title: Reduced glucocorticoid receptor expression predicts bladder tumor recurrence and progression.
abstract: OBJECTIVE
  To assess the levels of glucocorticoid receptor (GR) expression in bladder tumors because the status and its prognostic value remain largely unknown.
  
  
  METHODS
  We immunohistochemically stained for GR in bladder tumor and matched non-neoplastic bladder tissue specimens.
  
  
  RESULTS
  Overall, GR was positive in 129 (87%) of 149 urothelial tumors, which was significantly (P=.026) lower than in non-neoplastic urothelium (90 [96%] of 94). Forty-two (79%) of 53 low-grade tumors vs 45 (47%) of 96 high-grade carcinomas (P<.001) and 61 (73%) of 84 non-muscle-invasive (NMI) tumors vs 26 (40%) of 65 muscle-invasive (MI) carcinomas (P<.001) were moderately to strongly immunoreactive for GR. Kaplan-Meier and log-rank tests revealed that loss or weak positivity of GR significantly or marginally correlated with recurrence of NMI tumors (P=.025), progression of MI tumors (P=.082), and cancer-specific survival of MI tumors (P=.067). Multivariate analysis identified low GR expression as a strong predictor for recurrence of NMI tumors (P=.034).
  
  
  CONCLUSIONS
  GR expression was downregulated in bladder tumors compared with nonneoplastic bladder tumors and in high-grade/MI tumors compared with low-grade/NMI tumors. Decreased expression of GR, as an independent prognosticator, predicted recurrence of NMI tumors. These results support experimental evidence suggesting an inhibitory role of GR signals in bladder cancer outgrowth.
authors.affiliation: From the Departments of Pathology and Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, and Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishiguro
authors.affiliation: From the Departments of Pathology and Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, and Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawahara
authors.affiliation: From the Departments of Pathology and Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, and Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY.
authors.forename: Yichun
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: From the Departments of Pathology and Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, and.
authors.forename: George J
authors.initials: GJ
authors.lastname: Netto
authors.affiliation: From the Departments of Pathology and Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, and Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY. hmiyamo1@jhmi.edu.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyamoto
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D018450:Disease Progression; D015536:Down-Regulation; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D005820:Genetic Testing; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D011965:Receptors, Glucocorticoid / Q000235:genetics / Q000378:metabolism*; D001743:Urinary Bladder / Q000378:metabolism; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D019459:Urothelium / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D011965:Receptors, Glucocorticoid
keywords: Bladder cancer; Glucocorticoid receptor; Immunohistochemistry; Progression; Recurrence