title: Human epidermal growth factor receptor 2: a significant indicator for predicting progression in non-muscle-invasive bladder cancer especially in high-risk groups.
abstract: OBJECTIVE
  Current pathological and clinical parameters provide important prognostic information. However, they are still limitations for predicting the true malignant potential of a specific cancer. The aim of this study was to validate the predicting role of HER-2 expression and demonstrated that combination of the high-risk factors with HER-2 expression is more valuable for determining which non-muscle-invasive bladder cancer (NMIBC) is more aggressive.
  
  
  METHODS
  In total, 238 patients treated by transurethral resection of the bladder tumor were histopathologically confirmed to be NMIBC. Two experienced uropathologists re-reviewed the slides. HER-2 expression was evaluated by immunohistochemistry and scored for intensity and area of staining. The association of HER-2 staining with tumor recurrence and progression was evaluated by univariate and multivariate analyses and Kaplan-Meier survival curves.
  
  
  RESULTS
  In multivariable analyses, HER-2 expression was an independent risk factor for predicting tumor progression (HR 2.64, p = 0.024). Combining the EORTC risk scores with HER-2 expression status led to more accurate prediction of progression, especially in patients with intermediate- and high-risk EORTC scores (p < 0.0001, log-rank test).
  
  
  CONCLUSIONS
  HER-2 positivity is prognostic for predicting progression to muscle invasion in NMIBC. Combination of the high-risk factors with HER-2 expression is more valuable for determining which NMIBC is more aggressive.
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 200040, China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Ding
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 200040, China.
authors.forename: Shijun
authors.initials: S
authors.lastname: Tong
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 200040, China.
authors.forename: Yuancheng
authors.initials: Y
authors.lastname: Gou
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 200040, China.
authors.forename: Chuanyu
authors.initials: C
authors.lastname: Sun
authors.affiliation: Department of Pathology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Pathology, Huashan Hospital, Fudan University, Shanghai, 200040, China.
authors.forename: Zhongqing
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Biostatistics and Social Medicine, School of Public Health, Fudan University, Shanghai, 200032, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Tan
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 200040, China. drkexu@163.com.
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 200040, China.
authors.forename: Guowei
authors.initials: G
authors.lastname: Xia
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 200040, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ding
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000378:metabolism* / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000473:pathology*; D055815:Young Adult
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: EORTC; HER-2; Immunohistochemistry; Non-muscle-invasive bladder cancer; Prognosis