Significance of Tissue Laminin P1 Elastase and Fibronectin Levels in Transitional Cell Carcinoma of the Bladder

Abstract

Objective: Elastase is a serine protease which hydrolyses connective tissue components. Laminin and fibronectin also play an important role in progression and invasion of cancer. The purpose of this study is to investigate the relation between tissue elastase, laminin P₁ and fibronectin levels and tumor characteristics, and analyze the potential of these as prognostic factors in transitional cell carcinoma (TCC) of the bladder. Methods: Thirty–four patients with TCC of the bladder and 11 controls were included in this study. Elastase and fibronectin levels in tissue homogenates were determined using an enzyme immunoassay and laminin P₁ by radioimmunoassay. Mean follow–up was 43 months. Results: The mean elastase level in bladder carcinoma tissue was 120±11.42 ng/homogenate protein, while normal tissue level was 12.36±2.70 (p<0.01). The carcinoma and normal tissue mean laminin P₁ levels were 7.02±0.37 U and 0.65±0.10 U/mg homogenate protein, respectively (p<0.01). The mean fibronectin level was 19.97±1.45 ng/mg homogenate protein in the carcinoma tissue and 2.16±0.40 in normal tissue (p<0.01). There was no correlation between tumor stage, grade, size, multiplicity and elastase, laminin P₁ and fibronectin levels. Conclusion: These results provide evidence that tissue elastase, laminin P₁ and fibronectin levels increase in TCC of the human bladder. Further studies including serum and urine levels should be performed in order to analyze their value as tumor markers in a larger group of patients.