The role of epigenetic alterations in the carcinogenesis of solid tumors has been intensively investigated over the last ten years [2, 3]. DNA methylation at CpG rich regions often occurs at tumor suppressor gene promoters, frequently producing a reduction in the expression of target genes. An increasing number of papers are being published on the role

of gene methylation and its potential clinical application in human tumors [4]. Methylation seems to be an early event in the development of a number of solid tumors including bladder cancer [5, 6] and can thus be regarded as an early sign of cancer before the disease becomes muscle-invasive. Methylated tumor suppressor genes such as APC, RARB2, BRCA1 have recently been indicated as valid diagnostic markers for NMIBC Captisol [7–10]. A number of papers have also focused on the role of check details methylation as a prognostic marker, but it is not clear which methylated genes can accurately predict recurrence. Some studies have hypothesized hypermethylation of tumor suppressor genes, such as TIMP3, as a good prognostic marker [11, 12], while others have indicated hypermethylated E-cadherin, p16, p14, RASSF1,

DAPK, APC, alone or in different combinations, as potential markers of early recurrence and poor survival [13–15]. In the present study we evaluated the methylation status of a panel of 24 genes (TIMP3, APC, CDKN2A, MLH1, ATM, RARB, CDKN2B, HIC1, CHFR, BRCA1, CASP8, CDKN1B, PTEN, BRCA2, CD44, RASSF1, DAPK1, FHIT, VHL, ESR1, TP73, IGSF4, GSTP1 and CDH13) in superficial

bladder cancer to determine their ability to predict recurrence. Although methylation of some of these genes has already been investigated in bladder cancer [11–15], its relevance as an indicator of recurrence has yet to be confirmed. We used the relatively new methodology of methylation specific multiplex ligation dependent probe amplification (MS-MLPA) to evaluate epigenetic gene profiles. This approach permits methylation analysis of multiple targets in a single experiment [16, 17] and has been successfully used to evaluate the diagnostic or Dimethyl sulfoxide prognostic relevance of different markers in several tumor types such as lung [18], rectal [19], breast [20] and recently, bladder cancers [7, 8]. Methods Case series (retrospective cohort study) Tissue samples from 74 VRT752271 order patients (65 males, 9 females) submitted to transurethral resection of primary bladder cancer at the Department of Urology of Morgagni-Pierantoni Hospital in Forlì between 1997 and 2006 were used for the study. All samples were retrieved from the archives of the Pathology Unit of the same hospital. Median age of patients was 73 years (range 39–92): 31 were <70 years and 43 ≥70 years. On the basis of 2004 World Health Organization criteria, final diagnosis was low grade non muscle invasive bladder cancer (NMIBC) in 55 patients and high grade NMIBC in 19 patients.