Title | Association of oncofetal protein expression with clinical outcomes in patients with urothelial carcinoma of the bladder. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Xylinas E, Cha EK, Khani F, Kluth LA, Rieken M, Volkmer BG, Hautmann R, Küfer R, Chen Y-T, Zerbib M, Rubin MA, Scherr DS, Shariat SF, Robinson BD |
Journal | J Urol |
Volume | 191 |
Issue | 3 |
Pagination | 830-41 |
Date Published | 2014 Mar |
ISSN | 1527-3792 |
Keywords | Aged, Antigens, Neoplasm, Antigens, Surface, Biomarkers, Tumor, Carcinoma, Transitional Cell, Cystectomy, Glypicans, Humans, Lymph Node Excision, Lymphatic Metastasis, Membrane Glycoproteins, Middle Aged, Neoplasm Grading, Neoplasm Proteins, Neoplasm Staging, RNA-Binding Proteins, Treatment Outcome, Urinary Bladder, Urinary Bladder Neoplasms |
Abstract | PURPOSE: Oncofetal proteins are expressed in the developing embryo. Oncofetal protein expression correlates with the clinical outcome of nonmuscle invasive bladder urothelial carcinoma. IMP3, MAGE-A, glypican-3 and TPBG are oncofetal proteins that have not been well characterized in urothelial carcinoma of the bladder. MATERIALS AND METHODS: We investigated the expression of these 4 proteins and their association with clinical outcomes using tissue microarrays from 384 consecutive patients treated with radical cystectomy between 1988 and 2003 at 1 academic center. We stained for IMP3, MAGE-A, glypican-3 and TPBG. Univariable and multivariable Cox regression analyses were done to evaluate the association of oncofetal protein expression with disease recurrence and cancer specific mortality. RESULTS: IMP3, MAGE-A, glypican-3 and TPBG were expressed in 39.5%, 45%, 6% and 85% of urothelial bladder carcinomas, respectively. Expression was tumor specific and did not correlate with pathological features except for TPBG. At a median followup of 128 months 176 patients (46%) experienced disease recurrence, 175 (45.5%) had died of the disease and 96 (27.5%) had died of another cause. On univariable analysis IMP3 and MAGE-A expression was associated with an increased risk of disease recurrence (p <0.001 and 0.03) and cancer specific mortality (p = 0.004 and 0.03, respectively). On multivariable Cox regression analysis adjusted for the effects of standard clinicopathological features IMP3 and MAGE-A expression was independently associated with disease recurrence (p = 0.004, HR 1.55, 95% CI 1.15-2.11 and p = 0.02, HR 1.44, 95% CI 1.05-1.99, respectively) but not with cancer specific mortality. CONCLUSIONS: Oncofetal proteins are commonly and differentially expressed in urothelial carcinoma of the bladder compared to normal urothelium. IMP3 and MAGE-A expression was associated with disease recurrence and cancer specific mortality but glypican-3 and TPBG expression was not. |
DOI | 10.1016/j.juro.2013.08.048 |
Alternate Journal | J Urol |
PubMed ID | 23994370 |
Related Faculty:
Brian Robinson, M.D. Francesca Khani, M.D.