| Bladder cancer is a malignancy with the ninth incidence in all of the malignant tumors,which has the first fatality rate in urinary system.The incidence of bladder cancer is an upward trend in recent years,and the two biological behaviors of bladder cancer are the easy recovery and the multifocality,which result in the first fatality rate in the urinary tract malignant tumors.Therefore,early diagnosis and postoperative recurrence of bladder cancer are the key factors influencing the prognosis of the disease.Many factors and molecular changes involved in the occurrence and development of bladder cancer,Octamer-binding transcription factor 4(OCT4)is one member of the POU family transcription factors,which can maintain pluripotent embryonic stem cell properties,and it can regulate cell self-renewal and multi-directional differentiation.Therefore,the expression of OCT4 may be closely related with the occurrence and recurrence of bladder cancer.In recent years,with the development of the relationship between autophagy and a variety of tumors,autophagy may become a new kind of inhibiting tumor treatments.The autophagy gene Beclin 1 is a potential tumor suppressor gene,which has significant correlation with the occurrence and progress of many tumors including bladder cancer.The detection for Beclin 1and OCT4 at the same time has important reference meaning on the clinical evaluation and prognosis of the disease.This study showed the expression of Beclin 1 and OCT4 in bladder cancer tissues and the relationship with clinical pathological characteristics,and explored the correlation between the two factors in their roles in the development of bladder cancer by analyzing their influence on the prognosis of expression.Objective: To study the expression level of the stem cell marker Octamer-binding transcription factor 4(OCT4)and the autophagy gene Beclin 1 in bladder cancer tissue and the tissue adjacent to the carcinoma,and to explore the relationship between the expression level of them(OCT4 and Beclin 1)and the clinical pathological characteristics combined with the effect on the prognosis of survival.Further to analyze the correlation of OCT4 and Beclin 1,for clarifying the clinical significance and prognostic value.Methods:1 We selected 46 cases of bladder cancer after surgical removal of the paraffin fixed specimens in the department of urology in the Cangzhou people’s hospital from June 2010 to October 2011,and the specimens were paraffin-embedded after all of the specimens were fixed with formaldehyde.All of the 46 patients of bladder cancer were not given chemotherapy or radiation therapy preoperatively,and the postoperative tissue specimens were proved to be the pathological diagnosis of bladder cancer.By using immunohistochemical(IHC)experimental dyeing methods,in the 46 cases of bladder cancer tissues,and 46 cases of tissues adjacent to carcinoma,the expressions of OCT4 and Beclin 1 were observed to analyze the expression levels.2 In the 46 cases of bladder cancer tissues,the relationship between OCT4 and Beclin 1 expression and the clinical pathological characteristics(the patient’s age,gender,histologic grading,clinical stage,lymph node metastasis,tumor size and invasiveness)were studied.The survival analysis was carried out to definite the influence of the expression of OCT4 and Beclin1 on the prognosis,so as to further clarify their clinical significance.3 The use of Spearman ’s correlation analysis was made to identify the relevance of OCT4 and Beclin 1 expression.Results:1 In the bladder cancer tissue and the tissue adjacent to carcinoma of the46 cases,OCT4 was mainly expressed in the nucleus,and Beclin 1 was mainly expressed in the cytoplasm.In the 46 cases of primary bladder cancertissues,the positive expression rate of OCT4 was 76.1%(35/46),which was significantly higher than the positive expression rate 10.9%(5/46)of OCT4 in the 46 cases of tissues adjacent to carcinoma(statistically significant difference: chi-square = 39.808,P<0.001).In the 46 cases of primary bladder cancer tissues,the positive expression rate of Beclin 1 was 39.9%(18/46),significantly lower than the positive expression rate 91.3%(42/46)of in the46 cases of tissues adjacent to carcinoma(statistically significant difference,chi-square=25.348,P<0.001);2 In the 46 cases of bladder cancer,the abnormal expression of OCT4 and Beclin 1 was closely related to the histological grade,clinical stage,lymph node metastasis,invasiveness(P<0.05),and the abnormal expression of them was not related to the patient’s age,sex,tumor size(P>0.05).Survival analysis results showed that the expression of OCT4 and Beclin 1 were obviously associated with the prognosis of the patients(P<0.05),suggesting that OCT4 and Beclin 1 were both of the factors,which could affect the prognosis of bladder cancer.The prognosis of patients with survival analysis results indicated that,the median postoperative survival time in the patients of the high levels of OCT4 positive expression was significantly shorter than that in the patients of the low levels of OCT4 positive expression(19.000±0.557 months versus 36.000±2.942 months),and the median postoperative survival time in the patients of the low levels of Beclin 1 positive expression was significantly shorter than that in the patients of the high levels of Beclin 1positive expression(18.000±1.503 months versus 26.000±2.863 months).At the same time,the average postoperative survival time in the patients of the high levels of OCT4 positive expression was significantly shorter than that in the patients of the low levels of OCT4 positive expression(19.039±0.785 months versus 37.030±2.405 months),and the average postoperative survival time in the patients of the low levels of Beclin 1 positive expression was significantly shorter than that in the patients of the high levels of Beclin 1positive expression(17.870±1.176 months versus 27.317±1.623 months).3 At last,we found the expression of OCT4 and Beclin 1 in bladdercancer organizations existed negative correlations(rs = 0.386,P<0.05): Of all the 46 cases,35 cases of bladder cancer tissues were the high levels of OCT4 positive expression,which included 10 cases of the high levels of Beclin 1positive expression,and 25 cases of the low levels of Beclin 1 positive expression.Of all the 46 cases,11 cases of bladder cancer tissues were the low levels of OCT4 positive expression,which included 8 cases of the high levels of Beclin 1 positive expression,and 3 cases of the low levels of Beclin1 positive expression.At the same time,of all the 46 cases,18 cases of bladder cancer tissues were the high levels of Beclin 1 positive expression,which included 10 cases of the high levels of OCT4 positive expression,and8 cases of the low levels of OCT4 positive expression.Of all the 46 cases,28 cases of bladder cancer tissues were the low levels of Beclin 1 positive expression,which included 25 cases of the high levels of OCT4 positive expression,and 3 cases of the low levels of OCT4 positive expression.The Spearman ’s correlation analysis showed that OCT4 and Beclin 1 were the negative correlation expression in bladder cancer tissues,and the correlation coefficient rs = 0.386(P<0.05).Conclusions:1 The abnormal expression of OCT4 and Beclin 1 existed in the bladder cancer group compared with the tissue adjacent to carcinoma,that was to say,the expression of OCT4 protein was increased and the expression of Beclin 1protein was decreased.2 The abnormal expression of OCT4 and Beclin 1 was closely related with the histological grading,clinical stage,lymph node metastasis,and the invasiveness;The abnormal l expression of OCT4 and Beclin 1 may indicate poor prognosis.3 The expression of OCT4 and Beclin 1 in bladder cancer organizations existed negative correlations. |
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