Abstract

Aberrant activation of the Ras/Raf/ERK (extracellular-signal-regulated kinase)-MAPK (mitogen-activated protein kinase) pathway is involved in the progression of cancer, including urothelial carcinoma; but the negative regulation remains unclear. In the present study, we investigated pathological expression of Spred2 (Sprouty-related EVH1 domain-containing protein 2), a negative regulator of the Ras/Raf/ERK-MAPK pathway, and the relation to ERK activation and Ki67 index in various categories of 275 urothelial tumors obtained from clinical patients. In situ hybridization demonstrated that Spred2 mRNA was highly expressed in high-grade non-invasive papillary urothelial carcinoma (HGPUC), and the expression was decreased in carcinoma in situ (CIS) and infiltrating urothelial carcinoma (IUC). Immunohistochemically, membranous Spred2 expression, important to interact with Ras/Raf, was preferentially found in HGPUC. Interestingly, membranous Spred2 expression was decreased in CIS and IUC relative to HGPUC, while ERK activation and the expression of the cell proliferation marker Ki67 index were increased. HGPUC with membranous Spred2 expression correlated significantly with lower levels of ERK activation and Ki67 index as compared to those with negative Spred2 expression. Thus, our pathological findings suggest that Spred2 counters cancer progression in non-invasive papillary carcinoma possibly through inhibiting the Ras/Raf/ERK-MAPK pathway, but this regulatory mechanism is lost in cancers with high malignancy. Spred2 appears to be a key regulator in the progression of non-invasive bladder carcinoma.

Highlights

  • Bladder cancer is a highly prevalent disease and its incidence is steadily rising worldwide [1]

  • Spred2 mRNA expression in infiltrating urothelial carcinoma (IUC) was significantly lower than that in high-grade non-invasive papillary urothelial carcinoma (HGPUC) (Fig 1B). These results indicate that Spred2 mRNA expression was up-regulated in non-invasive papillary bladder cancer as compared to cancers with high malignancy including invasive carcinoma

  • Down-regulated Spred2 expression was evident in higher grade prostate cancers [32], and Spred2 expression levels in hepatocellular carcinoma (HCC) tissue were inversely correlated with the incidence of tumor invasion and metastasis [31]

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Summary

Introduction

Bladder cancer is a highly prevalent disease and its incidence is steadily rising worldwide [1]. In the United States, bladder cancer is the 4th most incident and 8th most deadly tumor among men [2]. Most of the bladder cancer is urothelial carcinoma arising from urothelial epithelium. Evidence indicates that urothelial carcinoma has two distinct clinical subtypes with distinct molecular features at bladder tumor initiation; low-grade tumors (superficial papillary) and high-grade tumors (flat, represented by carcinoma in situ) [3, 4].

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