Androgen receptor expression is inversely correlated with pathologic tumor stage in bladder cancer

Boorjian, Stephen; Ugras, Stacy; Mongan, Nigel P; Gudas, Lorraine J; You, Xueke; Tickoo, Satish K; Scherr, Douglas S

doi:10.1016/j.urology.2004.03.025

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Volume 64, Issue 2 , Pages 383-388, August 2004

Androgen receptor expression is inversely correlated with pathologic tumor stage in bladder cancer

Stephen Boorjian
- Department of Urology, New York Presbyterian Hospital-Weill-Cornell Medical Center, New York, New York, USA
Stacy Ugras
- Department of Urology, New York Presbyterian Hospital-Weill-Cornell Medical Center, New York, New York, USA
Nigel P Mongan
- Department of Pharmacology, New York Presbyterian Hospital-Weill-Cornell Medical Center, New York, New York, USA
Lorraine J Gudas
- Department of Pharmacology, New York Presbyterian Hospital-Weill-Cornell Medical Center, New York, New York, USA
Xueke You
- Department of Urology, New York Presbyterian Hospital-Weill-Cornell Medical Center, New York, New York, USA
Satish K Tickoo
- Department of Pathology, New York Presbyterian Hospital-Weill-Cornell Medical Center, New York, New York, USA
Douglas S Scherr
- Department of Urology, New York Presbyterian Hospital-Weill-Cornell Medical Center, New York, New York, USA
- Reprint requests: Douglas S. Scherr, M.D., Brady Urology Health Center, 525 East 68th Street, Starr 900, New York, NY 10021, USA

Received 30 December 2003; accepted 11 March 2004.

Abstract

Objectives

To evaluate the expression of the androgen receptor (AR) in transitional cell carcinoma (TCC) of the bladder, and to assess whether its expression correlated with pathologic tumor stage. TCC of the bladder is three times more common in males than in females. The origin of this sex difference in incidence is unknown.

Methods

We evaluated tumor specimens from 49 consecutive patients treated for TCC of the bladder at our institution between July 2002 and June 2003. Immunohistochemistry was performed using a monoclonal mouse anti-AR antibody on paraffin-embedded tissue sections of tumors obtained from transurethral resection, radical cystectomy, or resection of metastases. Specimens were assessed for AR expression, and, in tumors that demonstrated AR staining, the percentage of nuclei that stained positive was recorded.

Results

Of the 49 tumors, 26 (53.1%) expressed the AR. The percentage of tumors that expressed the AR decreased with increasing pathologic stage, from 88.9% of pTa lesions to 0% of pT3 tumors. Overall, 75% of superficial tumors (pTa + pT1 + carcinoma in situ) expressed the AR compared with 21.4% of invasive tumors (pT2 + pT3; P = 0.002). In addition, among AR-expressing tumors, the mean percentage of nuclei that stained positive for the AR was significantly greater in pTa tumors (62.5%) than in pT1 (31%) or pT2 (20%) tumors (P = 0.005).

Conclusions

We found a decrease in AR protein expression in tumors with increased pathologic stage. Our data suggest that the loss of AR expression is associated with invasive bladder cancer.