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. 2014 May 2;9(5):e91548.
doi: 10.1371/journal.pone.0091548. eCollection 2014.

Nestin is an independent predictor of cancer-specific survival after radical cystectomy in patients with urothelial carcinoma of the bladder

Ken-ichi Tabata  1 , Kazumasa Matsumoto  1 , Sho Minami  2 , Daisuke Ishii  1 , Morihiro Nishi  1 , Tetsuo Fujita  1 , Makoto Saegusa  3 , Yuichi Sato  2 , Masatsugu Iwamura  1
Affiliations

Nestin is an independent predictor of cancer-specific survival after radical cystectomy in patients with urothelial carcinoma of the bladder

Ken-ichi Tabata et al. PLoS One. .

Abstract

Objectives: To investigate the association between the expression of nestin, a class VI intermediate filament protein, and pathologic features or survival in patients with urothelial carcinoma of the bladder (UCB).

Methods: Nestin expression in tumor cells was immunohistochemically studied in 93 patients with UCB who underwent radical cystectomy with pelvic lymphadenectomy. The associations with clinicopathologic parameters were evaluated. Kaplan-Meier survival analysis and Cox proportional hazards models were used to estimate the effect of nestin expression on survival.

Results: Nestin expression in cystectomy specimens was observed in 13 of 93 patients (14.0%). Nestin expression was associated with pathologic tumor stage (p = 0.006). Nestin-negative patients had better overall survival compared with nestin-positive patients (log-rank p = 0.0148). Univariable analysis indicated that nestin expression, lymphovascular invasion, and lymph node status were significantly associated with cancer-specific survival (hazard ratios, 2.78, 2.15, and 2.80, respectively). On multivariable analysis, nestin expression and lymph node status were independent prognostic factors in cancer-specific survival (hazard ratios, 2.45 and 2.65, respectively).

Conclusions: The results suggest that nestin expression is a novel independent prognostic indicator for patients with UCB and a potentially useful marker to select patients who may be candidates for adjuvant chemotherapy.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Immunohistochemical analysis of nestin expression in UCB.
The photographs are representative tumor cells that were negative (A) and positive (B) for nestin. Nestin expression was also observed in the cytoplasm of vascular endothelial cells and fibroblasts in tumor stroma in each case (Figure 1A, B).
Figure 2
Figure 2. Cumulative survival of UCB patients according to nestin expression estimated sby the Kaplan–Meier method.
(A) Progression-free survival; (B) cancer-specific survival; and (C) overall survival.
See this image and copyright information in PMC

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