Prognostic significance of apoptotic cell death in bladder cancer: a tissue microarray study on 179 urothelial carcinomas from cystectomy specimens

SummaryAimsTo assess the prognostic significance of apoptosis related markers in bladder cancer.MethodsA tissue microarray containing 179 bladder carcinomas from cystectomy specimens was analysed immunohistochemically for active caspase-3, single-stranded DNA (ssDNA), p53, Bcl-2, Bax, and COX-2, in correlation to clinicopathological factors.ResultsActive caspase-3, ssDNA, p53, Bax and COX-2 were more frequently observed among high grade and higher stage (≥ T2) carcinomas compared with low grade and lower stage (T1) tumours. On the contrary, Bcl-2 was more frequently detected in T1 than in ≥ T2 carcinomas. Active caspase-3 correlated with a better survival of the patients.ConclusionsThe decreased detection of active caspase-3 and ssDNA and the increased presence of Bcl-2 in T1 carcinomas suggest that alterations in interrelated apoptosis markers may play an important role in the progression of urothelial carcinoma from a superficially infiltrating to a muscle invading tumour and would help to better characterise a subpopulation of T1 carcinomas that could profit from early cystectomy or more aggressive adjuvant chemotherapy. Active caspase-3 might be an important prognostic factor in bladder cancer.