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Glutathione S-transferase and multidrug-resistant phenotype in transitional cell carcinoma of the bladder
A Akdaş1, L N Türkeri, S Küllü
1Department of Urology, Marmara University School of Medicine, Istanbul, Turkey.
Objective:
To asses the role of expression of resistance phenotypes in treatment failure in patients with invasive transitional cell carcinoma of the urinary bladder, since P-glycoprotein and glutathione S-transferase pi (GST) expression are implicated in resistance to various chemotherapy agents in different tumors.
Methods:
Tumor samples from P-glycoprotein and GST-pi were analyzed by immunohistochemistry.
Results:
P-glycoprotein and GST-pi were found in 35.7 and 42.9% of the samples, respectively. In 21.4% of the samples there was simultaneous expression of both proteins. No significant impact on prediction of tumor behavior was evident on statistical analysis by any one of the protein expressions.
Conclusion:
Drug resistance in transitional cell carcinoma may be through different mechanisms. Although the small sample size of this study precludes firm conclusions, the assessment of P-glycoprotein or GST-pi expression appears to be of little value as a predictor of response to chemotherapy in this group of tumors.
Insights
This study found that P-glycoprotein and glutathione S-transferase pi (GST) expression in transitional cell carcinoma did not reliably predict chemotherapy response. Further research is needed to understand drug resistance mechanisms in bladder cancer.
Area of Science:
- Oncology
- Molecular Biology
- Urology
Background:
- Transitional cell carcinoma (TCC) of the urinary bladder is a significant health concern.
- Chemotherapy resistance is a major challenge in treating invasive TCC.
- P-glycoprotein and glutathione S-transferase pi (GST) are known markers implicated in multidrug resistance.
Purpose of the Study:
- To evaluate the role of P-glycoprotein and GST expression in predicting treatment failure in patients with invasive TCC.
- To determine if these resistance phenotypes are associated with chemotherapy response in bladder cancer.
Main Methods:
- Immunohistochemistry was used to analyze tumor samples for P-glycoprotein and GST-pi expression.
- Statistical analysis was performed to assess the impact of protein expression on tumor behavior and treatment outcomes.
Main Results:
- P-glycoprotein was expressed in 35.7% of samples, and GST-pi in 42.9%.
- Both proteins were simultaneously expressed in 21.4% of cases.
- No significant impact of individual protein expression on predicting tumor behavior was observed.
Conclusions:
- Drug resistance in TCC may involve diverse mechanisms beyond P-glycoprotein and GST-pi.
- The expression of P-glycoprotein or GST-pi has limited value as a predictor of chemotherapy response in TCC.
- The small sample size limits definitive conclusions, suggesting a need for larger studies.