Aim
To evaluate the effect of special AT-rich binding protein 1 (SATB1) and Dachshund homolog 1 (DACH1) on the biological behavior of bladder carcinoma through epithelial–mesenchymal transition (EMT) and to explore the relationship between SATB1, DACH1, and vimentin immunohistochemical expression and clinicopathological features of bladder carcinoma in Egyptian patients.
Background
In Egypt, bladder cancer has become number 3 in ranking of malignant tumors in both sexes with increased morbidity and mortality, which makes identification of valuable predictive markers of metastasis mandatory. In the past two decades, EMT has been known to play a key role in epithelial tumor progression and metastasis. SATB1 was identified as an additional EMT regulator. On the contrary, DACH1 acts as a negative regulator of EMT.
Design
Using the standard immunohistochemical technique, we assessed SATB1, DACH1, and vimentin expression in 90 (80 primary and 10 metastasizing) bladder carcinomas and 10 normal bladder urothelium specimens (control group).
Results
Both SATB1 and vimentin expression showed significant stepwise increased expression, from complete negativity in normal urothelium to higher in lymph node metastases than in primary bladder carcinoma; in contrast, DACH1 showed significant stepwise decreased expression. Both SATB1 and vimentin epithelial expressions showed significant association with poor prognostic factors including high-grade urothelial carcinoma, advanced pathological T stage, and presence of muscularis propria invasion. However, DACH1 epithelial expression showed significant association with good prognostic factors including low-grade urothelial carcinoma, early pathological T stage, and absence of muscularis propria invasion.
Conclusion
Both SATB1 and DACH1 could be promising candidate biomarkers that might serve as prognostic factors for the prediction of tumor aggressiveness and an excellent target for bladder cancer therapy in Egyptian patients.
