Epithelial-mesenchymal Transition In Bladder Urothelial Carcinoma

BackgroundBladder cancer is one of the most common malignant tumor in the urinary system.Itaccounts for4in men malignant,and for7in women in Ameria.The incidence of bladdercancer is the highest in the genitourinary system tumors in our Country. To detective bladdercancer invasion and metastasis mechanism will contribute to a better understanding of theoccurrence and development process, provide important theoretical basis for the treatment ofbladder cancer prognosis.At present, the diagnosis and treatment of bladder cancer has madeconsiderable progress,while the recurrence of non-invasive bladder cancer is the greatchallenge in clinical treatment, and invasive bladder cancer is still the cause of death ofpatients.The cure of bladder resection is the gold standard for treatment of invasive bladdercancer, but the prognosis of patients is poor, early detection and early diagnosis of bladdercancer is the objective of the study.to clinicians.Pathological evaluation, such as grading andstaging predict the biological behavior of bladder cancer is limited, so choose the appropriatemolecular markers of bladder tumor formation and biological change will make basis forclinical decision. Urothelial carcinoma of the bladder epithelial mesenchymal transition andbladder tumor stem cell research more, but the judgment of both the degree of malignancy ofbladder urothelial carcinoma and malignant urothelial carcinoma of the bladder level rise,both related to noclearly reported.ObjectiveTo detective the expression of E-cadherin、Vimentin and CK17、CD44in bladderurothelial carcinoma, analysis Epithelial-Mesenchymal Transition phenomenon and cancerstem cell in occurrence and development of bladder urothelial carcinoma. Provide a referenceindex for the Prognosis assessment of bladder cancer.Methods45cases of bladder urothelial carcinoma tissue was resected and pathologicallyconfirmed in2009~2011.16cases of adjacent noncancerous tissues (excluding cancerconfirmed by pathology) was taken. According to the2004WHO bladder tumor classification,26cases of papillary urothelial carcinoma of low-level,and19cases papillary urothelialcarcinoma of high-level in45cases of bladder urothelial carcinoma.The tissues was fixed with4%formalin, and embedded with paraffin.In experiment every cases was taken5μ mcontinuous cut thick slices (4, a do HE dyeing verify diagnoses,2copies of dyeing do index, anegative control).the another part of tissues fully cracking to get total protein. clinicalpathology material was get through reviews the patient records and tissue pathology report.Byusing the immunohistochemical and Western-blot, the expression of E-cadherin and Vimentinand CK17、CD44in45cases of bladder urothlial carcinoma and16cases of peficanceroustissues was detected. using SPSS software for inspection and Spearman related factorsanalysis, analysis of the index expression changes and the relationship between the clinicaland pathological features, and the correlation between them.Results(1)The positive expression rate of E-cadherin was44.4%in bladder urothelial carcinomaand that of Vimentin was62.2%.The positive expression rate of E-cadherin in Low gradeurothelial carcinoma and High grade urothelial carcinoma was57.7%and26.3%respectivelyand that of Vimentin was46.2%and84.2%respectively. The expression of E-cadherin andVimentin differences has statistically significant(P<0.05).(2) The positive expression ofE-cadherin and Vimentin in bladder urothelial carcinoma has a negativecorrelation(r=-0.038,P=0.033).(3)The positive expression rate of CK17was44.4%in bladderurothelial carcinoma and The positive expression rate of CK17in Low grade urothelialcarcinoma and High grade urothelial carcinoma was34.6%and57.9%respectively; Theexpression of CK17differences has no statistically significant(P>0.05).(4) The positiveexpression rate of CD44was55.6%in bladder urothelial carcinoma and The positiveexpression rate of CD44in Low grade urothelial carcinoma and High grade urothelialcarcinoma was42.3%and73.7%respectively; The expression of CD44differences has nostatistically significant(P>0.05).(5)The positive expression of E-cadherin and CK17、CD44inbladder urothelial carcinoma has a negative correlation; Vimentin and CK17、CD44inbladder urothelial carcinoma has a positive correlation; The positive expression of CK17andCD44in bladder urothelial carcinoma has no correlation.Conclusions(1)The expression of E-cadherin was negatively related with the malignant degree ofbladder urothelial carcinoma, while The expression of Vimentin was positively related withthe malignant degree of bladder urothelial carcinoma. The positive expression of E-cadherinand Vimentin in bladder urothelial carcinoma has a negative correlation. It suggest in theprogression of bladder urothelial carcinoma there is the phenomenon of Epithelial-Mesenchymal Transition.(2) the expression of E-cadherin and Vimentin has therelationship with the invasion and metastasis of bladder carcinoma. E-cadherin and Vimentinhave the value to predicate that the biological behavior of bladder urothelialcarcinoma.(3)CK17and CD44was positive expression inbladder cancer tissue, show thatbladder cancer organizations may have bladder cancer stem cells. bladder cancer growthprocess epithelial interstitial conversion and bladder cancer stem cells are to there are someextent contact in Epithelial-Mesenchymal Transition and cancer stem cell.