Association of Aromatase With Bladder Cancer Stage and Long-Term Survival: New Insights Into the Hormonal Paradigm in Bladder Cancer.
- Nguyen DP Department of Urology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY; Department of Urology, Bern University Hospital, Bern, Switzerland. Electronic address: danielphatnguyen@hotmail.com.
- O'Malley P Department of Urology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY.
- Al Hussein Al Awamlh B Department of Urology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY.
- Furrer MA Department of Urology, Bern University Hospital, Bern, Switzerland.
- Mongan NP Department of Pharmacology, Weill Cornell Medical College, New York, NY.
- Robinson BD Department of Pathology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY.
- Wang GJ Department of Urology, New York Hospital Queens, Flushing, NY.
- Scherr DS Department of Urology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY.
- 2016-06-22
Published in:
- Clinical genitourinary cancer. - 2017
Estrogen receptor beta
Hormones
Regulation
Stage
Tumor marker
Aged
Aromatase
Biomarkers, Tumor
Estrogen Receptor beta
Female
Gene Expression Profiling
Gene Expression Regulation, Neoplastic
Humans
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Survival Analysis
Up-Regulation
Urinary Bladder Neoplasms
English
BACKGROUND
Hormonal factors may play a role in bladder cancer (BCa). We investigated the expression of aromatase and estrogen receptor (ER)β and its association with pathological variables and survival outcomes.
PATIENTS AND METHODS
BCa specimens from 40 patients were evaluated. Immunohistochemistry was performed for aromatase and ERβ. Descriptive statistics and univariate analyses assessed the association of these markers with pathologic variables and survival outcomes.
RESULTS
Aromatase expression was significantly associated with tumor stage; muscle-invasive disease was found in 15 of 19 (79%) patients with positive staining and in 7 of 18 (39%) patients with negative staining (P = .02). Node-positive disease was found in 8 of 19 (42%) patients with positive staining and 1 of 18 (6%) patients with negative staining (P = .01). After a median follow-up of 112 months, Cox regression analysis demonstrated that aromatase expression was associated with a more than 2-fold risk of cancer recurrence (hazard ratio, 2.37; confidence interval, 0.92-6.08; P = .07) and an almost 4-fold higher risk of cancer-specific death (hazard ratio, 3.66; 95% confidence interval, 1.19-12.06; P = .02). Muscle-invasive disease was found in 15 of 18 (83%) ERβ-positive specimens and 4 of 12 (33%) ERβ-negative specimens (P = .0009). Hierarchical clustering analysis demonstrated a 4-fold up-regulation of ERβ gene expression in tumor versus adjacent, non-tumor urothelium (P < .05). However, no significant association with survival outcomes was found.
CONCLUSION
Aromatase expression in BCa may be associated with advanced tumor stage and poorer survival outcomes. ERβ is upregulated in malignant tissue, and its expression is associated with muscle-invasive disease. These findings provide further evidence for the hormonal paradigm in BCa.
Hormonal factors may play a role in bladder cancer (BCa). We investigated the expression of aromatase and estrogen receptor (ER)β and its association with pathological variables and survival outcomes.
PATIENTS AND METHODS
BCa specimens from 40 patients were evaluated. Immunohistochemistry was performed for aromatase and ERβ. Descriptive statistics and univariate analyses assessed the association of these markers with pathologic variables and survival outcomes.
RESULTS
Aromatase expression was significantly associated with tumor stage; muscle-invasive disease was found in 15 of 19 (79%) patients with positive staining and in 7 of 18 (39%) patients with negative staining (P = .02). Node-positive disease was found in 8 of 19 (42%) patients with positive staining and 1 of 18 (6%) patients with negative staining (P = .01). After a median follow-up of 112 months, Cox regression analysis demonstrated that aromatase expression was associated with a more than 2-fold risk of cancer recurrence (hazard ratio, 2.37; confidence interval, 0.92-6.08; P = .07) and an almost 4-fold higher risk of cancer-specific death (hazard ratio, 3.66; 95% confidence interval, 1.19-12.06; P = .02). Muscle-invasive disease was found in 15 of 18 (83%) ERβ-positive specimens and 4 of 12 (33%) ERβ-negative specimens (P = .0009). Hierarchical clustering analysis demonstrated a 4-fold up-regulation of ERβ gene expression in tumor versus adjacent, non-tumor urothelium (P < .05). However, no significant association with survival outcomes was found.
CONCLUSION
Aromatase expression in BCa may be associated with advanced tumor stage and poorer survival outcomes. ERβ is upregulated in malignant tissue, and its expression is associated with muscle-invasive disease. These findings provide further evidence for the hormonal paradigm in BCa.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/j.clgc.2016.05.017
- PMID 27324053
- Persistent URL
- https://sonar.ch/global/documents/184916
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