Expression And Clinical Significance Of NES1 In Bladder Transitional Cell Carcinoma

Objective and BackgroundThe bladder cancer is one of the most common and hazard diseases in urological malignant tumors in China.With the development of molecular biology,people find t a lot of factors can lead to cancer and the progress is step by step.During these courses,many anti-oncogenes are devitalized.Still,the molecular mechanism of the development and the progress of the bladder cancer is poorly understood.Doctors are still in lack of the effective diagnosis and prognosis tumor marker.NES1 gene is a newly disclosed anti-oncogene in recent years which have been confirmed to play a certain role in the regulation of the growth and differentiation of normal epithelial cell. The researches of NES1 gene are at the hot topic ever since the gene's recognition.It is widely expressed in lots of kinds of tumors,such as breast cancer,gastric cancer, ovarian cancer,prostatic carcinoma,carcinoma of testis,which give us a hint that the NES1 gene is a very important anti-oncogene.Since there have few reports on the correlation between the expression of NES1 gene and bladder tumor,we have no idea if NES1 gene has a vital role in the diagnosis and prognosis of bladder tumors.This study was to discover the expression and significance of NES1 gene in both bladder transitional cell carcinoma(BTCC)and the normal mucous membrane of urinary bladder.We would analyzed the relationship of the expression between NES1 gene and pathological grade,clinical stage and recurrence of bladder tumor,willing to provide new clinical theory basis for the diagnosis and therapy Of bladder tumor.Materials and MethodsThis study included 42 cases of patients,form December,2004 to February, 2006,who admitted in the affiliated hospital of Tianjin medical university for the treatment of BTCC.There were 31 male and 11 female.The median age was 57 (range 39-83).The clinical stage was assigned according to the 1998 TNM system:17 patients of superficial tumors(Tis-T₁)and 25 patients of invasive tumors(T_2-4).For pathologic grading:14 patients of Gradeâ… ,15 patients of Gradeâ…¡and 13 patients of Gradeâ…¢.None of them had received chemotherapy or radiotherapy before the operations.13 specimens of normal urothelium tissues were acquired as control. Immunohistochemical staining for NES 1 was carded out and SPSS11.5 for windows was used to evaluate the association between NES1 expression and clinico-pathologic parameters. Result1.The positive rate of NES1 expression in bladder cancer was 40.5%.While the positive rate of NES1 expression in normal bladder tissue was 76.9%.NES1 expression was significant differential between BTCC and normal urothelium (x²=5.277,P＜0.05).2.The intensive expression of NES1 was related to the classification,TNM stage of bladder tumor.The positive rate of NES1 expression in the superficial tumor was 58.8%,while the invasion tumor was 28.0%.A statistically significant difference was observed between them.The positive rate of NES1 at each histological stage in bladder tumor was 64.3%(Gâ… ),40.0%(Gâ…¡),15.4%(Gâ…¢),respectively.No statistically difference was seen between the two groups in patients' age,gender, number and size of the tumor.3.36 patients were followed up,the median follow-up was 18 months(range 13-33).Disease recurred in 17 patients,4 of which(23.5%)were positive expression of NES1;NES1 expression in the non-recurred group is 57.9%(11/19).NES1 expression was statistically significant associated with disease recurrence.Conclusion1.The study has shown that there are less expression of NES1 gene in the bladder transitional cell carcinoma than in the normal tissue.A statistically significant association was observed between them.2.The expression of NES1 gene in bladder cancer was related to tumor histological classification,TNM stage.The less expression of NES1 gene,the worse clinical-pathology features.NES1-targeted therapy may be a promising strategy to prevent progression of bladder cancer.3.NES1 gene has a close relationship with the prognosis of bladder cancer.The higher expression of NES 1 gene indicated a better prognosis.The study demonstrated a strong relationship between NES1 expression and recurrence risk of BTCC.NES1 expression was an promising independent prognostic factor of recurrence in BTCC.