Figure 6. SOX9 is overexpressed in human bladder cancer tissues.
A, Immunohistochemical SOX9 staining demonstrated undetectable or low levels in benign urothelium (n=49; representative section in A, top panel) Staining (both distribution and intensity) was slightly elevated in noninvasive carcinomas (n=56; staining not shown), more widespread and intense in the majority of high grade flat carcinoma in situ (Flat) lesions (n=15; staining not shown) and invasive human UroCas (n=84; A, middle panel). Overall, mean SOX9 scores for cancer exceeded those for than benign urothelium (* P=0.0001), and mean scores for invasive cancers exceeded those for noninvasive cancers († P<0.03). Compared to benign urothelium, SOX9 scores were slightly elevated in low grade papillary noninvasive cancers (n. s.) but became increasingly elevated in high grade and invasive tumors (* P<0.05). B, Model of EGF ligand-receptor-ERK1/2-SOX9 induction by injury. Note that the system turns off in response to completion of injury repair. With chronic injury, the system may remain activated and facilitate cancer formation.