Pathology & Oncology Research

, Volume 25, Issue 1, pp 225–231 | Cite as

Primary High-Grade Non-Muscle-Invasive Bladder Cancer: High NFκB Expression in Tumor Specimens Distinguishes Patients Who are at Risk for Disease Progression

  • Lampros MitrakasEmail author
  • Stavros Gravas
  • Christos Papandreou
  • Georgios Koukoulis
  • Foteini Karasavvidou
  • Georgios Dimakopoulos
  • Karl Weingärtner
  • Anastasios Karatzas
  • Ioannis Zachos
  • Vasilios Tzortzis
Original Article


To investigate the potential prognostic role of NFκB expression in primary high-grade non-muscle-invasive bladder cancer. Patients with primary high-grade non-muscle-invasive bladder cancer who received induction and maintenance BCG therapy were retrospectively included. Recurrence and progression were histologically proven. Intensity and extent of immunochemistry were assessed. The final evaluation of the NFκB staining was done by combining intensity and extent as ΄΄product΄΄ and expressing it as ΄΄low NFκΒ expression΄΄ or ΄΄high NFκB expression΄΄. Epidemiological, pathological, clinical parameters and NFκB expression were statistically analyzed for recurrence (REC), progression (PR), recurrence-free survival (RFS) and progression-free survival (PFS). NFκB is significantly associated with disease progression (p < 0,001 in univariate analysis and p = 0,001, Odds Ratio = 14,484, 95% Confidence Interval = 3187-65,821 in multivariate analysis), but not with recurrence. The median value of NFκB expression as ΄΄product΄΄ is significantly higher for the patients with progression in comparison to patients with recurrence only (p = 0,003) and patients without recurrence or progression (p = 0,001). Patients’ age is significantly associated (p = 0,001 in univariate analysis and p = 0,003, Odds Ratio = 1273, 95% Confidence Interval = 1086–1492 in multivariate analysis) with disease recurrence. High NFκB expression in primary high-grade non-muscle-invasive bladder cancer, treated with postoperative intravesical BCG immunotherapy, could represent an unfavorable prognostic factor.


NFκΒ High-grade Non-muscle-invasive Bladder cancer Progression; BCG 



The corresponding author has been awarded a supporting funding from the Hellenic Urological Association (HUA).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that there is no conflict of interest regarding the publication of this paper.


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Copyright information

© Arányi Lajos Foundation 2017

Authors and Affiliations

  • Lampros Mitrakas
    • 1
    • 2
    Email author
  • Stavros Gravas
    • 1
  • Christos Papandreou
    • 3
  • Georgios Koukoulis
    • 4
  • Foteini Karasavvidou
    • 4
  • Georgios Dimakopoulos
    • 5
  • Karl Weingärtner
    • 2
  • Anastasios Karatzas
    • 1
  • Ioannis Zachos
    • 1
  • Vasilios Tzortzis
    • 1
  1. 1.Department of Urology, Faculty of Medicine-School of Health Sciences-University of ThessalyUniversity Hospital of LarissaLarissaGreece
  2. 2.Klinik für Urologie und Kinderurologie, Sozialstiftung Bamberg-Klinikum am BruderwaldAkademisches Lehrkrankenhaus der Friedrich-Alexander-Universität Erlangen-NürnbergBambergGermany
  3. 3.Department of Oncology, Faculty of Medicine-School of Health Sciences-University of ThessalyUniversity Hospital of LarissaLarissaGreece
  4. 4.Department of Pathology and Cytology, Faculty of Medicine-School of Health Sciences-University of ThessalyUniversity Hospital of LarissaLarissaGreece
  5. 5.Medical StatisticsScience and Technology Park of EpirusIoanninaGreece

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