Expression Characteristics Of Fas, Survivin And TGF-β1 In Bladder Carcinoma And Their Prognostic Value In Bladder Carcinoma Patients

【Objective】: To study the expression of Fas , Survivin and TGF-β1 in the cause of bladder carcinoma and to evaluate their prognostic value in bladder carcinoma patients.【Methods】: Fas, Survivin and TGF-β1 were detected at their protein levels by immunohistochemistry (IHC) and image analysis (IA) techniques, and Fas messenger RNA (mRNA) was detected by hybridization in situ (ISH) in normal bladder mucosa and Grade I to Grade IV transitional cell carcinoma of the bladder. 20 cases of bladder carcinoma were followed to ascertain the influence of Fas, Survivin and TGF-β1 on survival of patients with bladder carcinoma.【Results】: The expression level of Fas protein is higher in normal bladder mucosal tissue than in bladder carcinoma, and the difference is significant (P＜0.05); Fas expression decreased gradually from GradeⅠto GradeⅣ, but the difference between the groups was not statistically significant; the expression difference of Fas between superficial carcinoma (Stage Ta-1) and invasive carcinoma (Stage T2-4) was not statistically significant either (P＞0.05). The expression difference of Fas mRNA between normal bladder mucosal tissue and all grades of bladder carcinoma was not statistically significant (P＞0.05), this result using hybridization in situ agrees with that of immunohistochemistry. The expression level of Survivin in normal bladder mucosa tissue is significantly lower than that in bladder carcinoma (P＜0.05); the Survivin expression increased as bladder carcinoma advances, and its expression in GradeⅠis significantly higher than that in GradeⅡ,ⅢandⅣ(P＜0.05), the Survivin level is significantly lower in superficial group than in invasive one (P＜0.05).The TGF-β1 expression is less in normal bladder mucosal tissue than in GradeⅣof TCC (transitional cell carcinoma) (P＜0.05); the TGF-β1 expression increases gradually from GradeⅠto GradeⅣof bladder carcinoma and the expression in GradeⅠ,ⅡandⅢis significantly lower than that in GradeⅣ(P＜0.05); its expression in superficial group is significantly lower than that in invasive one (P＜0.05). Fas and Survivin has negative correlation in the development of bladder carcinoma (P＜0.05, r_s=-0.275); Fas and TGF-β1 has no correlation in bladder carcinoma (P＞0.05) ; Survivin and TGF-β1 has no correlation in bladder carcinoma (P＞0.05). Decreased expression of Fas is closely correlated with prognosis (P＜0.05).【Conclusions】: Fas expression decreased gradually as bladder carcinoma advanced, and it indicates that Fas plays a role in the development of bladder carcinoma; as apoptosis inducer, Fas is expected to become one of the important molecular biological markers predicting the occurrence of bladder carcinoma. Survivin expression increased gradually as bladder carcinoma develops and invades, so it may also become an important molecular biological marker predicting the occurrence, development and invasion of bladder carcinoma. TGF-β1 expression increased significantly in GradeⅣand the invasive group indicating that TGF-β1 has a close correlation with highly malignant bladder carcinoma , and it can be used as detecting indicator showing that bladder carcinoma advances. Fas and Survivin has a negative correlation, and they can be used together as a prognostic indicator. TGF-β1 has no correlation with Fas or Survivin. Fas expression and bladder carcinoma prognosis are closely correlated, and it may become a predicator of bladder carcinoma prognosis.