title: Loss of coxsackie and adenovirus receptor expression is associated with features of aggressive bladder cancer.
abstract: OBJECTIVE
  To examine whether loss of coxsackie and adenovirus receptor (CAR) expression is associated with bladder cancer characteristics and clinical outcomes and with expression of p53 and E-cadherin. Low levels of CAR are associated with decreased efficiency of adenovirus-mediated gene transduction of bladder transitional cell carcinoma.
  
  
  METHODS
  Immunohistochemical staining for CAR and p53 was carried out on tissue microarrays from 62 patients who had undergone radical cystectomy. We also examined 30 specimens for E-cadherin expression.
  
  
  RESULTS
  CAR expression was lost in 17 (27%) of 62 tumors. Loss of CAR expression was associated with metastases to regional lymph nodes (P = 0.049), muscle-invasive disease (P = 0.025), grade 3 disease (P = 0.038), altered p53 status (P = 0.041), and loss of E-cadherin expression (P = 0.042). With a median follow-up of 60 months, loss of CAR expression was associated with decreased bladder cancer-specific survival (P = 0.029) but not disease progression. When adjusted for the effects of standard pathologic features, only lymph node metastasis was associated with bladder transitional cell carcinoma progression and mortality.
  
  
  CONCLUSIONS
  Loss of CAR expression is associated with established markers of biologically aggressive bladder transitional cell carcinoma. The association of CAR with E-cadherin and p53 suggests a potential role for CAR in the regulation of urothelium integrity and the cell cycle.
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Methodist Hospital, Houston, Texas, USA.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Gustavo E
authors.initials: GE
authors.lastname: Ayala
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Rauen
authors.forename: Seth P
authors.initials: SP
authors.lastname: Lerner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015820:Cadherins / Q000096:biosynthesis; D002295:Carcinoma, Transitional Cell / Q000378:metabolism* / Q000473:pathology*; D062727:Coxsackie and Adenovirus Receptor-Like Membrane Protein; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011991:Receptors, Virus / Q000096:biosynthesis*; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000473:pathology*
chemical_list: C568771:CLMP protein, human; D015820:Cadherins; D062727:Coxsackie and Adenovirus Receptor-Like Membrane Protein; D011991:Receptors, Virus; D016159:Tumor Suppressor Protein p53