RT Journal Article
SR Electronic
T1 Connexin 43 expression predicts poor progression-free survival in patients with non-muscle invasive urothelial bladder cancer
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 819
OP 824
DO 10.1136/jclinpath-2015-202898
VO 68
IS 10
A1 Poyet, Cédric
A1 Buser, Lorenz
A1 Roudnicky, Filip
A1 Detmar, Michael
A1 Hermanns, Thomas
A1 Mannhard, Doris
A1 Höhn, Andrej
A1 Rüschoff, Jan
A1 Zhong, Qing
A1 Sulser, Tullio
A1 Moch, Holger
A1 Wild, Peter J
YR 2015
UL http://jcp.bmj.com/content/68/10/819.abstract
AB Objectives To evaluate the protein expression of connexin 43 (Cx43) in primary urothelial bladder cancer and test its association with the histopathological characteristics and clinical outcome.Methods A tissue microarray containing 348 tissue samples from 174 patients with primary urothelial carcinomas of the bladder was immunohistochemically stained for Cx43. The intensity of staining was semiquantitatively evaluated (score 0, 1+, 2+), and the association with clinicopathological features was assessed. Univariable and multivariable analyses were performed to identify predictors for progression-free survival (PFS).Results Membranous Cx43 immunoreactivity was detected in 118 (67.8%) of 174 analysable urothelial carcinomas, of which 31 (17.8%) showed even a strong (score 2+) and mainly homogeneous staining. Strong expression levels of Cx43 (score 2+) were associated with higher tumour grade, multiplicity and increased proliferation (all p<0.05). In the subgroup of patients with stage pTa and pT1 bladder tumours (n=158), strong Cx43 expression (p<0.001), solid growth pattern (p<0.001) and increased Ki-67 proliferation fraction (p<0.05) were significantly associated with shorter PFS in an univariable Cox regression analysis. In multivariable Cox regression models, Cx43 immunoreactivity and histological growth pattern remained highly significant and adverse risk factors for PFS.Conclusions The expression levels of Cx43 are frequent in non-muscle invasive bladder cancer (NMIBC), with high expression levels being associated with poor prognosis. Routine assessment of Cx43 expression may improve the identification of high-risk NMIBC.