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SNAI1 protein expression is an independent negative prognosticator in muscle-invasive bladder cancer.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2013 Oct; Vol. 20 (11), pp. 3669-74. Date of Electronic Publication: 2013 Jun 27. - Publication Year :
- 2013
-
Abstract
- Background: The prognosis of muscle-invasive bladder cancer is poor. Molecular prognosticators have gained increasing attention for individualized therapeutic options because they can identify patients with different prognoses.<br />Methods: Tissue microarrays of formalin-fixed and paraffin-embedded tumor samples from 206 bladder cancer patients treated with cystectomy and chemotherapy were studied for SNAI1 protein expression by immunohistochemistry. SNAI1 expression was evaluated using an immunoreactive score (IRS). For statistical analysis, the patients were separated into two groups: those with tumor specimens negative for SNAI1 expression (IRS = 0), and the other positive for SNAI1 expression (IRS ≥1).<br />Results: Tumor samples from 42 patients showed negative SNAI1 expression, whereas the nuclei of tumor cells from 164 patients showed detectable nuclear staining of SNAI1. A Kaplan-Meier analysis of the bladder cancer patients with negative SNAI1 expression showed significantly reduced disease-specific survival (DSS) and progression-free survival (PFS) compared to the patients with positive expression (p = 0.010 and 0.013). A multivariate Cox regression analysis (adjusted for gender, age, tumor stage, tumor grade, lymph node metastasis, chemotherapy, and histologic subtype) again showed a significant correlation between patients lacking SNAI1 expression and DSS (p = 0.005; relative risk 2.31; 95 % confidence interval 1.28-4.17) or PFS (p = 0.004; relative risk 2.20; 95 % confidence interval 1.29-3.78) compared to patients with positive SNAI1 staining.<br />Conclusions: Loss of SNAI1 protein expression is an independent prognosticator for PFS and DSS in bladder cancer patients treated by radical cystectomy and adjuvant chemotherapy. Its prognostic value for neoadjuvant or adjuvant chemotherapy must be evaluated in further prospective randomized controlled trials.
- Subjects :
- Adult
Aged
Biomarkers, Tumor metabolism
Carcinoma, Papillary metabolism
Carcinoma, Papillary pathology
Carcinoma, Papillary therapy
Combined Modality Therapy
Female
Follow-Up Studies
Humans
Immunoenzyme Techniques
Lymphatic Metastasis
Male
Middle Aged
Muscle Neoplasms metabolism
Muscle Neoplasms pathology
Muscle Neoplasms therapy
Neoplasm Grading
Neoplasm Invasiveness
Neoplasm Staging
Prognosis
Snail Family Transcription Factors
Survival Rate
Tissue Array Analysis
Urinary Bladder Neoplasms metabolism
Urinary Bladder Neoplasms pathology
Urinary Bladder Neoplasms therapy
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma, Papillary mortality
Cystectomy mortality
Muscle Neoplasms mortality
Transcription Factors metabolism
Urinary Bladder Neoplasms mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 20
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 23807662
- Full Text :
- https://doi.org/10.1245/s10434-013-3075-6