Loss of androgen receptor expression is not associated with pathological stage, grade, gender or outcome in bladder cancer: a large multi-institutional study.
OBJECTIVE
• To investigate androgen receptor (AR) expression in a large series of patients with bladder cancer (BC) because data on a limited number of patients showed that loss of AR expression was associated with invasive BC.


METHODS
• A total of 472 patients with urothelial bladder carcinoma (UBC) from two institutional centres (Toronto and Dallas) were analysed. Tissue microarrays comprising both non-muscle-invasive UBC (n= 167) and muscle-invasive UBC (n= 305) were accrued and immunohistochemical staining for AR was performed. • We used bright-field microscopy imaging coupled with advanced colour detection software to detect, classify and count stained cellular objects and manual scoring. • Results obtained in Dallas were blindly reviewed and validated in Toronto and samples randomly chosen were further analysed in Rochester, NY, USA.


RESULTS
• The AR were positively expressed in 61/472 (12.9%) bladder tumours. No statistically significant difference in AR expression between men and women was observed. • Only 9.0% of non-muscle-invasive BC expressed the AR compared with 15.1% of muscle-invasive tumours (P= 0.059). The highest percentage of AR positivity (28.9% of cases) was found in T2 tumours. • There was no statistically significant difference in death from BC, time to death, or time to recurrence between AR-positive and AR-negative cases.


CONCLUSIONS
• In contrast to previous reports, based on our large BC series, we did not observe a decrease in AR protein expression in bladder tumours with increased pathological stage. Our data do not suggest that loss of AR expression is gender-related nor is it associated with invasive BC.
Division of Urology, Mount Sinai Hospital, Rochester, NY, USA.
Carmen
C
Mir
Shahrokh F
SF
Shariat
Theodorus H
TH
van der Kwast
Raheela
R
Ashfaq
Yair
Y
Lotan
Andrew
A
Evans
Sean
S
Skeldon
Sally
S
Hanna
Rati
R
Vajpeyi
Cynthia
C
Kuk
Sultan
S
Alkhateeb
Juan
J
Morote
Bas W G
BW
van Rhijn
Peter
P
Bostrom
Jorge
J
Yao
Hiroshi
H
Miyamoto
Michael
M
Jewett
Neil
N
Fleshner
Ed
E
Messing
Alexandre R
AR
Zlotta
D014408:Biomarkers, Tumor / Q000378:metabolism*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009361:Neoplasm Invasiveness; D011379:Prognosis; D011944:Receptors, Androgen / Q000378:metabolism*; D012737:Sex Factors; D046888:Tissue Array Analysis; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000473:pathology*
D014408:Biomarkers, Tumor; D011944:Receptors, Androgen