Epithelial-mesenchymal transformation is the hallmark of the aggressive clinical behavior in cancers of different localization. It is well known that еpithelial-mesenchymal transformation is characterized by different degree, but the findings of the gradation of еpithelial-mesenchymal transformation in the scientific literature are practically absent. The purpose of the study was to investigate the immunohistochemical markers of еpithelial-mesenchymal transformation, considered as an aggregate, with identification it stage, as the criteria for recurrence and progression of the non-invasive urothelial bladder cancer. Material and methods. Non-invasive urothelial bladder cancers were divided into three groups by 14 cases for each group: group I – cancers without recurrence, group II – cases with recurrence without progression, and group III – cases with recurrence and progression. The immunohistochemical research was performed with application of E-cadherin, N-cadherin, vimentin, cytokeratins 7 and 20 monoclonal antibodies. Non-invasive urothelial bladder cancer on the degree of еpithelial-mesenchymal transformation was divided into 6 categories: 1) cancers without еpithelial-mesenchymal transformation (not expressing mesenchymal markers); 2) cancers with signs of еpithelial-mesenchymal transformation, predominantly epithelial phenotype (expression of epithelial markers was dominant over the expression of mesenchymal, p<0.05); 3) cancers with intermediate epithelial phenotype (expression of epithelial markers was dominant over the expression of mesenchymal, p>0.05); 4) cancers with intermediate mesenchymal phenotype; 5) cancers with a predominantly mesenchymal phenotype; 6) cancers with mesenchymal phenotype. Results and discussion. Expression of markers of the mesenchymal phenotype (vimentin and N-cadherin) was observed in 45.2% (19/42) of non-invasive urothelial bladder cancers. The appearance of еpithelial-mesenchymal transformation was associated with recurrence of the tumor (p<0.03). However, investigated markers of еpithelial-mesenchymal transformation variorum did not demonstrate statistical significance of belonging to any groups of research, so they cannot serve the criteria for recurrence or recurrence with progression of non-invasive urothelial bladder cancers. After distribution of еpithelial-mesenchymal transformation in two stages, it was revealed that non-invasive urothelial bladder cancers with recurrence were associated with the 1st stage of еpithelial-mesenchymal transformation (cancers with predominantly epithelial phenotype) (p<0.03), non-invasive urothelial bladder cancers with recurrence and progression were associated with the 2nd stage of еpithelial-mesenchymal transformation (cancers with intermediate epithelial phenotype) (p<0.05). Conclusion. Thus, staging of еpithelial-mesenchymal transformation with calculation of markers in conjunction is the valuable prognostic criteria for non-invasive urothelial bladder cancers.
Keywords: epithelial-mesenchymal transformation, non-invasive urothelial bladder cancer
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