Expression Of Livin And Bcl-2 And Their Correlation In Transitional Cell Carcinoma Of The Bladder

Objective: it is now generally recognized that the occurrence of tumor cell is the result of imbalance between the cell proliferation and apoptosis caused by many factors outside and inside the cells. Inhibitor of apoptosis protein (IAP) is a kind of endogenous inhibitory factor, the apoptosis would be reduced if IAP is over-expressed, and it is closely related with the tumor development. Livin (also known as KIAP.MLIAP) is a newly discovered member of the IAP, mainly through direct inhibition of caspase or procaspase to suppress apoptosis. BCL-2 inhibited apoptosis through three channels: 1. Mitochondrial pathway regulation. 2. Endoplasmic reticulum pathway. 3. Death receptor pathway regulation. Research had found that the expression of Livin was increased in the BTCC tissue, the positive rate was 85.2%. However, the relationship between its expression and the biological behavior of bladder transitional cell carcinoma was not studied in a large scale. If Livin can be used as a bladder transitional cell carcinoma clinical prognosis and biological characteristics useful indicator, we have not yet fully appreciate. Research showed that BCL-2 was significantly correlated with the strength of invasive and the clinical prognosis. Whether BCL-2 protein expression can be considered as a bladder tumor marker and if it was correlated with the patient survival, it should be further studied. In addition, the relationship between Livin and BCL-2 in bladder transitional cell carcinoma is not yet clear. Therefore, we preliminary analysis the expression of Livin and BCL-2 in bladder transitional cell carcinoma and peritumorial tissues with flow cytometry, and their relationship in bladder transitional cell carcinoma.To analysis the correlation between clinical and pathological stage. The aim is provide a theoretical basis in the diagnosis and clinical treatment of bladder transitional cell carcinoma.Methods: The expression of Livin and Bcl-2 was examined by the flow cytometry analysis in 45 cases of (BTCC),45 cases of Peritumorial,10 cases of normal bladder tissues. In 45 cases BTCC, 33 men and 12 women, mean age 50.24±9.87 years, ranging from 26 to 68 years. According to standard of pathologic grading of WHO:gradeⅠ12 cases, gradeⅡ20 cases and gradeⅢ13 cases. According to TNM clinic staging: superficial tumors (Ta-1 stage) was 19 cases, invasion tumors (T2-4 stage) was 26 cases. Primary group 29 cases, recurrence group 16 cases. Ten cases of normal bladder tissue proved by pathological were collected from trans-bladder operation patients with benign prostatic hyperplasia and bladder stones. We studied the relationship between the expression of Livin and Bcl-2 and the age, sex, as well as clinical pathologic parameters and lymphatic metastasis.Results: 1 No expression of Livin was observed in Normal bladder tissues and Peritumorial tissues no expression of Livin was observed too. In (BTCC) tissues, the positive expression rate was 71.11%. The result was: 32 cases of positive,13 cases of negative.Primary BTCC group:19 cases of positive (65.52%),10 cases of negative;Recurrence BTCC group:13 cases of positive (81.25%),3 cases of negative.In gradeⅠ, 6 cases of positive (50.00%),6 cases of negative ; in gradeⅡ, 14 cases of positive (70.00%),6 cases of negative; in gradeⅢ,12 cases of positive (92.31%); 1 cases of negative.Lymph node metastasis group: 11 cases of positive (100.00%), 0 cases of negative; nonlymph node metastasis group: 21 cases of positive (61.76%), 0 cases of negative.So it can be concluded that the positive expression rate of Livin protein correlated to the grades of BTCC. It showed with BTCC's invasive degree increasing the Bcl-2 expression was progressive increase.In primary BTCC group and recurrence BTCC group, the difference of Livin protein is significant (P<0.05). The positive expression rate of Livin in superficial BTCC was lower than that in invasion BTCC, but, there was no remarkable difference (p>0.05). It showed that the positive expression rate of Livin protein did not show correlation with the clinical stages of BTCC. The positive expression rate of Livin in lymph node metastasis BTCC was higher than that in nonlymph node metastasis BTCC, and there was remarkable difference (p<0.05).2 The results of positive expression of Bcl-2: The positive expression of Bcl-2 was significant difference (P<0.05) in transitional cell carcinoma of the bladder (BTCC) tissues (51.11%) and peritumorial tissues (73.33%); There was 23 cases positive expression in 45 cases BTCC patients, the positive expression rate was 51.11%. The positive expression rate has a remarkable up-regulation compared with 10% expression rate of normal bladder tissues (P<0.05).Primary BTCC group :6 cases of positive (20.69%),23cases of negative;Recurrence BTCC group :9 cases of positive (56.25%),7cases of negative.In gradeⅠ, 2 cases of positive (16.67%),10 cases of negative ; in gradeⅡ, 9 cases of positive (45.00%),11 cases of negative; in gradeⅢ,8 cases of positive (61.54%); 5 cases of negative.Lymph node metastasis group: 8 cases of positive (72.72%), 3 cases of negative; nonlymph node metastasis group: 15 cases of positive (44.12%), 19 cases of negative.The Bcl-2 expression was progressive increase in the cases of tumor grade, it was statistically different (P<0.05) in gradeⅠ(16.67%)and gradeⅢ(81.64%), as well as gradeⅡ(45.00%)and gradeⅢ(81.60). It showed with BTCC's invasive degree increasing the Bcl-2 expression was progressive increase. The positive expression rate of Bcl-2 in superficial BTCC was lower than that in invasion BTCC, but there was no remarkable difference (p>0.05). It showed that the positive expression rate of Bcl-2 protein did not show correlation with the clinical stages of BTCC (P>0.05). The positive expression rate of Bcl-2 in recurrence BTCC was higher than that in primary BTCC, and the difference was significant (P<0.05).the positive expression rate of Livin protein show correlation to the recurrent or not of BTCC (P>0.05), Bcl-2 can prove new appropriate index for tumor recurrence forecast. The positive expression rate of Livin in lymph node metastasis BTCC was higher than that in nonlymph node metastasis BTCC, but there was not remarkable difference (p>0.05).3 There was significant correlation between the expression of Livin and Bcl- 2 In BTCC tissues, the expression of Bcl-2 and Livin progressively increase with the tumor grade, showing a positive correlation. In the 45 cases of BTCC, the positive expression of Livin protein while the negative expression of Bcl-2 protein was 11 cases, all positive was 21 cases, the negative expression of Livin protein while the positive expression of Bcl-2 protein was 2 cases, all negative was 11 cases. The positive expression rate of Livin was 91.30% in the positive expression of Bcl-2 in BTCC tissues. The positive expression rate of Livin was 50.00% in the negative expression of Bcl-2 in BTCC tissues, which showing positive correlation(P<0.01). Conclusions: 1 Livin does not express in regular bladder tissues. Livin does not express in peritumorial tissues too. In BTCC tissues, the positive expression rate is 71.11%. From the research, it can be concluded that the positive expression rate of Livin protein showed correlation with the pathological grades, it is statistically different (P<0.05) in gradeⅠand gradeⅢ, It shows that with BTCC's invasive degree increasing the expression of Bcl-2 is progressive increase. But it did not show correlation with clinical stages and recurrence of BTCC (P>0.05). The expression of Livin is up-regulate in BTCC tissues which suggests that Livin plays an important role in tumor occurrence and progress by inhibiting cell apoptosis. Therefore, we conclude that Livin might be an index for indentifying BTCC, and might be a new appropriate target for gene therapy to BTCC.2 The expression of Bcl-2 is low in Normal bladder tissues. The positive expression of Bcl-2 is significant different (P<0.05) in BTCC tissues and peritumorial ones. The expression of Bcl-2 is progressive increase with the tumor grade, it is statistically different (P<0.05) in gradeⅠand gradeⅢ, as well as gradeⅡand gradeⅢ. It shows that with BTCC's invasive degree increasing the expression of Bcl-2 is progressive increase. The positive expression rate of Bcl-2 in superficial BTCC is lower than that in invasion BTCC, but, there is no remarkable difference (p>0.05). It shows that the positive expression rate of Bcl-2 protein does not show correlation with the clinical stages of BTCC (P>0.05). The positive expression rate of Bcl-2 in recurrence BTCC is higher than that in primary BTCC, but the difference is not significant (P>0.05). We researched the correlation of the expression of Livin and Bcl-2 Correlation test: there is a significant correlation between the expression of Livin and Bcl-2. Livin and Bcl-2 may play an important role in the regulation of cell apoptosis in BTCC.