title: Livin, Survivin and Caspase 3 as early recurrence markers in non-muscle-invasive bladder cancer.
abstract: OBJECTIVE
  To explore the potential correlation and prognostic value of Livin, Survivin and Caspase 3 expression in non-muscle-invasive bladder cancer (NMIBC).
  
  
  METHODS
  We prospectively examined the simultaneous expression of Livin, Survivin and Caspase 3 with immunohistochemistry in the paraffin blocks of 138 patients who underwent transurethral resection, and ten cases of normal bladder specimens were studied as the control group. During a 48-month follow-up, clinical pathologic factors including gender, age, pathology stage, histology grade, adjuvant therapy and recurrence time were recorded. The curves for recurrence-free survival (RFS) were estimated by the Kaplan-Meier method, and the relationship between these proteins' expression and clinical pathologic factors was analyzed with the Cox regression model.
  
  
  RESULTS
  Livin and Survivin showed a high expression (H-exp) level of 65.22 and 71.01 % in NMIBC, respectively, whereas Caspase 3 expression level was 50.72 %, and H-exp level of Livin and Survivin were 72.7 and 80.0 % in pT1 stage, respectively, which were proved to be higher than that in pTa/Tis ratio (P < 0.05). The relation between the H-exp and low-expression (L-exp) groups of Livin and Survivin and RFS were found statistically significant (P < 0.05). Conversely, there was better RFS in H-exp Caspase 3 group than in L-exp group (P < 0.05). A risk score was developed on the basis of all three biomarkers to estimate the prognosis of NMIBC patients, and those expressing high Survivin and Livin and low Caspase 3 had a significant shorter RFS time (P < 0.05).
  
  
  CONCLUSIONS
  Livin, Survivin and Caspase 3 may be valuable as promising indicators of early recurrence in NMIBC.
authors.affiliation: Division of Urology, Beijing ChaoYang Hospital, Capital Medical University, Beijing, 100020, China, wjianw88@gmail.com.
authors.forename: Jianwen
authors.initials: J
authors.lastname: Wang
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zhang
authors.forename: Ping
authors.initials: P
authors.lastname: Wei
authors.forename: Junhui
authors.initials: J
authors.lastname: Zhang
authors.forename: Yinong
authors.initials: Y
authors.lastname: Niu
authors.forename: Ning
authors.initials: N
authors.lastname: Kang
authors.forename: Yuxiang
authors.initials: Y
authors.lastname: Zhang
authors.forename: Weili
authors.initials: W
authors.lastname: Zhang
authors.forename: Nianzeng
authors.initials: N
authors.lastname: Xing
mesh_terms: D048868:Adaptor Proteins, Signal Transducing / Q000378:metabolism*; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002277:Carcinoma / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality; D053148:Caspase 3 / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D000077022:Survivin; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality
chemical_list: D048868:Adaptor Proteins, Signal Transducing; C107489:BIRC5 protein, human; C419866:BIRC7 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D009363:Neoplasm Proteins; D000077022:Survivin; D053148:Caspase 3