Correlation Of Tumor Necrosis Factor-related Apoptosis-inducing Ligand Expression To Recurrence Of Bladder Transitional Cell Carcinoma

ObjectiveTo determine the expression of Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in Bladder transitional cell carcinoma( BTCC) and normal bladder mucosa (NBM) and explore the correlation between TRAIL and clinicopathologic parameters and prognosis of BTCC.Methods76 BTCC specimens including male 59 cases and female 17 cases were analyzed retrospectively. Including 59 cases and female 17 cases; 25 were at GI, 38 at G2 and 13 at G3 according to pathologic grading (WHO 1973) and all were diagnosed as bladder transitional Cell Carcinoma (BTCC) ;45 cases were at Ta-T₁, 31 cases at T2a according to pathologic staging(UICC 2002TNM); Single tumor 47 case, multiplicity tumor 29 cases. Select normal bladder mucous (NBM) 15 cases as blank control, 5 cases from Lithotomy of urinary bladder, 5 cases from suprapubic transvesical prostatectomy, and 5 cases from transurethral ureteroscopic resection. All the samples were measured for TRAIL by immunohistochemistry.(1) All 76 cases underwent TURBt, performance status 0-2 stage (Zubrod-ECOG-WTO), heart, lung, hepatic and renal function of patients were normal or close to normal. After the operation, mitomycin irrigation of bladder . regular follow-up by cystoscopy for 12-60 months (average 30.54mouth).(2) Analyzed the relationship between TRAIL expression in BTCC and clinicophathologic parameters, as well as the relationship between TRAIL expression and BTCC Recurrence .Results(1) The rate of TRAIL positive expression was decreased from NMB,high differentiation tissues/to moderate and poor differentiation degree. The rate was lower in poorly differentiated (G₂, G₃) tumors than in well differentiated (G₁) tumors (31.37%vs60.00%, P<0.05), it was significantly lower in multiplicity tumors than in single tumors (24.14%vs51.06%, P<0.05). There is no correlation between sex,pathology staging,age,tumor size and TRAIL positive expression.(2) Survival curves determined by the Kaplan-Meier method and log-rank test analysis demonstrated that recurrence free survival rates in group of positive expression of TRAIL was higher than those in group of negative expression (46. 49months vs33. 65months P<0.05).ConclusionsDown-regulated expression of TRAIL in BTCC showed correlation with grade,tumor number and prognosis and it can be a reference index for judging prognosis of BTCC . Meanwhile the expression of TRAIL has negative correlation with different tumor numbers, grades and recurrence of BTCC; it also can be a new approach for the etiology and treatment research to BTCC.