Prognostic Value of CD44 and HER2/Neu in Invasive Transitional Cell Carcinoma of the Urinary Bladder

Purpose: Urinary bladder cancer is a very common world wide cancer. In Egypt, there was a significant rise in the incidence of TCC in the last years. CD44 is a transmembrane glycoprotein thought to play an important role in cell-cell and cell-matrix interactions. HER-2/neu is an oncogene. Its overexpression has been associated with some different types of human cancers. The present study aimed at evaluating the prognostic value of CD44 and HER2/neu in invasive TCC of urinary bladder. Patients and Methods: This study includes 6 cases of normal bladder mucosa as a control and 40 cases of TCC (15 cases of grade 2 and 25 cases of grade 3). Cases were collected from Pathology Department, Faculty of Medicine, Benha University and Egyptian National Cancer Institute (NCI) in the period 2009 – 2011. Follow-up of the selected cases was recorded for 2 years. Immunohistochemical staining for CD44 and HER2/neu was performed in all cases and the patterns of expression were analyzed. Results: The expression of CD44 was higher in control cases than TCC and was significantly decreased in cases with poor patient prognosis (p 0.05). The high tumor grades and the deeply invasive tumors (T3) were significantly associated with low CD44 expression (p 0.01). The expression of HER2/neu increased in tumor cases than control. HER2/neu expression was significantly increased in cases with higher tumor grade (p 0.01). Conclusion: Low CD44 expression was correlated to higher tumor grade and stage and poor patient’s survival. HER2/neu overexpression was relevant in high grade (grade 3) specimens compared with lower grade of TCC.