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Park, Lee, Yum, Kang, and Yoo: Clusterin Expression and Apoptosis in Transitional Cell Carcinoma of the Bladder
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(4): 402-407.

Published online: 30 April 2007

DOI: https://doi.org/10.4111/kju.2007.48.4.402

Clusterin Expression and Apoptosis in Transitional Cell Carcinoma of the Bladder

Hyun Jung Park, Ho Jung Lee1, Yoon Hee Yum2, Jeong Yoon Kang, Tag Keun Yoo

Department of Urology, Eulji Medical Center, College of Medicine, Eulji University, Seoul, Korea.

1Department of Pathology, Eulji Medical Center, College of Medicine, Eulji University, Seoul, Korea.

2Life Science Institute, Eulji Medical Center, College of Medicine, Eulji University, Seoul, Korea.

Corresponding author (kjy5205@eulji.or.kr)

Received 28 November 2006       Accepted 8 March 2007

Copyright © 2007 The Korean Urological Association

Abstract

Purpose

The clusterin expression has been associated with tumorigenesis of various malignancies, including tumors of the prostate, colon and breast. Furthermore, the expression of clusterin is modulated by many factors that are believed to regulate tumor growth and apoptosis. We studied the clusterin expression in transitional cell carcinoma (TCC) of the bladder and we investigated its correlation with apoptosis.

Materials and Methods

Eighty five bladder tumor specimens from radical cystectomy or transurethral resection were subjected to immunohistochemical clusterin staining with Ig G clusterin Ab. We examined the immunohistochemical localization of clusterin, and this was followed by TUNEL staining to detect the apoptotic cells. After double-staining with Hoechst 33258, we detected the apoptotic cells under a fluorescence microscope and we calculated the apoptotic index.

Results

Invasive TCC showed a stronger positive expression of clusterin as compared with superficial TCC, but the positivity of the clusterin expression was not in proportion to the tumor grade. The apoptotic indices of cancer were 0.52±0.28%, 0.30±0.16% and 0.17±0.11% in Grade I, Grade II and Grade III superficial TCC, respectively, and it was 0.23±0.13% in Grade III invasive TCC. Apoptotic cells were not detected in the cancer cells stained with clusterin. Conversely, clusterin was not expressed in the cells showing apoptosis.

Conclusions

These results suggest that clusterin could be used as a marker to provide prognostic information for the TCC patients. The apoptotic index revealed that apoptosis and the clusterin expression have correlation with transitional cell cancer. Further study will be needed to clarify the role of clusterin as a therapeutic target for cancer treatment.

Keywords: Apoptosis, Clusterin, Transitional cell carcinoma

Figures and Tables

Fig. 1
The expressions of clusterin in bladder cancer specimens with the degree, from negative (A) to 3+ (D).
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Fig. 2
The clusterin expression is shown (A) and the same slide stained with TUNEL assay (B). Cells stained with clusterin are not stained with TUNEL (C).
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Table 1
Correlation of the clusterin expression with the tumor grade
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*p<0.05 between superficial and invasive group by Fisher's exact test. 1+: <25% cells stained, 2+: <50% cells stained, 3+: ≥50% cells stained

Table 2
Apoptotic indices of transitional cell carcinoma of the bladder
kju-48-402-i002

Each index is expressed in mean±SD. *p<0.05 by Kruskall-Wallis test

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