Expression of Wnt5a in Urothelial Carcinoma as a Potential Prognostic Marker
Bladder cancer is the fifth most common cancer in the USA. An estimated 72,570 new cases were diagnosed in 2013 and 15,210 will lead to a cancer-related death. Approximately 95% of bladder cancers occur in the urothelium to cause urothelial carcinoma. Finding molecular biomarkers for urothelial carcinoma can help determine prognosis and tailor management plans. The Wnt family of proteins has been shown to play a critical role in embryonic development, regulation of cell proliferation, motility, morphology, and cell fate. Aberrant Wnt signaling has been implicated in cancer. Wnt5a signaling, a β-catenin independent pathway has been implicated as tumor suppressor or tumor promoter for different types of cancer. Recently Wnt5a/Ror2 signaling has been described as an important pathway in epithelial-mesenchymal transition and metastatic processes. Several prognostic biomarkers have already been studied for urothelial carcinoma, including β-catenin and E-cadherin. β-catenin and E-cadherin are cell membrane proteins important for cell adhesion. β-catenin, as part of the β-catenin dependent pathway, becomes dissociated from the cell membrane and enters the nucleus to induce gene expression. Decreased expression of E-cadherin from the cell membrane has been associated with increased invasiveness.