Clinical significance of MACC1, Twist1, and KAI1 expressions in infiltrating urothelial carcinoma of the bladder

Background: Metastasis-associated in colon cancer 1 (MACC1), a candidate oncogene, promotes tumor cell invasion and metastasis in various cancers. Twist1, a key transcriptional gene of the epithelial-mesenchymal transition (EMT), is involved in EMT and metastasis in many cancers. KAI1, also known as CD82, was originally considered as a suppressor gene of tumor metastasis. In this study, we investigated the expressions and significance of MACC1, Twist1, and KAI1 in infiltrating urothelial carcinoma of bladder (IUCB). Methods: The expressions of MACC1, Twist1, and KAI1 in 195 IUCB specimens and their corresponding control specimens were investigated by immunohistochemistry. The patients' clinical, demographic, and follow-up data were collected. Results: The rates of the positive expressions of MACC1 and Twist1 were significantly higher in IUCB tissues than in normal bladder mucosa tissues, and their expressions were positively correlated with tumor stages, grades of differentiation, lymph node metastasis (LNM), and tumor-node-metastasis (TNM) stages. The rate of positive expression of KAI1 was significantly lower in IUCB than in the control tissues, and its expression was inversely associated with tumor stages, grades of differentiation, LNM, and TNM stages. Patients who expressed MACC1 or Twist1 had an unfavorable overall survival (OS) time when compared with patients who did not express these proteins. However, patients who expressed KAI1 had a favorable OS when compared with patients who did not express this protein. A multivariate analysis demonstrated that the expressions of MACC1, Twist1, and KAI1, tumor stages, grades of differentiation, LNM, as well as TNM stages were independent prognostic indicators for IUCB patients. Conclusion: Therefore, MACC1, Twist1, and KAI1 should be considered potentially promising biomarkers of IUCB prognosis.