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Prognostic impact of plasminogen activator inhibitor type 1 expression in bladder cancer
Article first published online: 19 AUG 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 19, pages 4502–4512, 1 October 2010
How to Cite
Becker, M., Szarvas, T., Wittschier, M., vom Dorp, F., Tötsch, M., Schmid, K. W., Rübben, H. and Ergün, S. (2010), Prognostic impact of plasminogen activator inhibitor type 1 expression in bladder cancer. Cancer, 116: 4502–4512. doi: 10.1002/cncr.25326
- Issue published online: 18 JUN 2010
- Article first published online: 19 AUG 2010
- Manuscript Accepted: 22 FEB 2010
- Manuscript Revised: 10 FEB 2010
- Manuscript Received: 25 NOV 2009
- bladder cancer;
- plasminogen activator inhibitor type 1;
Recent studies have demonstrated a poor prognosis for patients who have altered expression of plasminogen activator inhibitor type 1 (PAI-1) in several cancer types. The objective of the current study was to investigate the prognostic impact of PAI-1 on patients with transitional cell carcinoma (TCC) of the urinary bladder.
PAI-1 expression was quantified using real-time polymerase chain reaction in 91 TCCs and in 6 normal tissue specimens. PAI-1 concentrations were analyzed by enzyme-linked immunoadsorbent assay in plasma from 104 patients and 10 controls and in urine from 244 patients and 74 controls. PAI-1 expression was evaluated immunohistochemically in paraffin-embedded tissues (94 tumor samples and 10 adjacent normal tissue samples). The results were analyzed in relation to clinical features and follow-up.
Significantly higher PAI-1 levels were detected in tissue and plasma samples, but not in urine, from patients with bladder cancer compared with controls (P = .001 and P = .008, respectively). Elevated gene expression and plasma protein concentrations were independent of tumor stage and grade. Immunostaining revealed a subgroup of patients with single tumor cells that strongly expressed PAI-1. These patients' survival was significantly shorter, and their clinical presentation was correlated significantly with lymph node-positive disease.
PAI-1 gene expression in tissues and plasma protein levels were elevated in patients with TCC compared with controls. PAI-1 gene or protein expression was not associated with the clinical characteristics of bladder TCC. Although the assessment of PAI-1 expression in plasma or urine may not serve as an independent predictor of prognosis in patients with TCC, the immunohistochemical detection of single PAI-1–positive cells may serve as a predictor of survival and a possible indicator of metastasis. Cancer 2010. © 2010 American Cancer Society.