Prognostic significance of the epithelial-to-mesenchymal transition markers e-cadherin, vimentin and twist in bladder cancer

ObjectiveThe goal of this study was to utilize long-term patient follow-up to determine whether epithelial-to-mesenchymal transition (EMT)-related markers can predict bladder cancer patient survival and progression of disease.Materials and MethodsThis study included 121 patients with bladder cancer. Sixty-four of these patients presented with non-muscle invasive (NMI, stage T1) bladder cancer and 57 with muscle invasive (MI, stage T2, T3). The patients were diagnosed and treated between May 1998 and July 2012. The EMT markers E-cadherin, Twist, and Vimentin were detected via immunohistochemistry. Univariate and multivariate/Cox analyses were then utilized to determine whether these EMT markers could be useful prognostic markers for predicting bladder cancer patient outcomes.ResultsAnalysis of the 121 bladder cancer patients in this study revealed that the frequency of E-cadherin expression was 59.5% (72/121), Twist was 54.5% (66/121), and Vimentin was 24.8% (30/121). Twist and Vimentin were found to have statistically significant correlations with grade, recurrence, and progression but not with stage, whereas E-cadherin was associated with stage but not with the other parameters. In the univariate analysis, grade (p = 0.02) was the only significant predictor for progression-free survival (PFS). Stage, grade, and expression of E-cadherin, Vimentin and Twist were included in the multivariate analysis of predicting PFS. In this analysis, grade (p = 0.01) and Vimentin expression (p = 0.001) were found to be significant prognostic factors in predicting PFS.ConclusionsGrade and Vimentin are potential independent indicators in predicting bladder cancer progression and survival.

Evaluating expression and potential diagnostic and prognostic values of survivin in bladder tumors: a preliminary report

Survivin, an inhibitor of apoptosis [IAP], has been reported to be capable of regulating both cellular proliferation and apoptotic cell death. Survivin expression has been described during embryonic development and in adult cancerous tissues, with greatly reduced expression in adult normal differentiated tissues, particularly if their proliferation index is low. In the present study, the expression and potential diagnostic and prognostic value of survivin in bladder tumors was evaluated. Primary and recurrent bladder tumor specimens were obtained from patients referred to the Shaheed Labbafinejad Medical Center in Tehran, Iran. Total RNA was isolated from frozen tissues, reverse transcribed and amplified by means of a nested polymerase chain reaction technique. Survivin was detected in 3 cases of primary tumors [42.8%] and 6 cases of recurrent tumors of bladder [60%]. Survivin-deltaEx3 expression was seen in 41.2% of the 17 cases with bladder cancer. Our findings suggest that the expression of survivin and survivin-deltaEx3 is well associated with invasive and more-aggressive forms of bladder cancer. Our data also indicate that the presence of survivin-deltaEx3 is better correlated with tumorigenesis of bladder cancer compared with survivin expression

Malignant inverted papilloma of the urinary bladder: the histopathological aspect of malignant potential of inverted papilloma

To investigate the histopathological characteristics of inverted papillomas of the urinary bladder, including the possibility of malignant transformation, we studied the indicators of cellular proliferation activity in 7 inverted papillomas of the bladder including two cases of malignant inverted papilloma of the bladder. PCNA expression rates in two cases of malignant inverted papilloma were higher than in benign inverted papillomas. Mean numbers of AgNORs per nucleus in malignant inverted papillomas were much more than in benign inverted papillomas. The c-erbB-2 oncoprotein was expressed only in malignant inverted papillomas. These results suggest that PCNA expression rate, mean number of AgNORs per nucleus and c-erB-2 oncoprotein expression may be merited as good indicators to detect the inverted papilloma with more proliferative and aggressive lesions, and with the potential of malignant transformation.