Abstract. Heat shock protein 105 (Hsp105) is one of the cancer/testis antigens, which is overexpressed in a variety of cancer cells, including urinary bladder cancer, and has been investigated as a target molecule for immunotherapy due to its immunogenicity. In this study, we assessed the expression of Hsp105 in primary bladder cancer samples from 84 patients treated with radical cystectomy, using immunohistochemical analysis, and investigated its correlation with clinicopathological characteristics and cancer-specific survival. The immunoreactivity of Hsp105 expression was evaluated as a score of 0-3, according to the intensity of the signal. The Hsp105 expression was high (score 2 or 3) in 31 cases and low (score 0 or 1) in 53 cases; however, it was not significantly correlated with age, nuclear grade, pathological tumor stage and previous intravesical Bacillus Calmette-Guérin immunotherapy. Female gender, lymphovascular invasion and lymph node metastasis were associated with low Hsp105 scores, although the differences were not statistically significant (P=0.071, 0.061 and 0.175, respectively). However, a high Hsp105 score was significantly associated with a favorable prognosis (P=0.017) and was identified as an independent prognostic factor by multivariate analysis (P=0.032; hazard ratio, 2.34). These findings suggested that the expression of Hsp105 may be a novel indicator of a favorable prognosis in bladder cancer.
IntroductionUrinary bladder cancer is the second most common urological cancer and is responsible for 2.0% of cancer-related mortality cases worldwide (1). Muscle invasion is a key factor for the prognosis of patients with bladder cancer. Non-muscle invasive bladder cancer (stages Ta, T1 and Tis) generally has a good prognosis, whereas muscle-invasive bladder cancer (MIBC; stages T2, T3 and T4) frequently develops metastases and has a poor prognosis, with a 5-year survival of 65-70% following radical cystectomy (2,3). However, clinical and pathological markers for the prediction of prognosis of patients with bladder cancer following radical cystectomy have not yet been established.Heat shock proteins (HSPs) are stress proteins released in response to various stress factors, such as heat, infection, ischemia and cancer (4). The expression of HSPs in cancer cells has been implicated in the regulation of apoptosis (5,6). HSPs also modulate cancer cell immunogenicity (7,8). Heat shock protein 105 (Hsp105) is a high-molecular-weight protein that belongs to the Hsp105̸110 family. It is one of several cancer̸testis antigens that were identified by serological analysis of antigens by recombinant expression cloning (SEREX) (9). Previous studies have suggested that Hsp105 enhances stress-induced apoptosis in embryonal cells (10), while suppressing stress-induced apoptosis in neuronal (11) and cancer cells (12,13). Hosaka et al (12) reported that the knockdown of Hsp105 induced apoptosis in the HCT116 human colon cancer and the KATO-3 human gastric cancer cell lines. Furthermore, Hsp105 was shown to be ove...