Role of CD44 And MMP2 Marker in Diagnosis and Prognosis of Urinary Bladder Carcinoma

Introduction: Lower urinary tract symptoms are caused by several factors. If a patient suffering from frequent urination associated with pain and blood in urine draws the attention of patients and brings them for consultations with the clinicians. Among serious causes for lower urinary tract symptoms is bladder carcinoma, affecting more men (3.67%) and comparatively fewer (0.83%) women. Clinicians, with the help of pathologists, confirm their diagnosis to decide on the choice of treatment options for better quality of life for the patients. Pathologists accomplish histopathology and subsequent use of CD44 and MMP2 antibodies as diagnostic and prognostic markers in urinary bladder carcinoma. Enables urologists to choose better treatment options to improve the quality of life of the sufferer.

Aim: This study was aimed at determining the sensitivity and specificity of CD44 and MMP2 for the diagnosis and prognosis of urinary bladder carcinoma.

Study Design: Prospective cross sectional analytical study design was chosen.

Material and Methods: Overall, 56 histopathological specimens were taken for study from men and women between the ages of 18 and 60 years. The tissue was received after transurethral resection of bladder tissue (TURBT) and radical cystectomy from the urology department. The tissues after fixation in 10% buffered formalin solution, grossing and sectioning were made. Thin sections of 4-to-6-micron thickness were prepared. Following standard tissue processing protocol, haematoxylin and eosin staining was done. The Dako immunohistochemistry protocol was followed for the positivity of the prepared and stained sections for liquid anti-CD44 antibody [ERP1013Y] ab51037 and anti-MMP2 antibody ab3750 reagents in 1:70 dilution. Then each section was examined under a microscope in high power at 100X.

Results and Observations: SPSS version 21 software was used for data analysis. Mean age ± SD of patients was 55.07±11.99 years. Bladder carcinoma was found highest (46.4%) in patients of age group 60 years or more. Among study groups, males constituted 50 (89.3%) and females 6 (10.7%). The CD44 expression was significantly less in high grade than in low grade (p<0.001). The highly significant association was found between MMP2 expression and tumour grades (p=0.006). The MMP2 expression was significantly more in the high grade than the low grade (p=0.001). In the present study, sensitivity was 89.2% (% accuracy of prediction of high grade. Specificity observed was 100% (% accuracy of prediction of low grades). Overall diagnostic accuracy reported 92.9% (% accuracy of true prediction).

Conclusion: CD44 expression is significantly more expressed in low grade non-invasive urothelial carcinoma (NMIBC) while MMP2 is significantly more expressed in high grade muscle invasive urothelial carcinoma (MIBC). Therefore, both CD44 and MMP2 is reliable and an excellent diagnostic biomarker marker.