Growth factors and oncogene products in transitional cell carcinoma

Epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha) stimulate cellular proliferation, whereas epidermal growth factor receptor (EGFR) and c-erb-B-2 oncoprotein are involved in the regulation of cellular growth. Although the immunoreactivity for growth factors and oncogene products in transitional cell carcinoma (TCC) of the urinary bladder has been shown to correlate with clinicopathologic findings and prognoses, there have been no such reports on TCC of the upper urinary tract (TCC-UUT). The present study investigated the prognostic value of these growth factors (EGF and TGF-alpha) and oncogene products (EGFR and c-erb-B-2) in TCC-UUT. Formalin-fixed, paraffin-embedded tumor tissues from 133 patients with TCC-UUT were analyzed using immunohistochemical staining. Immunohistochemically, EGF was recognized as positive in 50.4% of the samples, TGF-alpha in 27.8%, EGFR in 41.3%, and c-erb-B-2 oncoprotein in 6.8%. The immunoreactivity for EGF and c-erb-B-2 oncoprotein was significantly (P < 0.05) correlated with both stage and grade, whereas TGF-alpha correlated only with stage and EGFR only with grade. The 5-year survival rate for all cases taken together was 66.7%. Univariate analysis revealed that patients with EGF- and c-erb-B-2 oncoprotein-positive tumors had a worse clinical course than patients with EGF- and c-erb-B-2 oncoprotein-negative tumors, whereas in the final models of multivariate analysis, stage was found to be the only prognostic factor. Detection of immunoreactivity for growth factors and oncogene products does not appear to be of any real value in deciding the prognosis of TCC-UUT.