Prognostic significance of type IV collagen and laminin immunoreactivity in urothelial carcinomas of the bladder

Abstract

Invasion of a carcinoma involves the degradation and penetration of the subepithelial basement membrane (BM). This phenomenon might be used for histopathologic evaluation of neoplasms of the bladder. The authors studied the clinicopathologic data and tissue specimens of 125 cases of urothelial carcinomas collected prospectively. Penetration of the BM was evaluated by immunohistochemical staining of the BM components laminin and type IV collagen. The use of this parameter as a prognostic indicator in bladder cancer was assessed. The 5-year survival rate of patients having tumors with an interrupted or absent BM was significantly lower than that of patients having tumors with an intact BM. The rate of progression was greater in tumors with an interrupted or absent BM than in tumors with an intact BM. No association was found between BM status and recurrence. However, a significant correlation between tumor stage and BM staining was found. A correlation was also found between ploidy and BM staining as well as between histologic grade and BM staining pattern. When evaluating histologic grade, stage, ploidy, age, and BM score as prognostic parameters, the stage of bladder carcinomas turned out to be the most important factor in predicting the survival rate and the progression-free survival. However, BM staining was found to be of value for early identification of microinvasion and is helpful for correct staging of urothelial carcinomas.

p53 immunohistochemistry in transitional cell carcinoma and dysplasia of the urinary bladder correlates with disease progression

“…It has also been shown that BM disruption in bladder carcinomas correlates with lower 5-year survival rate, higher tumour stage, higher histological grade and tumour ploidy (Schapers et al, 1990). In this material BM disruption was also associated with positive p53 immunohistochemistry, further emphasising the fact that p53 positive bladder carcinomas are of a more aggressive nature.…”

Extracellular matrix and integrin composition of the normal bladder wall

“…Previously, the integrity of the UBM was demonstrated using polyclonal and monoclonal antibodies to type IV collagen and/or laminin and was used to establish a relationship between superficial and invasive transitionalcell carcinomas, the latter often being associated with the loss of basement membrane staining [4,15,20]. Normally the UBM is continuous, with colocalization of type IV collagen and/or laminin occuring in normal and nonmalignant inflammation specimens [2,5], although an unspecified, indistinct staining pattern was found in 1 of 17 normals associated with inflammatory infiltrates in an earlier study [4].…”

Type IV collagen-initiated signals provide survival and growth cues required for liver metastasis

“…Different studies have shown that the metastatic potential of primary tumors correlates with the degree of BM loss (Barsky et al, 1983;Havenith et al, 1988;Schapers et al, 1990). An altered ECM, in particular the loss of collagen expression, is characteristic of the latter stages of malignant progression and was shown to coincide with the acquisition of an invasive phenotype (Tanaka et al, 1997;Nakano et al, 1999;Catusse et al, 2000).…”