Survivin and MKI67 mRNA Expression in Bladder Washings of Patients with Superficial Urothelial Cell Carcinoma Correlate with Tumor Stage and Grade but Do Not Predict Tumor Recurrence

Abstract

Seventy percent of patients with superficial urothelial cell carcinoma develop recurrences after transurethral resection of the primary tumor. Because recurrence prediction on the basis of tumor size, grade, and multiplicity is unreliable, all patients need regular bladder examination with cystoscopy. An accurate method to differentiate between patients with short or long recurrence-free periods might reduce the number of invasive cystoscopies in a subgroup of patients. The gene MKI67 (proliferation marker antigen identified by the monoclonal antibody Ki-67) and the antiapoptosis gene survivin are promising prognostic markers, because increased MKI67 and survivin mRNA concentrations indicate short recurrence-free periods (1)(2)(3)(4). In addition to the presence of survivin mRNA in tumor tissue, we observed a relationship between early tumor recurrence and increased concentrations of survivin mRNA in bladder washings (5). Bladder washings are easily obtained during cystoscopy and generally reflect the molecular biological status of the urothelium (6)(7). To confirm our previous findings regarding survivin and to investigate the recurrence-predictive value of MKI67 mRNA, we collected …