TY - JOUR T1 - Connexin 43 expression predicts poor progression-free survival in patients with non-muscle invasive urothelial bladder cancer JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 819 LP - 824 DO - 10.1136/jclinpath-2015-202898 VL - 68 IS - 10 AU - Cédric Poyet AU - Lorenz Buser AU - Filip Roudnicky AU - Michael Detmar AU - Thomas Hermanns AU - Doris Mannhard AU - Andrej Höhn AU - Jan Rüschoff AU - Qing Zhong AU - Tullio Sulser AU - Holger Moch AU - Peter J Wild Y1 - 2015/10/01 UR - http://jcp.bmj.com/content/68/10/819.abstract N2 - Objectives To evaluate the protein expression of connexin 43 (Cx43) in primary urothelial bladder cancer and test its association with the histopathological characteristics and clinical outcome.Methods A tissue microarray containing 348 tissue samples from 174 patients with primary urothelial carcinomas of the bladder was immunohistochemically stained for Cx43. The intensity of staining was semiquantitatively evaluated (score 0, 1+, 2+), and the association with clinicopathological features was assessed. Univariable and multivariable analyses were performed to identify predictors for progression-free survival (PFS).Results Membranous Cx43 immunoreactivity was detected in 118 (67.8%) of 174 analysable urothelial carcinomas, of which 31 (17.8%) showed even a strong (score 2+) and mainly homogeneous staining. Strong expression levels of Cx43 (score 2+) were associated with higher tumour grade, multiplicity and increased proliferation (all p<0.05). In the subgroup of patients with stage pTa and pT1 bladder tumours (n=158), strong Cx43 expression (p<0.001), solid growth pattern (p<0.001) and increased Ki-67 proliferation fraction (p<0.05) were significantly associated with shorter PFS in an univariable Cox regression analysis. In multivariable Cox regression models, Cx43 immunoreactivity and histological growth pattern remained highly significant and adverse risk factors for PFS.Conclusions The expression levels of Cx43 are frequent in non-muscle invasive bladder cancer (NMIBC), with high expression levels being associated with poor prognosis. Routine assessment of Cx43 expression may improve the identification of high-risk NMIBC. ER -