Evaluation of E- cadherin and telomerase expression in urothelial carcinoma of the urinary bladder

ABSTRACT

E-cadherin is a transmembrane glycoprotein involved in intercellular adhesion. A loss or reduction in e-cadherin expression has been linked to the invasive phenotype of a wide variety of human neoplasms. including bladder tumors. Human telomerase reverse transcriptase [hTERT] is a catalytic subunit of telomerase and is a potentially useful diagnostic marker for cancers in many neoplasms, increased telomerase activity is associated with poor clinical outcomes. The objective of the present study was to evaluate the immunohistochemical expression and the potential prognostic value of E-cadherin and telomerase catalytic subunit [hTERT]in urothelial carcinoma of the urinary bladder by comparing them to other prognostic parameters as tumor grade, depth of invasion, and stage. The study comprised 54 patients with bladder tumors who underwent TUR or cystectomy. Formalin fixed paraffin sections from the tumors were processed with a hot, citric acid antigen retrieval method, followed by immunostaining using a monoclonal antibody E-cadherin [NCL-E-cad] Novocastra, mouse monoclonal antibody NCL-L-hTERT [Novovastra]and peroxidase detection system [Novocastra]. Showed loss of normal membrane E-cadherin immunoreactivity in 49 [90.7%] patients. Abnormal expression of E-cadherin was associated with muscle invasive disease [p = 0.0002] and high grade tumors [p = 0.0002].Telomerase [hTERT] was detected in 5 1/54 [94.4%] of urothelial carcinoma, and negative in all normal urothelium adjacent to the neoplasm in cystectomy specimens. No association was found between telomerase and other prognostic factors. In bladder cancer altered E-cadheri n expression is associated with the degree of invasiveness, and tumor grade. However, Telomerase [hTERT] detection by immunostaining is a highly sensitive diagnostic marker for urothelial malignancy but its value as a prognostic marker needs further assessment