Association of nucleophosmin/B23 mRNA expression with clinical outcome in patients with bladder carcinoma

Objectives. To determine whether nucleophosmin/B23 mRNA expression in bladder carcinoma predicts recurrence, progression, and survival. Methods. Real-time reverse transcriptase-polymerase chain reaction was performed on 50 fresh cancer specimens. The change in the cycle of threshold (Ct) was the difference in the Ct values derived from the nucleophosmin/B23 gene assayed and the 18S ribosomal RNA control [Ct (18S) - Ct (nucleophosmin/B23)]. Results. Fifty patients diagnosed with bladder cancer were followed up postoperatively for a median of 24 months. Overexpression of nucleophosmin/B23 mRNA was observed in 37.1% of patients with Stage pT1 and 73.3% of those with pT2-T4 disease. Nucleophosmin/B23 overexpression was not associated with tumor grade (P = 0.163) but was associated with bladder cancer recurrence (68.2%) and progression (88.9%) when adjusted for the effects of clinical stage. Multivariate analysis revealed that the overall tumor stage and nucleophosmin/B23 mRNA overexpression were important prognostic indicators for bladder carcinoma (P <0.05). Patients with nucleophosmin/B23 mRNA overexpression were at a significantly greater risk of disease recurrence and progression than those with low expression of nucleophosmin/B23 mRNA. Conclusions. Overexpression of nucleophosmin/B23 mRNA was independently associated with bladder cancer recurrence and progression. In patients with muscular invasion disease, overexpression of nucleophosmin/B23 mRNA was associated with the greatest risk of recurrence and progression, suggesting a potential rationale for early definitive therapy in these patients. (C) 2004 Elsevier Inc.