Immunohistochemical Analysis of Urothelial Bladder Cancers

Abstract

Malignant cancers of urinary bladder are the second most common malignancy of the urinary tract and the fourth most common malignancy in general, especially in men. The aim of this study was a retrospective analysis of selected markers (p53, Ki-67 and E-cadherin) of urinary bladder cancers from the Department of Urology in Bratislava, Slovak Republic between years 2007 and 2009. We analysed 244 patients (202 males, 42 females) with diagnosed bladder cancer via cystoscopy and subsequent transurethral resection. Patients' age varied from 36 to 98 years. Obtained samples were fixed by 10% buffered formalin for 24 to 48 h. Subsequently, they were dehydrated in ascending ethanol series and embedded in paraffin. The parafin sections of 5 µ m were prepared by microtome and they were stained by haematoxylin and eosin. The antibodies against to p53, Ki-67 and E-cadherin were used in immunohistochemical analysis. Statistical evaluation was performed via SPSS using non-parametric Kruskal-Wallis test and p values<0.05 were considered statistically significant. No significant differences in the expression of selected markers were found between genders. Expression of p53 and Ki-67, in G1 and G2 of low grade tumours was lower in comparison to their expression in G3 tumors. Expression of E-cadherin was the opposite in this case. The expression of p53 and Ki-67 positively correlated with tumor's depth of invasion, while the expression of E-cadherin significantly decreased. In case of T4 tumors, the expression of all markers exhibited consistently high values. When analysing tumor multiplicity, the expression of p53 and Ki-67 significantly decreased, while the expression of E-cadherin significantly increased. Based on the obtained results it can be concluded that the analysis of p53, Ki-67 and E-cadherin expression is essential for diagnostics and prognostics of bladder cancer and should be routinely used in daily practise together with "conventional" markers to improve prognosis estimation.

Bcl-2 over-expression in urothelial tumors of the bladder. An immunohistochemical study

“…Statistically, the overexpression of Bcl2 in relation to stage was not significant confirming the observation by others. 9,14,15,17 On the contrary other studies had reported significant correlation with higher stages. 10,12,13,20 (13) 2013…”

“…Oncogenes may contribute to transformation and progression of tumors by being either overexpressed or mutated to produce an oncoprotein. 9 One of the more important mechanisms by which oncogenes are overexpressed in bladder cancer is through gene amplification. 9 Overexpression of Bcl-2 has been reported in a wide variety of cancers including those of prostate, colorectum, lung, kidney, and bladder.…”

“…9 One of the more important mechanisms by which oncogenes are overexpressed in bladder cancer is through gene amplification. 9 Overexpression of Bcl-2 has been reported in a wide variety of cancers including those of prostate, colorectum, lung, kidney, and bladder. 10 Several studies have provided conclusive evidence that over-expressionof Bcl-2 causes resistance to both chemotherapy and radiotherapy and increases the proliferation of malignant cells.…”

Current look at the most promising proteomic and glycomic biomarkers of bladder cancer

“…Diagnosis, therapy, and prognosis of NMIBC suffer from an unpredictable recurrence rate and a chance of progression, while MIBC often represents aggressive neoplasms with peripheral invasion, metastases, and poor response to treatment (Cho et al 2009 ; Fukumoto et al 2016 ). Classic immunohistochemical analysis of cancer tissue is widely utilized, but studies show that this method is unsuitable for the use of prediction of recurrence and progression (Bevizova et al 2013 ; Repiska et al 2010 ). Over the last few years, the European Association of Urology (EAU) has slowly adopted and implemented molecular markers into BC diagnosis, but they are not yet suitable for routine application, and cystoscopy in combination with cytology is still the gold standard (EAU Guidelines 2020 , 2021 , 2022 ).…”