| Bladder carcinoma is the most common cancer of genitourinary tract, over 90% of bladder cancers are of transitional cell origin. Recurrence of transitional cell carcinoma of the bladder is high. More than 50 to 70% of superficial tumors recur within 5 years and almost 90% recur within 15 years while 10 to 20% progress to invasive disease. Thus, early detection and monitoring of patients with transitional cell carcinoma of bladder may be important for successful treatment. But it still can't be clearly understood for the pathogenesis and the carcinogenesis mechanism of bladder carcinoma, so there isn't diagnostic test that is less invasive than cystoscopy but more sensitive than cytology. As many cancers, the carcinogenesis and development of transitional cell carcinoma of bladder not only involves activation of proto-oncogene and inhibition of antioncogene, but also involves cell proliferation and apoptosis factors.In the present study, we investigated the expression of minichromosome maintenance 5 (MCM5) and survivin in transitional cell carcinoma of bladder cellcarcinoma and the value of diagnosis of bladder carcinoma by detection of MCM5 and survivin in urine sediments. The major results were reported as follows:1. The expressions of MCM5 and survivin mRNA in 36 cases of transitional cell carcinoma of bladder tissues and in 10 cases of normal bladder tissues were examined by RT-PCR, and the expressions of MCM5 and survivin proteins in 76 cases of paraffin-embedded transitional cell carcinoma of bladder tissues and in 20 cases of normal bladder tissues were examined by immunohistochemical technique (S-P).Results showed that MCM5 positive staining was located in nucleus. In normal bladder tissues, MCM5 expression was present only in basal epithelial cells, together with some cells in the immediate suprabasal several layers, the more superficial differentiating cells of each epithelium were negative. In transitional cell carcinoma of bladder tissues, in contrast, MCM5 was expressed in the majority of cells, extending to surface layers of stratified epithelia. The median labeling indexes (LI) of MCM5 were 65% in transitional cell carcinoma of bladder tissues and 17.5% in normal bladder tissues respectively (p<0.01). MCM5 protein expression was related to pathological grades and clinical stages. The median LI of MCM5 in grades I , II and III were 38%, 62.5% and 84% respectively. Statistical significance was found in I and II, I and III, II and III respectively (p<0.01). The median LI of MCM5 in superficial and invasive tumor were 42.5% and 80% respectively. The differences of them were significant (p<0.01). MCM5/ P -actin (0.7900 ± 0.1903) and MCM5 mRNA positive rate (100%) in transitional cell carcinoma of bladder tissues were both significantly higher than those in normal bladder tissues (0.1967 ± 0.1394, 60%). MCM5 mRNA expression was related to pathological grades and clinical stages (p<0.01). The result of RT-PCR was consistent with that of immunohistochemistry.The positive expression rates of survivin protein were 74.4% (55/76) in patientswith transitional cell carcinoma of bladder and 0% in the normal bladder tissues respectively (p<0.01). Survivin positive staining in transitional cell carcinoma of bladder was located in cytoplasm, or both in cytoplasm and nucleus. Significant difference of survivin protein expression was observed in transitional cell carcinoma of bladder with different pathological grades I, II and III, its positive expression rates were 53.4% (11/21), 70% (21/30), 92% (23/25) respectively. Statistical significance was found in I and III, II and III, I and II + III respectively (p<0.05). Survivin protein expression was related to the clinical stages and its positive expression rates among superficial and invasive tumor were 60.9% (28/46) and 90% (27/30) respectively (p<0.01). The positive expression rates of survivin mRNA were 94.4% (34/36) in patients with transitional cell carcinoma of bladder and 0% in the normal bladder tissues respectively (p<0.01). The concentration of survivin mRNA wa... |
