Background
According to the results of the National Population-based Cancer Registry
Program, bladder cancer is the second most common cancer after liver cancer
that is prevalent among Egyptian males. About 70% of bladder cancers are
diagnosed as nonmuscle invasive cancers with high risk of recurrence, besides
the risk of progression to muscularis propria invasion. The challenge is to identify
noninvasive cancers using a reliable method for accurate diagnosis as well as for
predicting the prognosis.
Aim
We aimed to evaluate the immuno-histochemical expression of claudin-1 (CLDN-1)
and CLDN-4 in invasive and noninvasive urothelial lesions and correlate them with
clinicopathological findings.
Patients and methods
This retrospective study included 36 different cases of urinary bladder lesions: 30
cases of urothelial carcinomas (UCs) and six papillary urothelial neoplasms of low
malignant potential in addition to six normal control cases. Cases were graded
according to the WHO classification and staged according to the TNM pathological
staging system. Slides were subjected to immunohistochemical staining by CLDN-
1 and CLDN-4.
Results
CLDN-1 showed the highest level of expression among carcinoma cases, while
CLDN-4 showed the highest expression among control cases (P? 0.000 for both).
Increased CLDN-1 expression was significantly related to muscle invasion
(P=0.000), advanced T stage (P=0.000), and high tumor grade (P=0.012).
CLDN-4 expression showed a statistically significant difference in UCs without
muscle invasion (P=0.000), earlier T stage, and low tumor grade (P=0.006).
Conclusion
CLDN-1 and CLDN-4 could be used as potential markers to differentiate invasive
from noninvasive and low grade from high grade UC. They can predict the clinical
outcome and play a role in the assessment of patients with UC. |
