MDR1/P-Glycoprotein Overexpression in Bladder Transitional Cell Carcinoma and its Correlation with Expression of Survivin and Fas

Bladder transitional cell carcinomas (BTCC) are the most com- mon urologic tumors in China and the sixth most common ma- lignancy in developed countries.[1] One characteristic feature of BTCC is the high recurrence incidence which is about 75-80% after op…

MDR1/P-glycoprotein overexpression in bladder transitional cell carcinoma and its correlation with expression of survivin and Fas

OBJECTIVE To explore the expression of the MDR1/P-glycoprotein, Fas and survivin and to examine their correlation with the biologic behavior of bladder transitional cell carcinoma (BTCC). METHODS Immunohistochemistry was used to examine the expression of P-gp, survivin and Fas in BTCC (n=64) and normal bladder mucosa (n=12). RESULTS The expression level of P-gp and survivin in BTCC was higher compared to normal bladder mucosa (P<0.01) and their expression was strongly correlated with clinical grading (P<0.01). In BTCC and normal bladder mucosa Fas expression was 50% and 100%, respectively (P< 0.01). Recurrent BTCC showed higher expression than primary BTCC (P< 0.01) and the expression of P-gp in BTCC had a reverse correlation with Fas expression but no correlation with survivin expression. CONCLUSUON The MDR of BTCC was strongly correlated with the ex- pression of P-gp and Fas, but was not correlated with survivin expres- sion. Thus, enhancing cancer sensitivity to chemotherapy by reversing multidrug resistance with reversal agents or up-regulating Fas expres- sion by apoptotic enhancing agents, might be a potential therapy to pre- vent tumor recurrence and invasiveness.