IMP3 predicts aggressive superficial urothelial carcinoma of the bladder
Sitnikova, Lioudmila ; Mendese, Gary Wayne ; Liu, Qin ; Woda, Bruce A. ; Lu, Di ; Dresser, Karen A. ; Mohanty, Sambit ; Rock, Kenneth L. ; Jiang, Zhong
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UMass Chan Affiliations
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Keywords
Aged, 80 and over
Carcinoma, Papillary
Disease Progression
Female
Humans
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Metastasis
Neoplasm Proteins
Prognosis
RNA-Binding Proteins
Survival Analysis
Tumor Markers, Biological
Urinary Bladder Neoplasms
Urothelium
Life Sciences
Medicine and Health Sciences
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Abstract
PURPOSE: In this study, we investigated whether an oncofetal protein, IMP3, can serve as a new biomarker to predict progression and metastasis of early-stage urothelial carcinoma of the bladder.
EXPERIMENTAL DESIGN: The expression of IMP3 in 242 patients with primary superficial bladder urothelial carcinoma and metastatic urothelial carcinoma was evaluated by immunohistochemistry. Patients with primary superficial urothelial carcinoma of the bladder were further investigated by use of survival analysis.
RESULTS: Twenty percent (42 of 214) of primary superficial urothelial carcinomas and 93% (26 of 28) of metastatic urothelial carcinomas expressed IMP3. Kaplan-Meier plots and log-rank tests showed that patients with IMP3-positive tumors had a much lower progression-free survival (P = 0.0002) and disease-free survival rate (P = 0.0067) than did those with IMP3-negative tumors. The 5-year progression-free and disease-free survival rates were 91% and 94% in IMP3-negative patients versus 64% and 76% in IMP3-positive patients, respectively. Sixty percent of IMP3-positive patients with superficial invasive urothelial carcinoma at initial diagnosis went on to develop metastases, whereas no metastasis was found in IMP3-negative patients (P = 0.0017). In the multivariable Cox analysis, patients with IMP3 expression in their superficial urothelial carcinomas subsequently developed invasive tumors or metastasis at a rate that was about five times greater than cases without expression of IMP3 adjusting for other well-known clinical variables (tumor stage and grade, etc.).
CONCLUSIONS: Our findings indicate that IMP3 is an independent prognostic marker that can identify a group of patients with a high potential to develop progression and who might benefit from early aggressive therapy.
Source
Clin Cancer Res. 2008 Mar 15;14(6):1701-6. Link to article on publisher's site