title: Expression of cathepsin D in bladder carcinoma: correlation with pathological features and serum cystatin C levels.
abstract: OBJECTIVE
  The aim of this study is to evaluate the expression of cathepsin D in primary bladder cancer and to determine its relationship with conventional pathological features and serum cystatin C levels.
  
  
  METHODS
  The immunohistochemical cathepsin D expression and staining patterns of epithelial and stromal cells were investigated in 21 patients with primary bladder carcinoma. Serum cystatin C levels were determined by immunoturbidimetry and compared with matched controls.
  
  
  RESULTS
  There were 7 papillary neoplasms of low malignant potential, 7 low-grade and 7 high-grade carcinomas. Six tumors were invasive. Statistical analysis showed a significant inverse relationship between cathepsin D expression of the tumor cells and tumor grade and stage (P = 0.018 and P = 0.046, respectively). Serum cystatin C levels of the controls and patients varied between 0.39 mg/L and 1.99 mg/L (P > 0.05). There was no significant relation between cathepsin D expression in tumor tissue and serum cystatin C levels.
  
  
  CONCLUSIONS
  Loss of cathepsin D expression in bladder carcinomas may be associated with high-grade and invasive tumors. Thus, increased cathepsin D expression by tumor cells may be related to local tumor invasion at an early stage, but it seems that extracellular cystatin C is not affected by cathepsin D expression of tumor or stromal cells, and cystatin C concentrations are not directly correlated with the progression of primary bladder carcinomas.
authors.affiliation: Department of Pathology, School of Medicine, Afyon Kocatepe University, Afyon, Turkey. ctokyol@yahoo.com
authors.forename: Cidğem
authors.initials: C
authors.lastname: Tokyol
authors.forename: Tülay
authors.initials: T
authors.lastname: Köken
authors.forename: Murat
authors.initials: M
authors.lastname: Demirbas
authors.forename: Fatma Hüsniye
authors.initials: FH
authors.lastname: Dilek
authors.forename: Kutsal
authors.initials: K
authors.lastname: Yörükoglu
authors.forename: Ugur
authors.initials: U
authors.lastname: Mungan
authors.forename: Ziya
authors.initials: Z
authors.lastname: Kirkali
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000097:blood; D002277:Carcinoma / Q000097:blood / Q000737:chemistry* / Q000473:pathology*; D016022:Case-Control Studies; D002402:Cathepsin D / Q000032:analysis*; D055316:Cystatin C; D015891:Cystatins / Q000097:blood*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D001749:Urinary Bladder Neoplasms / Q000097:blood / Q000737:chemistry* / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D002402:Cathepsin D