title: HSP60 may predict good pathological response to neoadjuvant chemoradiotherapy in bladder cancer.
abstract: BACKGROUND
  Heat shock proteins (HSPs) play crucial roles in cellular responses to stressful conditions. Expression of HSPs in invasive or high-risk superficial bladder cancer was investigated to identify whether HSPs predict pathological response to neoadjuvant chemoradiotherapy (CRT).
  
  
  METHODS
  Immunohistochemistry was used to assess expression levels of HSP27, HSP60, HSP70, HSP90 and p53 in 54 patients with invasive or high-risk superficial bladder cancer, prior to low-dose neoadjuvant CRT, followed by radical or partial cystectomy. Patients were classified into two groups (good or poor responders) depending on pathological response to CRT, which was defined as the proportion of morphological therapeutic changes in surgical specimens. Good responders showed morphological therapeutic changes in two-thirds or more of tumor tissues. In contrast, poor responders showed changes in less than two-thirds of tumor tissues.
  
  
  RESULTS
  Using a multivariate analysis, positive HSP60 expression prior to CRT was found to be marginally associated with good pathological response to CRT (P = 0.0564). None of clinicopathological factors was associated with HSP60 expression level. In the good pathological responders, the 5-year cause-specific survival was 88%, which was significantly better than survival in the poor responders (51%) (P = 0.0373).
  
  
  CONCLUSIONS
  Positive HSP60 expression prior to CRT may predict good pathological response to low-dose neoadjuvant CRT in invasive or high-risk superficial bladder cancer.
authors.affiliation: Department of Urology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Urushibara
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kageyama
authors.forename: Takumi
authors.initials: T
authors.lastname: Akashi
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Touichiro
authors.initials: T
authors.lastname: Takizawa
authors.forename: Morio
authors.initials: M
authors.lastname: Koike
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kihara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015415:Biomarkers; D001706:Biopsy; D018834:Chaperonin 60 / Q000378:metabolism*; D005260:Female; D006360:Heat-Shock Proteins / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012189:Retrospective Studies; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D018834:Chaperonin 60; D006360:Heat-Shock Proteins