title: High expression of karyopherin-α2 defines poor prognosis in non-muscle-invasive bladder cancer and in patients with invasive bladder cancer undergoing radical cystectomy.
abstract: BACKGROUND
  Conventional clinicopathologic risk factors have failed to accurately predict the prognosis of patients with bladder cancer (BC).
  
  
  OBJECTIVE
  To evaluate karyopherin-α2 (KPNA2) expression as a progression marker in patients with non-muscle-invasive BC (NMIBC) treated by conservative methods and as a prognostic marker in patients with invasive BC undergoing radical cystectomy (RC).
  
  
  METHODS
  Two different tissue microarrays were constructed, one with 234 primary Ta/T1 tumours from patients treated by transurethral resection of the bladder and one with 377 tumours from RC patients.
  
  
  METHODS
  KPNA2 expression based on immunohistochemistry.
  
  
  METHODS
  Risk of progression of Ta/T1 patients to muscle-invasive BC was estimated in clinical follow-up to progression or a minimum of 53 mo. Risk of recurrent disease and death following RC was estimated in clinical follow-up of a minimum of 24 mo in patients alive.
  
  
  CONCLUSIONS
  A high KPNA2 expression in Ta/T1 patients was significantly correlated with a higher risk of progression that was independent of conventional risk factors in multivariate analysis. In patients undergoing RC, a high KPNA2 expression was an independent predictor of poor prognosis. A high KPNA2 expression was correlated with a higher risk of visceral metastasis rather than lymphatic spread.
  
  
  CONCLUSIONS
  KPNA2 expression is a marker for progression of NMIBC and a prognostic marker in patients undergoing RC.
authors.affiliation: Department of Urology, Aarhus University Hospital, Skejby, Denmark.
authors.forename: Jørgen Bjerggaard
authors.initials: JB
authors.lastname: Jensen
authors.forename: Pia Pinholt
authors.initials: PP
authors.lastname: Munksgaard
authors.forename: Christoffer Mørk
authors.initials: CM
authors.lastname: Sørensen
authors.forename: Niels
authors.initials: N
authors.lastname: Fristrup
authors.forename: Karin
authors.initials: K
authors.lastname: Birkenkamp-Demtroder
authors.forename: Benedicte Parm
authors.initials: BP
authors.lastname: Ulhøi
authors.forename: Klaus Møller-Ernst
authors.initials: KM
authors.lastname: Jensen
authors.forename: Torben F
authors.initials: TF
authors.lastname: Ørntoft
authors.forename: Lars
authors.initials: L
authors.lastname: Dyrskjøt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D015153:Blotting, Western; D019556:COS Cells; D045744:Cell Line, Tumor; D002522:Chlorocebus aethiops; D015653:Cystectomy / Q000009:adverse effects / Q000401:mortality; D003718:Denmark; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D046888:Tissue Array Analysis; D014162:Transfection; D016896:Treatment Outcome; D015854:Up-Regulation; D001749:Urinary Bladder Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D028901:alpha Karyopherins / Q000235:genetics / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; C490630:KPNA2 protein, human; D028901:alpha Karyopherins