title: Clinical Use of Tumor Markers for the Detection and Prognosis of Bladder Carcinoma: A Comparison of CD44, Cytokeratin 20 and Survivin.
abstract: OBJECTIVE
  To investigate the role of CD44, cytokeratin 20 (CK20) and survivin for the detection and prognosis of patients with urothelial carcinoma of the bladder.
  
  
  METHODS
  The study included 82 patients who underwent transurethral resection of bladder tumors between 2009 and 2014. The patient and tumor characteristics with relevance to age, tumor size and focality, grade and stage, recurrence and progression were noted. Patients with carcinoma in situ, those who had at more than 3 sites of lesions and greater than 3 cm tumors were excluded. All cases were ex-smokers. All histological samples stained with hematoxylin and eosin were re-evaluated according to the 2004 World Health Organization/International Society of Urological Pathology (WHO/ISUP) classification system and immunohistochemically stained for CD44, CK20 and survivin.
  
  
  RESULTS
  The study group comprised 57 (69.5%) males and 25 (30.5%) females with a mean age of 60 years (range, 26-87 years). All were newly-diagnosed patients with bladder tumors. Immunohistochemical evaluation revealed that there was a statistically significant correlation between the grade and stage of the tumor with CK20 and survivin positivity (P &lt; .05). As the grade and stage increased CD44 immunoreactivity significantly decreased (P = .002, P = .0001, respectively). However, relationship of protein expressions with recurrence and progression remained insignificant (P &gt; .05).
  
  
  CONCLUSIONS
  In cases of bladder urothelial carcinoma positivity for CD44, CK20, and survivin has significant relation with the tumor grade and stage while no significant relationship was determined in terms of recurrence and progression&nbsp.
authors.affiliation: Department of Urology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara 06200, Turkey. numanyikilmaz@gmail.com.
authors.forename: Taha Numan
authors.initials: TN
authors.lastname: Yikilmaz
authors.affiliation: Department of Urology, Baskent University, Ankara 06200, Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Dirim
authors.affiliation: Department of Pathology, Baskent University, Ankara 06200, Turkey.
authors.forename: Ebru Sebnem
authors.initials: ES
authors.lastname: Ayva
authors.affiliation: Department of Pathology, Baskent University, Ankara 06200, Turkey.
authors.forename: Handan
authors.initials: H
authors.lastname: Ozdemir
authors.affiliation: Department of Urology, Baskent University, Ankara 06200, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozkardes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000032:analysis*; D051034:Inhibitor of Apoptosis Proteins / Q000032:analysis*; D053554:Keratin-20 / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D000077022:Survivin; D001749:Urinary Bladder Neoplasms / Q000737:chemistry* / Q000473:pathology
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; C497483:CD44 protein, human; D018960:Hyaluronan Receptors; D051034:Inhibitor of Apoptosis Proteins; D053554:Keratin-20; D000077022:Survivin