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Epithelial–mesenchymal transformation markers E-cadherin and survivin predict progression of stage pTa urothelial bladder carcinoma
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Epithelial–mesenchymal transformation markers E-cadherin and survivin predict progression of stage pTa urothelial bladder carcinoma
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Journal Article
Epithelial–mesenchymal transformation markers E-cadherin and survivin predict progression of stage pTa urothelial bladder carcinoma
2016
Overview
Purpose
To determine whether the immunohistochemical markers survivin and E-cadherin can predict progress at initially diagnosed Ta bladder cancer.
Methods
We retrospectively searched for every initially diagnosed pTa urothelial bladder carcinoma having been treated at our single-center hospital in Germany from January 1992 up to December 2004. Follow-up was recorded up to June 2010, with recurrence or progress being the endpoints. Immunohistochemical staining and analysis of survivin and E-cadherin of the TURB specimens were performed. Outcome dependency of progression and no progression with immunohistochemical staining was analyzed using uni- and multivariate regression analysis, Kaplan–Meier analysis and uni- and multivariate Cox regression analysis.
Results
Overall, 233 patients were included. Forty-two percent of those were tumor free in their follow-up TURBs, 46 % had at least one pTa recurrence and 12 % even showed progress to at least pT1 bladder cancer. Aberrant staining of E-cadherin was found within 71 % of patients with progression in contrast to only 40 % in cases without progression (
p
= 0.004). Of all progressed patients, 92 % showed overexpression of survivin in their initial pTa specimen compared to 61 % without progression (
p
= 0.001). Kaplan–Meier analysis revealed aberrant E-cadherin staining to be associated with worse progression-free survival (PFS) (
p
= 0.005) as well as overexpression of survivin (
p
= 0.003). In multivariate Cox regression analysis, strong E-cadherin staining was an independent prognosticator for better PFS (
p
= 0.033) and multifocality (
p
= 0.046) and tumor size over 3 cm (
p
= 0.042) were prognosticators for worse PFS.
Conclusion
Adding the immunohistochemical markers survivin and E-cadherin could help to identify patients at risk of developing a progressive disease in initial stage pTa bladder cancer.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
/ Carcinoma, Transitional Cell - chemistry
/ Carcinoma, Transitional Cell - pathology
/ Epithelial-Mesenchymal Transition
/ Female
/ Humans
/ Inhibitor of Apoptosis Proteins - analysis
/ Male
/ Medicine
/ Oncology
/ Urinary Bladder Neoplasms - chemistry
/ Urinary Bladder Neoplasms - pathology
/ Urology
