibodies; group 2 including 93 specimens contained both tumor and benign tissues were treated with PTEN antibody. Semi- quantitatively, according to the amount of the stained cells, they were divided into 3 levels: level 1, scanty; level 2, focal; and level 3, diffuse. Association of immunoreactivity with tumor grade and stage was examined. Prognostic significance of tumor marker expression in patients¡¦ survival was accessed. Results: Group1: Of the 91 tumors most (98.9%) of the specimens showed level 1 bcl-2 expression and only 1 patient had level 2 expression. The p53 mutations were identified level 3 expression in 48.4% of the cases, followed by level 2 (26.4%) and level 1 (25.3%) identifications. The Ki-67 expression was recognized level 3 in 6 patients, level 2 in 21 and level 1 in 66 cases. Significant correlations were seen between p53 expression and tumor grading (p=0.004) and between immunostain of Ki-67 and clinical stage (p=0.031). The p53, bcl-2 and Ki-67 expressions in upper urinary tract TCC specimens were not a significant factor of patients¡¦ survival. Group 2: Of the tumors all cytoplasm has level 3 PTEN expressions and the nuclei, 18 (19.4%) showed scanty expression, 35 (37.6%) revealed focal expression, and diffuse expression was noted in 40 (43.0%) cases. Loss of PTEN expression in tumor nuclei was positively correlated with pathologic stage (p=0.019). Of the fibrocytes adjacent to tumor cells, the nuclei showed 24 (25.8%) scanty, 59 (63.4%) focal and 10 (10.8%) diffuse distribution of PTEN expressions. Poorly differentiated tumor (grade 3) specimens were correlated with loss of PTEN expression in fibrocytic nuclei adjacent to tumor (p=0.028). Most (58%) fibrocytic cytoplasm was scanty PTEN expression, followed by 23 (24.7%) diffuse and 16 (17.2%) focal immunostaining. PTEN expressions in upper urinary tract TCC specimens were not a significant factor of patients¡¦ survival. Conclusions: We examined 93 surgical specimens of upper urinary tract TCC for the expression of PTEN and 91 cases for bcl-2, p53 and Ki-67 by immunohistochemical stained. Correlation between tumor grading and p53 mutations and correlation between clinical stage and Ki-67 immunoreactivity were observed. Meanwhile, loss of PTEN expression in tumor nuclei of upper urinary TCC is correlated significantly with advanced tumor stage, and poorly differentiated tumor specimens were correlated with loss of PTEN expression in normal nuclei adjacent to tumor cells. However, no correlation between overall survival rate and tumor markers was identified. Thus, the detection of p53, bcl-2, Ki-67 and PTEN would be not enough for evaluation the prognosis of upper TCC.