The expression of laminin-5, matrix metalloproteinase 9, E-cadherin, beta catenin, VEGF relationship with invasion in bladder urothelial carcinomas

Purpose: Bladder carcinomas are seen at 3-7 % of all malign tumors and constitute the most frequently observed tumors in urinary system. It is critical to diagnose early those urinary bladder carcinomas that have got a high risk of muscle invasion in determining treatment methods, and life expectancy. Although degree of tumors is an important indicator for the treatment , there is no certain prognostic indicator to determine the probability of tumor progression and prognosis. Given these facts, the present study aims to display the relationship between the immunoreactivity of Laminin-5, matrix metalloproteinase 9 (MMP- 9), E-cadherin, ß catenin, and VEGF at bladder tumors and invasion progression.Material and Method: Our study has used samples of bladder tissue derived from 86 cases diagnosed as urinary carcinoma and samples of bladder tissue with normal histomorphology derived from 15 autopsies made at the Hospital of Medicine Faculty, Afyon Kocatepe University, Turkey, for the period of 2000 ? 2008. The following variables are determined through the retrospective examination of pathology reports: age and gender of the patients, availability and number of relapse. By re-examination of the related preparations taken from the archive, stained with hematoxylin - eosin, the following points are evaluated: presence of invasion at the tumor, if so, depth of invasion, lenfovascular invasion, and mucosal change. All samples are re-graded in accordance with the grading systems used by the World Health Organization in 1973, 1998 and 1999. Laminin-5, matrix metalloproteinase 9, E-cadherin, ß catenin, and VEGF are stained as immunocytochemical to the sections. The findings as a result of the immünohistochemical stain are evaluated on the basis of scores given according to prevalence and intensity.Results: It is seen that invasion, lenfovascular invasion, and the probability of lenfovascular invasion at invasive tumors increase as the grading of tumor. Loss of ß catenin expression is seen at invasive tumors, whose amount increases in parallel to invasion depth. Loss of ß catenin expression also exists at lenfovascular invasive tumors with high grade. Similarly, loss of E-cadherin expression is seen at invasive tumors, whose amount increases in parallel to invasion depth. Loss of E-cadherin expression also exists at lenfovascular invasive tumors with high grade.On the other hand, there is no statistically significant relationship between the laminin staining and invasion, depth of invasion, and grade of tumor. However, it is seen that tumors with a high score of laminin staining make more lenfovascular invasion.As regards VEGF expression, it increases at invasive tumors with high grade, but there is no statistically significant relationship between the score of VEGF staining and depth of invasion as well as presence of lenfovascular invasion.Similarly, there is no statistically significant relationship between the score of MMP-9 staining and invasion as well as depth of invasion. However, loss of MMP-9 expression is found at lenfovascular invasive tumors with high grade.Conclusion: In the light of above given findings, it may be possible to think a higher probability of invasion progression at tumors with loss of E-cadherin expression and of ß catenin expression but with high VEGF expression. Although an increase is found in Laminin 5 gamma 2 chain expression at invasive tumors, this is not statistically significant at noninvasive tumors. However, the increase is found to be in relation with lenfovascular invasion. The study comes to the conclusion that we need further studies with more samples to display the relationship between invasion on the one hand and Laminin 5 gamma 2 chain and MMP-9 on the other.