Abstract

5'-Adenosine monophosphate activated protein kinase has a significant role in tumor growth, progress and metastasis, so the study of 5'-Adenosine monophosphate activated protein kinase's association with cancer risk is of important value. The aim of this study is to describe 5'-Adenosine monophosphate activated protein kinase expression and investigates its possible association with the clinicopathological factors of urinary bladder cancer to estimate its clinical usefulness in diagnosis and prognosis. This retrospective study utilized previously diagnosed 128 cases of bladder cancer and twenty-three specimens of normal bladder, which were assembled from the pathology archive, and were employed in the construction of tissue microarrays in this study. An immunohistochemistry staining has been applied to tissue microarrays slides for the revealing of 5'-Adenosine monophosphate activated protein kinase expression. Brown cytoplasmic staining were presented in malignant urothelial cells of 106 (82.8 %) bladder neoplasms of which 98 (92.5 %) cases showed weak staining. On the other hand, out of 23 positive normal bladder mucosa 18 (78.3 %) cases revealed moderate to strong 5'-Adenosine monophosphate activated protein kinase expression. Positive 5'-Adenosine monophosphate activated protein kinase immunohistochemistry staining in malignant urothelial cells was significantly more prevalent in low grade bladder tumors (p=0.035). A Cox proportional hazards model showed that high grade tumors had a significant effect on the hazard/survival in comparison with tumors of low grade (p=0.032). Furthermore, Kaplan-Meier survival distribution curves showed that survival behavior is better in low grade tumors and cases with negative vascular invasion. The outcomes of this study suggest that 5'-Adenosine monophosphate activated protein kinase immunohistochemistry staining could be a supportive tool to predict grade and prognosis of urinary bladder cancer.