The role of immunohistochemical expression of OCT-4 and SOX2 as predictors of recurrence and progression in superficial urinary bladder carcinoma

    loading  Checking for direct PDF access through Ovid

Abstract

Background

Tumor recurrence and progression are two important landmarks in non-muscle-invasive bladder cancer (NMIBC) patients. Periodic cystoscopic follow-up visits of NMIBC patients are necessary after complete tumor resection as tumor recurrence occurs in nearly 70–80% of cases. Patients with a high risk for frequent tumor recurrence and disease progression may benefit from immediate adjuvant chemotherapy, immunotherapy, or even early cystoscopy. Accumulating pieces of evidence suggest that cancer stem/progenitor cells are involved in tumor relapse and therapy resistance in different solid tumors, including urinary bladder cancer (UBC), according to cancer stem cell theory. Octamer-binding transcription factor-4 (OCT-4) and sex-determining region Y-box 2 (SOX2) have been identified as two important cancer stem cell markers in various cancer tissues, not only as diagnostic markers but also as a predictor of tumor progression. In the present study, we evaluated the expression pattern of OCT-4 and SOX2 in patients with NMIBC and their role in predicting patients with a high risk for tumor recurrence and progression.

Patients and methods

Tumor tissue samples from 50 patients with NMIBC were collected; the pathological follow-up data of these patients were recorded; and expression status of OCT-4 and SOX2 was examined in these tissue samples by immunohistochemistry.

Results

Correlation between clinicopathologic parameters and follow-up results reveals that tumor size greater than 3 cm is significantly associated with tumor recurrence (MCP=0.049) and approaches level of significance with poor recurrence-free rate (MCP=0.052) based on a follow-up period of 36 months.

Results

As regards tumor progression in either histologic grade or pathologic stage, we found a significant correlation between tumor size greater than 3 cm with tumor progression (MCP=0.027) and progression-free rate (MCP=0.031).

Results

Positive OCT-4 expression was detected in 68% of cases and it was significantly associated with high tumor grade (P=0.035); this may indicate the role of OCT-4 in tumor cell dedifferentiation and promote the aggressive behavior of UBC.

Results

Positive SOX2 expression was detected in 50% of cases and was not significantly associated with tumor recurrence or tumor progression.

Conclusion

The present study reveals that tumor size is an important clinical risk factor for tumor recurrence and progression.

Conclusion

Positive OCT-4 expression may be a predictive marker in NMIBC progression. More prospective studies on different stages of UBC are needed to clarify the potential role of OCT-4 in the biology and behavior of UBC.

Conclusion

However, SOX2 has limited role in early-stage bladder cancer.

Related Topics

    loading  Loading Related Articles