EVALUATION OF FASCIN AND MMP-9 EXPRESSION AS MARKERS OF INVASION IN UROTHELIAL CARCINOMA OF THE URINARY BLADDER.

Background:Fascin and matrix metalloproteinase-9 (MMP-9) have been implicated in regulation of cell invasion and metastasis in many types of cancers. Aim: To evaluate the expression of fascin and MMP-9 in urothelial carcinoma (UC) of the urinary bladder and correlate their expression with the clinicopathological variables and to assess the relationship between them. Materials and methods: Fascin and MMP-9 immunoexpression was evaluated semiquantitatively in 60 cases of UCs according to the percentage of the positive cells. Results:Fascin and MMP-9 expression was observed in 66.7% and 60% of the studied cases of UCs respectively. The expression was significantly different from the normal urothelium. Fascin and MMP-9 expression was significantly higher with advanced tumor stage (P =0.02 and =0.01 respectively) and lymph-vascular space invasion (LVSI) (P<0.001 and =0.03 respectively). MMP-9 overexpression was significantly associated with the tumor grade (P =0.03). There was a positive correlation between fascin and MMP-9 expression (r =0.5, P =0.03). More intense immunostaining was detected at the invasive fronts compared with other areas of the tumor in 50% and 40% of UCs with positive fascin and MMP-9 expression respectively. Conclusion: Our results point to an association between increased fascin and MMP-9 expression and UC invasiveness and suggest that both markers may act in concert to mediate a more aggressive behavior through promoting tumor cell invasion.