Clinicopathological correlates of Gli1 expression in a population-based cohort of patients with newly diagnosed bladder cancer

Einar F. Sverrisson, Michael S. Zens, Dennis Liang Fei, Angeline Andrews, Alan Schned, David Robbins, Karl T. Kelsey, Hua Li, James DiRenzo, Margaret R. Karagas, John D. Seigne

Research output: Contribution to journalReview article

8 Scopus citations

Abstract

Introduction: Dysregulation of the hedgehog signaling pathway has been linked to the development and progression of a variety of different human tumors including cancers of the skin, brain, colon, prostate, blood, and pancreas. We assessed the clinicopathological factors that are potentially related to expression of Gli1, the transcription factor that is thought to be the most reliable marker of hedgehog pathway activation in bladder cancer. Methods: Bladder cancer cases were identified from the New Hampshire State Cancer Registry as histologically confirmed primary bladder cancer diagnosed between January 1, 2002, and July 31, 2004. Immunohistochemical analysis was performed on a tissue microarray to detect Gli1and p53 expression in these bladder tumors. We computed odds ratios (ORs) and their 95% CIs for Gli1 positivity for pathological category using T category (from TNM), invasiveness, and grade with both the World Health Organization 1973 and World Health Organization International Society of Urological Pathology criteria. We calculated hazard ratios and their 95% CI for Gli1 positivity and recurrence for both Ta-category and invasive bladder tumors (T1+). Results: A total of 194 men and 67 women, whose tumors were assessable for Gli1 staining, were included in the study. No appreciable differences in Gli1 staining were noted by sex, age, smoking status, or high-risk occupation. Ta-category tumors were more likely to stain for Gli1 as compared with T1-category tumors (adjusted OR = 0.38, CI: 0.17-0.87). Similarly, low-grade (grades 1-2) tumors were more likely to stain for Gli1 as compared with high-grade tumors (grade 3) (adjusted OR = 0.44, CI: 0.21-0.93). In a Cox proportional hazards regression analysis, non-muscle-invasive bladder tumors expressing Gli1 were less likely to recur (adjusted hazard ratio = 0.48; CI: 0.28-0.82; P<0.05) than those in which Gli1 was absent. Conclusion: Our findings indicate that Gli1 expression may be a marker of low-stage, low-grade bladder tumors and an indicator of a reduced risk of recurrence in this group.

Original languageEnglish (US)
Pages (from-to)539-545
Number of pages7
JournalUrologic Oncology: Seminars and Original Investigations
Volume32
Issue number5
DOIs
StatePublished - Jul 2014

Keywords

  • Bladder neoplasm
  • Gli1

ASJC Scopus subject areas

  • Oncology
  • Urology

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    Sverrisson, E. F., Zens, M. S., Liang Fei, D., Andrews, A., Schned, A., Robbins, D., Kelsey, K. T., Li, H., DiRenzo, J., Karagas, M. R., & Seigne, J. D. (2014). Clinicopathological correlates of Gli1 expression in a population-based cohort of patients with newly diagnosed bladder cancer. Urologic Oncology: Seminars and Original Investigations, 32(5), 539-545. https://doi.org/10.1016/j.urolonc.2014.03.006