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Role of Tumor Suppressor and Angiogenesis Markers in Prediction of Recurrence of Non Muscle Invasive Bladder Cancer

  • Published:
Pathology & Oncology Research

Abstract

Non muscle invasive bladder cancers recur frequently and identification of biomarkers for predicting recurrence are necessary. The present study evaluated the individual and synergistic effects of tumor suppressor (p53/p21waf1) and angiogenesis [vascular endothelial growth factor (VEGF)/endoglin (CD105)] markers. The study included 90 cases of non muscle invasive bladder cancer. Cell spots were stained with primary antibodies and Flourescein isothiocyanate (FITC). Slides were observed under confocal laser scanning microscope for protein expression. The association between the markers individually and synergistically with recurrence were assessed by a χ2 and Fisher’s Exact test. Survival analysis was performed to predict recurrence and test for significant difference in recurrence free survival probability. Recurrence [overall:39(43.3%) and low grade(LG):26(54.2%)] was significant with p53 and VEGF expression and the profiles p53/VEGF, p53/CD105, VEGF/CD105, p53/p21/CD105, p53/VEGF/CD105 and all four were significantly associated with recurrence in both groups. In the multivariable model the [HR(95%CI),p: overall and LG] profiles p21/VEGF [2.195(1.052-4.582),0.036; 3.425(1.332-8.811),0.011], VEGF/CD105[2.624(1.274-5.403),0.009 and 3.380(1.348-8.472),0.009], p53/p21/CD105 [2.000(0.993-4.027),0.052 and 2.539(1.047-6.157),0.039], p53/VEGF/CD105 [2.360(1.148-4.849),0.020 and 2.738(1.104-6.788),0.030], p21/VEGF/CD105 [2.611(1.189-5.731),0.017 and 3.946(1.530-10.182),0.005] and all four [2.382(1.021-5.556),0.045 and 3.572(1.287-9.911),0.014] significantly predicted the recurrence along with significant log rank. In the pTa subset (n = 33) the profiles p53/p21, p53/CD105, p21/VEGF, VEGF/CD105, p53/VEGF/CD105, p53/p21/CD105 and p21/VEGF/CD105, significantly predicted hazard for recurrence. The present study emphasizes an underlying association between tumor suppressor (p21waf1) and angiogenesis (VEGF/CD105) biomarkers. In addition combination profiles appeared to indicate an aggressive nature with high propensity for recurrence in LG and pTa tumours.

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References

  1. Consolidated Report of Population Based Cancer Registries 2001–2004, Incidence and Distribution of Cancer (2006) National Cancer Registry Programme. Indian Council of Medical Research (ICMR). Bangalore

  2. Mackenzie N, Torti FM, Faysal M (1981) The natural history of superficial bladder tumors. Proc Am Soc Cancer Res 22:198

    Google Scholar 

  3. Oosterlinck W, Lobel B, Jakse G et al (2002) European Association of Urology (EAU) working group on oncological urology. Guidelines on bladder cancer. Eur Urol 41:105–112

    Article  PubMed  Google Scholar 

  4. Mohanty NK, Nayak RL, Vasudeva P et al (2008) Management of BCG non-responders with fixed dose intravesical gemcitabine in superficial transitional cell carcinoma of urinary bladder. Indian J Urol 24:44–47

    Article  PubMed  CAS  Google Scholar 

  5. Pfister C, Moore L, Allard P et al (1999) Predictive value of cell cycle markers p53, MDM2, p21, and Ki-67 in superficial bladder tumor recurrence. Clin Cancer Res 5:4079–4084

    PubMed  CAS  Google Scholar 

  6. Cordon-Cardov C, Zhang Z, Dalbagni G et al (1997) Cooperative effects of p53 and pRb alterations in primary superficial bladder tumors. Cancer Res 57:1217–1221

    Google Scholar 

  7. Esrig D, Elmajian D, Groshen S et al (1994) Accumulation of nuclear p53 and tumor progression in bladder cancer. N Engl J Med 331:1259–1264

    Article  PubMed  CAS  Google Scholar 

  8. Sarkis AS, Dalbagni G, Cordon-Cardo C et al (1993) Nuclear overexpression of p53 protein in transitional cell bladder carcinoma: a marker for disease progression. J Natl Cancer Inst 85:53–59

    Article  PubMed  CAS  Google Scholar 

  9. Zeng YX, El-Deiry WS (1996) Regulation of p21WAF1/CIP1 expression by p53-independent pathways. Oncogene 12:1557–1564

    PubMed  CAS  Google Scholar 

  10. El-Deiry WS, Tokino T, Waldman T et al (1995) Topological control of p21WAF1/CIP1 expression in normal and neoplastic tissues. Cancer Res 55:2910–2919

    PubMed  CAS  Google Scholar 

  11. Crew JP, O’Brien T, Bradburn M et al (1997) VEGF is a predictor of relapse and stage progression in superficial bladder cancer. Cancer Res 57:5281–5285

    PubMed  CAS  Google Scholar 

  12. Duff SE, Li C, Garland JM et al (2003) CD105 is important for angiogenesis: evidence and potential applications. FASEB J 17:984–992

    Article  PubMed  CAS  Google Scholar 

  13. Dangle PP, Wang WP, Mayerson J et al (2008) Low grade papillary transitional cell carcinoma pelvic recurrence masquerading as high grade invasive carcinoma, ten years after radical cystectomy. World J Surg Oncol 6:103

    Article  PubMed  Google Scholar 

  14. Mian C, Lodde M, Comploj E et al (2006) Multiprobe fluorescence in situ hybridisation: prognostic perspectives in superficial bladder cancer. J of Clin Pathol 59:984–987

    Article  CAS  Google Scholar 

  15. Lu M, Wikman F, Orntoft TF et al (2002) Impact of alterations affecting the p53 pathway in bladder cancer on clinical outcome, assessed by conventional and array-based methods. Clin Cancer Res 8:171–179

    PubMed  CAS  Google Scholar 

  16. Datto MB, Li Y, Panus JF et al (1995) Transforming growth factor beta induces the cyclin-dependent kinase inhibitor p21 through a p53-independent mechanism. Proc Natl Acad Sci USA 92:5545–5549

    Article  PubMed  CAS  Google Scholar 

  17. Stein JP, Ginsberg DA, Grossfeld GD et al (1998) Effect of p21waf1/cip1 expression on tumour progression in bladder cancer. J Natl Cancer Inst 90:1072–1079

    Article  PubMed  CAS  Google Scholar 

  18. Lipponen P, Aaltomaa S, Eskelinen M et al (1998) Expression of p21(waf1/cip1) protein in transitional cell bladder tumors and its prognostic value. Eur Urol 34:237–243

    Article  PubMed  CAS  Google Scholar 

  19. Korkolopoulou P, Konstantinidou AE, Thomas-Tsagli E et al (2000) WAF1/p21 protein expression is an independent prognostic indicator in superficial and invasive bladder cancer. Appl Immunohistochem Mol Morphol 8:285–292

    Article  PubMed  CAS  Google Scholar 

  20. Feliksas J, Peter G, Kushima M et al (2002) Value of p21 and p53 overexpression in predicting the outcome after systemic chemotherapy of Urothelial cancers. Acta Med Litu 9:93–99

    Google Scholar 

  21. Grossfield GD, Ginsberg DA, Stein JP (1997) Thrombospondin-1 expression in bladder cancer with p53 alteration, tumor angiogenesis and tumor progression. J Natl Cancer Inst 89:219–227

    Article  Google Scholar 

  22. Saad RS, Liu YL, Nathan G et al (2004) Endoglin (CD105) and vascular endothelial growth factor as prognostic markers in colorectal cancer. Mod Pathol 17:197–203

    Article  PubMed  CAS  Google Scholar 

  23. Mineo TC, Ambrogi V, Baldi A et al (2004) Prognostic impact of VEGF, CD31, CD34, and CD105 expression and tumour vessel invasion after radical surgery for IB–IIA non-small cell lung cancer. J Clin Pathol 57:591–597

    Article  PubMed  CAS  Google Scholar 

  24. El-Gohary YM, Silverman JF, Olson PR et al (2007) Endoglin (CD105) and vascular endothelial growth factor as prognostic markers in prostatic adenocarcinoma. Am J Clin Pathol 127:572–579

    Article  PubMed  CAS  Google Scholar 

  25. Kumar S, Ghella A, Li C et al (1999) Breast carcinoma: vascular density determined using CD105 antibody correlates with tumor prognosis. Cancer Res 59:856–861

    PubMed  CAS  Google Scholar 

  26. Fonsatti E, Altomonte M, Nicotra MR et al (2003) Endoglin (CD105): a powerful therapeutic target on tumor-associated angiogenetic blood vessels. Oncogene 22:6557–6563

    Article  PubMed  CAS  Google Scholar 

  27. Ellis LM, Hicklin DJ (2008) VEGF-targeted therapy: mechanisms of anti-tumour activity. Nat Rev Cancer 8:579–591

    Article  PubMed  CAS  Google Scholar 

  28. Shariat SF, Tokunaga H, Zhou J et al (2004) p53, p21, pRB, and p16 expression predict clinical outcome in cystectomy with bladder cancer. J Clin Oncol 22:1014–1024

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Sunita Saxena.

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Agrawal, U., Mishra, A.K., Salgia, P. et al. Role of Tumor Suppressor and Angiogenesis Markers in Prediction of Recurrence of Non Muscle Invasive Bladder Cancer. Pathol. Oncol. Res. 17, 91–101 (2011). https://doi.org/10.1007/s12253-010-9287-1

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  • DOI: https://doi.org/10.1007/s12253-010-9287-1

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