Maspin and it’s evolving role in tumor progression in systemic malignancies

Abstract

The recent article by Bhattacharjee et al. [1] provided for highly stimulating and interesting reading. Maspin may also influences progression and prognosis in a number of other systemic malignancies. For instance, a similar relationship is seen in bladder carcinomas. Maspin assessment is especially useful in stage T1 bladder carcinomas [2]. Assessment of maspin expression in this stage serves as an independent and significant prognosisinfluencing parameter in bladder malignancies. For instance, the chances of relapse are almost twice in those tumors negative for maspin expression in contrast to the chances of relapse in those with positive expression of maspin [3]. Maspin is 52 % sensitive in predicting tumor recurrence and 95 % in predicting bladder cancer progression [4]. Not surprisingly, shorter progression-free survival rates are seen in tumors that are negative for maspin. These results have been corroborated by Kramer et al. [5] in a recent study. Maspin expression also plays a role in progression of colorectal malignancies. For instance, endothelial expression of maspin is seen in nearly 27 % of all stage III colorectal carcinomas [6]. ‘‘High-risk microsatellite stable’’ colorectal tumors can be identified when using maspin expression in conjunction with p53 expression. Amongst the tumors positive for maspin expression, 48 % of the colorectal tumors demonstrate maspin in the nuclear area in contrast to 72 % that express maspin in the cytoplasmic region only [7]. In addition, ‘‘microsatellite instability’’ tumors that are more responsive to chemotherapeutic intervention with agents such as 5-fluorouracil can be identified in this way. Tumors that exhibit cytoplasmic as well as nuclear positivity for maspin exhibit significantly decreased ‘‘overall survival’’ rates [8]. Thus maspin can be utilized as a significant parameter to determine clinical prognosis in colorectal malignancies. It is obvious from the above examples that maspin plays a major role in tumor progression in a number of systemic malignancies.