TFPI-2 expression is decreased in bladder cancer and is related to apoptosis.

Purpose: This study aimed to study the role of TFPI-2 in bladder cancer and its relation with apoptosis. Methods: Immunohistochemical (IHC) staining of TFPI-2 and TUNEL were applied. By semi quantitative analysis of the IHC data, we compared the TFPI-2 expression with clinicopathological parameters of 24 bladder cancer samples. TUNEL assay was used to study the apoptotic level of bladder cancer cells. Also, quantitative PCR and Western blot were used to confirm IHC results. Results: The expression of TFPI-2 decreased with progression of bladder cancer grade (p<0.001) and tumor stage (p<0.001). Also, TFPI-2 expression was not significantly decreased in smaller and single tumors (p=0.536 and p=0.378, respectively). Increased TFPI-2 expression was significantly correlated with increased apoptosis (p<0.001). Lower TFPI-2 was also correlated with lower Ki67 index but not with TP53 positivity (p=0.003 and p=0.195, respectively). Expression of TFPI-2 detected by IHC was consistent with that detected by Western blotting and PCR. Conclusion: TFPI-2 expression was decreased in bladder cancer. TFPI-2 expression was decreased with progression in tumor grade and stage and was correlated to decreased apoptosis. Our findings indicated that TFPI-2 could be a marker of bladder cancer and enhancement of TFPI-2 could combat bladder cancer.