Prognostic significance of apoptotic cell death in bladder cancer: a tissue microarray study on 179 urothelial carcinomas from cystectomy specimens.
OBJECTIVE
To assess the prognostic significance of apoptosis related markers in bladder cancer.


METHODS
A tissue microarray containing 179 bladder carcinomas from cystectomy specimens was analysed immunohistochemically for active caspase-3, single-stranded DNA (ssDNA), p53, Bcl-2, Bax, and COX-2, in correlation to clinicopathological factors.


RESULTS
Active caspase-3, ssDNA, p53, Bax and COX-2 were more frequently observed among high grade and higher stage (> or =T2) carcinomas compared with low grade and lower stage (T1) tumours. On the contrary, Bcl-2 was more frequently detected in T1 than in > or =T2 carcinomas. Active caspase-3 correlated with a better survival of the patients.


CONCLUSIONS
The decreased detection of active caspase-3 and ssDNA and the increased presence of Bcl-2 in T1 carcinomas suggest that alterations in interrelated apoptosis markers may play an important role in the progression of urothelial carcinoma from a superficially infiltrating to a muscle invading tumour and would help to better characterise a subpopulation of T1 carcinomas that could profit from early cystectomy or more aggressive adjuvant chemotherapy. Active caspase-3 might be an important prognostic factor in bladder cancer.
Karamitopoulou
Eva
E
2nd Department of Pathology, University of Athens, Attikon University Hospital, Athens, Greece.
Rentsch
Cyrill A
CA
Markwalder
Regula
R
Vallan
Claudio
C
Thalmann
George N
GN
Brunner
Thomas
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000378:metabolism; D002295:Carcinoma, Transitional Cell / Q000235:genetics / Q000378:metabolism / Q000401:mortality / Q000556:secondary*; D053148:Caspase 3 / Q000378:metabolism; D015653:Cystectomy; D053938:DNA Fragmentation; D004273:DNA, Neoplasm; D004277:DNA, Single-Stranded; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D046888:Tissue Array Analysis; D001749:Urinary Bladder Neoplasms / Q000235:genetics / Q000378:metabolism / Q000401:mortality / Q000473:pathology*
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D004277:DNA, Single-Stranded; D053148:Caspase 3