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Title of the item:

Epithelial-mesenchymal transformation markers E-cadherin and survivin predict progression of stage pTa urothelial bladder carcinoma.

Epithelial-mesenchymal transformation markers E-cadherin and survivin predict progression of stage pTa urothelial bladder carcinoma.
Breyer, Johannes
Gierth, Michael
Shalekenov, Sanzhar
Aziz, Atiqullah
Schäfer, Julius
Burger, Maximilian
Denzinger, Stefan
Hofstädter, Ferdinand
Giedl, Christian
Otto, Wolfgang
Subject Terms:
BLADDER cancer diagnosis
MESENCHYMAL stem cells
CANCER invasiveness
TUMOR markers
TRANSITIONAL cell carcinoma
World Journal of Urology; May2016, Vol. 34 Issue 5, p709-716, 8p
Academic Journal
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. [ABSTRACT FROM AUTHOR]
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