Prognostic significance of heat shock proteins in urothelial carcinoma of the urinary bladder

Aims Heat shock proteins (HSPs) are a group of molecules induced by a variety of environmental and pathophysiological stresses, including cancer. The expression of HSPs has been implicated in the regulation of apoptosis and immunity in neoplasia. The purpose of this study was to evaluate the expression and clinicopathological relevance of several HSPs in urothelial carcinomas of the urinary bladder. Methods and results Immunohistochemical staining for HSP27, HSP60, HSP70 and HSP90 was performed on samples collected from 744 clinical cases. The results were correlated with clinicopathological characteristics using univariate and multivariate analyses. High expression of HSP70 predicted recurrence of non-muscle-invasive urothelial carcinoma treated by transurethral resection, and low expression of HSP27 correlated with progression and cancer-specific mortality for non-muscle-invasive cancers treated by transurethral resection. Low expression of HSP27 also predicted cancer-specific mortality for patients who underwent cystectomy. Conclusions Both HSP27 and HSP70 impact on the biological behaviour of urothelial carcinomas of the urinary bladder. Immunohistochemical assessment of HSPs can provide useful prognostic information that could ultimately help to develop individualized surveillance programmes.