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(American Journal of Pathology. 1999;155:1427-1432.)
© 1999 American Society for Investigative Pathology

Short Communications

Focal Loss of CD44 Variant Protein Expression is Related to Recurrence in Superficial Bladder Carcinoma

Valeriu Toma^*, Dieter Hauri, Ulrico Schmid, Daniel Ackermann^§, Robert Maurer^¶, Göran Alund^||, Hartmut Knönagel^**, Marcus Rist, Thomas C. Gasser, Guido Sauter^§§ and Jürgen Roth^*

From the Division of Cell and Molecular Pathology^*
and the Department of Pathology and Urologic Clinic,
University Hospital, University of Zürich, Zürich; the Institute for Pathology
and Urologic Clinics,^§
Cantonal Hospital St. Gallen, St. Gallen; the Institute for Pathology^¶
and Urologic Clinics,^||
City Hospital Triemli, Zürich; the Urologic Clinics,^**
Limmattal Hospital, Schlieren; the Clara Hospital,
Basel; and the Urologic Clinics
and Institute for Pathology,^§§
University of Basel, Basel, Switzerland

The majority of papillary transitional cell carcinomas of the bladder are localized tumors at initial diagnosis; identification of those developing recurrence and an aggressive behavior is important. CD44 variant proteins have been implicated in tumor progression and metastasis, and a correlation with adverse prognosis has been demonstrated in a variety of human tumors. Here, the usefulness of conventional CD44 protein immunohistochemistry as a prognostic parameter for recurrence of superficial transitional cell carcinomas was assessed in paraffin sections of 241 tumors with long-term follow-up. A highly significant association was found between focal loss of CD44v3 and -v6 immunostaining and short recurrence-free interval in noninvasive (pTa) transitional cell carcinomas (P = 0.005), but not in minimally invasive (pT1) carcinomas (P = 0.78). Our results indicate the value of conventional CD44 immunohistochemistry as an additional tool for identifying patients at high risk for recurrence of pTa transitional cell carcinomas. They also point to biological differences between noninvasive and minimally invasive transitional cell carcinomas of the bladder.