Clinical use of tumor markers for the detection and prognosis of bladder carcinoma:A comparison of cd44, cytokeratin 20 and survivin

Bladder cancer is the most common cancer of the urinary tract. Urothelial carcinoma constitutes more than 90% of these tumors. Although urothelial carcinoma is often seen in the elderly, it may also arise at an earlier age. Tumor histological grade and stage are the most important factors prognosis. In this study, CD44, CK20 and survivin immunoreactivity were investigated in urothelial carcinomas and their relation with the tumor (number, size, pattern, grade, stage, recurrence, progression) and patient (age, gender) characteristics were evaluated. Study material included 82 patients who underwent transürethral resection of bladder tumors between 2000 and 2009 and their histopathologic specimens. All histological samples were re-evaluated by a single pathologist (E.Ş.A.) according to the WHO/ISUP classification system that revealed 44 cases with low-grade and 38 cases with high-grade papillary urothelial carcinoma. Immunohistochemical evaluation revealed that, there was a statistically significant correlation between the grade and stage of the tumor with CK20 and survivin staining (p< 0.05). As the grade and stage incresaed CD44 positivity (immunoreactivity) decreased significantly (p= 0.002, p= 0.0001). However, relations between protein expressions and recurrence and progression were not significant (p> 0.05).