HMOX1 Is an Important Prognostic Indicator of Nonmuscle Invasive Bladder Cancer Recurrence and Progression

J Urol. 2011 Feb;185(2):701-5. doi: 10.1016/j.juro.2010.09.081. Epub 2010 Dec 18.


Purpose: HMOX1, which is highly expressed in various solid tumors, has an important role in rapid tumor growth. We investigated the relationship between HMOX1 expression and clinicopathological parameters in patients with NMIBC.

Materials and methods: We analyzed 211 primary NMIBC tissue specimens by real-time PCR and compared the results with clinicopathological parameters. Kaplan-Meier survival curves and multivariate Cox regression analysis were used to assess the prognostic value of HMOX1 in NMIBC cases.

Results: HMOX1 mRNA expression was significantly higher in patients with higher grade and multiple tumors than in those with lower grade and single tumors (each p <0.05, respectively). Kaplan-Meier estimates showed HMOX1 expression was significantly associated with recurrence and progression (log rank test p = 0.010 and <0.001, respectively). A multivariate Cox regression model revealed that HMOX1 mRNA expression was an independent predictor of recurrence (HR 1.832, p = 0.017) and progression (HR 5.241, p = 0.001) in patients with NMIBC.

Conclusions: Analysis of HMOX1 expression in 211 NMIBC tissue specimens revealed its potential usefulness as a marker to predict the NMIBC prognosis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers, Tumor / genetics*
  • Biopsy, Needle
  • Carcinoma, Transitional Cell / genetics*
  • Carcinoma, Transitional Cell / mortality
  • Carcinoma, Transitional Cell / pathology
  • Carcinoma, Transitional Cell / surgery
  • Cohort Studies
  • Cystectomy / methods
  • Disease Progression
  • Female
  • Gene Expression Regulation, Neoplastic
  • Heme Oxygenase-1 / genetics
  • Heme Oxygenase-1 / metabolism*
  • Humans
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness / genetics
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / genetics*
  • Neoplasm Recurrence, Local / mortality
  • Prognosis
  • Proportional Hazards Models
  • RNA, Messenger / analysis
  • Reverse Transcriptase Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Survival Analysis
  • Urinary Bladder Neoplasms / genetics*
  • Urinary Bladder Neoplasms / mortality
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery


  • Biomarkers, Tumor
  • RNA, Messenger
  • HMOX1 protein, human
  • Heme Oxygenase-1