Mcm2 predicts recurrence hazard in stage Ta/T1 bladder cancer more accurately than CK20, Ki67 and histological grade

Abstract

Stage Ta/T1 urothelial carcinoma of the bladder (Ta/T1 BC) has a marked tendency to recur. Besides histopathology, markers such as CK20 expression and proliferation index (Ki67) have been shown to predict its clinical course. The replication-licensing factor minichromosome maintenance protein 2 (Mcm2) is a marker of proliferative potential shown to be a promising prognostic marker in various malignancies. The aim of the present study was to evaluate the prognostic value of Mcm2 in comparison to stage, grade, CK20 and Ki67. Initial sporadic Ta/T1 BC (n ¼ 71) were evaluated for their expression of CK20, Ki67 and Mcm2 by immunohistochemistry and tissue microarray technology. Prognostic power was analysed by univariate and multivariate Cox regression model for tumour recurrence rate. Median follow-up period was 39 months. A total of 35% patients experienced recurrence. While CK20 was not predictive, grade, Ki67 and Mcm2 were significantly related to recurrence rate in univariate Cox regression model. Only grade (HR 2.37; 95% CI 1.24 -4.51; P ¼ 0.009) and Mcm2 expression with a cutoff X40% (HR 5.81; 95% CI 2.41 -14.00; Po0.001) were independent predictors of recurrence rate in multivariate Cox regression analysis. In addition to grade, expression of Mcm2 is an independent predictor of recurrence in Ta/T1 BC.

A Novel Molecular Grading Model: Combination of Ki67 and VEGF in Predicting Tumor Recurrence and Progression in Non-invasive Urothelial Bladder Cancer

“…In previous studies, increased Ki67 expression was proven to be related to tumor grade, stage, recurrence, progression and the survival of bladder cancer (Margulis et al, 2006;Yurakh et al, 2006;Gonul et al, 2008;Margulis et al, 2009;van Rhijn et al, 2010). It is an independent risk factor for prognosis (Burger et al, 2007). Vascular endothelial growth factor (VEGF) is a potent stimulator of endothelial cell proliferation in vitro and in vivo16.…”

Multifunctional Imaging Signature for V-KI-RAS2 Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) Mutations in Colorectal Cancer

“…Images were then captured using an Olympus DP20 digital camera and displayed on a computer monitor. For mcm2, 3 separate areas of tumor were analyzed, and cases with greater than 40% of tumor cells positive with mcm2 were scored as positive, the prognostic value of threshold having previously been established for other tumor types (26,27). The HIF-1a score was based on the combined cytoplasmic and nuclear staining as previously described (28).…”

Comparative Evaluation of ProEx C and ImmunoCyt/uCyt Assays in Atypical Urine Cytology

“…[8][9][10] During the past several years, literature has emerged regarding the value of minichromosome maintenance protein 2 (MCM2) and minichromosome maintenance protein 5 (MCM5) as immunoassays in urothelial carcinoma. [11][12][13] A short publication in the Lancet in 1999, by Stoeber K et al 13 reported on the possible use of MCM5 as a noninvasive, urinary, cytologic, immunofluorometric assay for the detection of urothelial cancers. High expression levels of MCM2 have also been shown to be of prognostic value in predicting urothelial tumor recurrence, particularly in T1 tumor evaluation.…”

“…High expression levels of MCM2 have also been shown to be of prognostic value in predicting urothelial tumor recurrence, particularly in T1 tumor evaluation. 11,12 MCM2 and MCM5 are part of a highly conserved family of proteins responsible for the unwinding of the DNA helix during initiation of replication in eukaryotic cells. The dysregulation of these proteins is a key characteristic of changes associated with urothelial neoplasia.…”

“…11,[15][16][17][18] In our institution, uCyt is a commonly used ancillary test. 17 It identifies 3 biomarkers, 2 for the mucin glycoprotein and one for the glycosylated form of carcinoembryonic antigen commonly found in bladder cancer cells.…”