IMPACT OF THE EXPRESSION OF EPIDERMAL GROWTH-FACTOR, TRANSFORMING-GROWTH-FACTOR-ALPHA, AND EPIDERMAL GROWTH-FACTOR RECEPTOR ON THE PROGNOSIS OF SUPERFICIAL BLADDER-CANCER

Objectives. To investigate the correlation of epidermal growth factor receptor (EGFR) expression and its ligands EGF and transforming growth factor-alpha (TGF-alpha) with disease outcome in a cohort of patients with superficial bladder cancer. Methods. Tumor samples of 21 patient s with transitional cell carcinoma of the bladder were analyzed by imm unohistochemistry for expression of EGFR, EGF, and TGF-alpha. Disease- related events were recorded during a routine clinical follow-up and a nalyzed for possible correlation with the expression status of the abo ve-mentioned proteins. Results. All Stage pT1 transitional cell carcin omas expressed EGFR, and IO of 21 (48%) tumors showed focal areas of s trong EGF and/or TGF-alpha expression. Of these, 80% with EGF positivi ty (8 of 10) had recurrences, whereas only 9% of patients without EGF staining (1 of 11) did so. The same pattern was observed with TGF-alph a. A strong association was confirmed between EGF/TGF-alpha positivity and tumor recurrence (P<0.005). We also found that EGF and TGF-alpha were expressed in stroma and/or around the vessels of tumor tissue in 48% and 38% of the tumors, respectively. No association was found betw een the recurrence rate/vascular invasion and the stromal/vascular wal l expression of the growth factors. Conclusions. Expression of EGF and TGF-alpha is correlated with tumor recurrence. Also, there is the abi lity of vessel walls to express EGF and TGF-alpha in superficial bladd er cancer. Further clarification of the impact of this expression on a ngioinvasion of tumor cells may be helpful in understanding the nature of local invasion and metastasis. (C) 1998, Elsevier Science Inc. All rights reserved.