Variables Sex Male Female Age (years) ≤ 70 > 70 Stage pTa-T1 ≥PT2 Grade Slug Twist LG HG + - + - Snail + - E-cadherin + - 87 33 64 56 76 44 41 79 75 45 53 67 19 101 89 31 78(75.7%) 25(24.3%) 58(56%) 45(44%) 6871.8% 3528.2% 40(38.8%) 63(61.2%) 63(61%) 40(39%) 41(40%) 62(60%) 16(15%) 87(85%) 86(83.5%) 17(16.5%) Yu et al. Journal of Experimental & Clinical Cancer Research 2010, 29:119 http://www.jeccr.com/content/29/1/119 Page 7 of 9 Table 5 Univariate analyses of various clinicopathological parameters in relation to survival of patients with bladder tumor Patients (n = 120) Progression-free survival(PFS) 5-year survival (%) (n = 103) Overall survival(OS) 5-year survival (%) (n = 61) cadherin. In undifferentiated BT cells (HTB-1 and T24), Slug and Twist completely repressed E-cadherin (Fig. 1). With increasing differentiation, Slug and E-cadherin or Twist and E-cadherin were coexpressed in BT cells (Fig. 1). This agrees with the fact that Slug and Twist is expressed at higher levels in poorly differentiated pan- creatic cancer cell lines and that these tumors are more likely to grow invasive [35,36]. In contrast to Twist and Slug, Snail showed no expression in 84.2% of human BT tissues and in all five human BT cell lines. This was an interesting fact because several studies have shown an overexpression of Snail in a variety of different tumors [18,19,37]. However, the mechanism(s)involved therein have not been examined so far in BT. Table 6 Multivariate analyses of Snail, Slug, Twist and E-cadherin Variables Progression-free survival OR (95% CI) P-Value Overall survival OR (95% CI) P-Value Slug 0.656 (0.215-2.003) Twist 0.276(0.090-0.841) Snail 0.858(0.221-3.777) E-cadherin 23.608(6.113-3.331) 0.457 0.018 0.891 0.000 0.409 (0.017-0.140) 0.510(0.245-1.058) 1.403(0.521-3.777) 3.435(1.421-8.305) 0.000 0.069 0.502 0.005 Many studies have showed that Twist, Slug and Snail expression is related to the invasive proliferation of tumors and to be a poor prognostic factor in various human tumors. Our results showed that Twist expresse in human BT tissues was significantly correlated to the tumor stage, grade and progression (P = 0.000, P = 0.000 and P = 0.021, respectively);Snail was significantly correlated to nodal involvement (P = 0.000), but Snail was not involved in bladder tumor differentiation, stage, grade and progression;Slug was only significantly corre- lated to nodal involvement (P = 0.012). It would seem unnecessary to evaluate new progression marker in the very aggressive group of invasive BT of which the prog- nosis is pejorative, but the comparison of the molecular profile between superficial and invasive BT could allow individualizing a molecular marker of interest in order to treat earlier and more efficiently the high-risk of pro- gression superficial bladder tumor. However, it has been demonstrated in human tumor cell lines that the forced expression of E-cadherin was not sufficient to reverse the process in Slug, Snail or Twist-expressing cells, and this result supports that Slug, Snail or Twist might mod- ulate other important signaling pathways involved in tumor progression and metastasis development P-Value 0.051 0.108 0.175 0.008 0.457 0.018 0.732 0.000 42(68.9%) 19(31.1%) 34(55%) 27(45%) 45(74%) 16(26%) 27(38%) 34(62%) 40(66%) 21(34%) 22(36%) 39(64%) 11(18%) 50(82%) 52(85%) 9(15%) P-Value 0.363 0.591 0.016 0.018 0.479 0.069 0.502 0.005