Aurora-A in transitional cell carcinoma of urinary bladder: an immunohistochemical study with clinicopathological correlation

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Abstract

Background and objective

Bladder cancer (BC) is one of the most common urological malignancies and has the highest recurrence rate among all malignancies. Despite considerable progress made in the treatment of BC, the incidence of this disease is gradually increasing and the prognosis of BC patients is still poor. Aurora-A is a serine-threonine kinase protein that plays an essential role in chromosome segregation through establishment of bipolar spindles, and its overexpression contributes to tumour development and aggressiveness, and chemoresistance of human cancers. The aim of this study was to assess the immunohistochemical expression of aurora-A in patients with transitional cell carcinoma (TCC) of the urinary bladder, and to correlate it with various clinicopathological parameters such as age, sex, histologic type and grade, lymphovascular and perineural invasion, and pathologic T-stage and lymph node status. This study was conducted as a trial to outline the characteristics of patients who may benefit from the targeted therapy using aurora-A inhibitors.

Materials and methods

This retrospective study was conducted on a total of 60 cases of TCC tissue samples. Cases were retrieved from the archives of the Pathology Department, Ain Shams University, and from the Pathology Lab of Ain Shams University Specialized Hospitals. Immunohistochemistry using the rabbit polyclonal anti-aurora-A antibody was carried out to detect the expression of aurora-A protein (diffuse cytoplasmic staining with or without nuclear staining), which was in turn correlated with clinicopathological factors.

Results

Immunohistochemical staining of aurora-A expression was cytoplasmic with or without nuclear expression in malignant urothelial cells. Higher expression of aurora-A protein expression correlated significantly with histological type (P=0.04), histologic grade (P=0.04), and depth of invasion (pathological T-stage) (P<0.001). On the other hand, no significant correlation was found with age, sex, lymphovascular invasion, perineural invasion, and lymph node metastasis.

Conclusion

Aurora-A expression has an essential role in tumor carcinogenesis, and progression and aggressiveness of TCC, thus providing a basis for targeted therapy, which could play a major role in the treatment of different cases of TCC of urinary bladder.

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