• MUROOJ JASSIM MOHAMMED Department of Pathology and Forensic Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq.
  • BASIM SHEHAB AHMED Department of Pathology and Forensic Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq.


Objectives: The objectives of this study were to provide an outlook of urothelial carcinoma through the immunohistochemical expression patterns of octamer-binding transcription factor 4 (OCT4) in high-grade transitional cell carcinoma (TCC) of the urinary bladder.

Methods: A total number of 60 tissue samples were collected for the study. Patients were divided into two groups according to the pathological diagnosis of the bladder tissue, Group A: 30 cases with high-grade TCC of the bladder and Group B: 30 cases with apparently normal bladder tissue. Tissue immunohistochemical analysis was applied to investigate the expression patterns of cancer stem cell (CSC) markers OCT4 in bladder samples.

Results: OCT4 was positive in 80% of specimens of Group A and 3.3% in specimens of Group B. The association between OCT4 marker result and certain histopathological features in high-grade group: Positive OCT4 result was found in patients with inflammation and necrosis (90.9%) with a significant association (p=0.013). Regarding muscular invasion, we noticed that 87.5% of patients with muscular invasion showed positive OCT4 marker result with a significant association (p=0.039) between OCT4 marker result and muscular invasion. As well, OCT4 marker was highly sensitive and specific (sensitivity=66.7%, specificity=96.7%, and accuracy=76.7%).

Conclusion: There was a significant expression of CSC OCT4 in high-grade TCC, OCT4 can be considered as a key regulator of tumor progression, aggressive behavior, and metastasis.

Keywords: Octamer-binding transcription factor 4,, Transitional cell carcinoma,, Bladder.


1. Al-Kuraishy HM, Al-Gareeb AI. Erectile dysfunction and low sex drive in men with type 2 DM: The potential role of diabetic pharmacotherapy. J Clin Diagn Res 2016;10:FC21-FC26.
2. Al-Kuraishy HM, Al-Gareeb AI, Al-Buhadilly AK. P53 gene (NY-CO-13) levels in patients with chronic myeloid leukemia: The role of imatinib and nilotinib. Diseases 2018;6:13.
3. Chan KS, Espinosa I, Chao M, Wong D, Ailles L, Diehn M, et al. Identification, molecular characterization, clinical prognosis, and therapeutic targeting of human bladder tumor-initiating cells. Proc Natl Acad Sci U S 2009;106:14016-21.
4. Holla SN, Nayak V, Bairy KL, Tripathy A, Holla NS. Her-2 gene, receptors and drug target: A systematic review. Int J Pharm Pharm Sci 2016;8:4-9.
5. Takeda J, Seino S, Bell GI. Human Oct3 gene family: CDNA sequences, alternative splicing, gene organization, chromosomal location, and expression at low levels in adult tissues. Nucleic Acids Res 1992;20:4613-20.
6. Al-Kuraishy HM, Al-Gareeb AI. Potential effects of pomegranate on lipid peroxidation and pro-inflammatory changes in daunorubicin-induced cardiotoxicity in rats. Int J Prev Med 2016;7:85.
7. Rodda DJ, Chew JL, Lim LH, Loh YH, Wang B, Ng HH, et al. Transcriptional regulation of nanog by OCT4 and SOX2. J Biol Chem 2005;280:24731-7.
8. Atlasi Y, Mowla SJ, Ziaee SA, Bahrami AR. OCT-4, an embryonic stem cell marker, is highly expressed in bladder cancer. Int J Cancer 2007;120:1598-602.
9. Al-Kuraishy HM, Al-Gareeb AI. Acylation-stimulating protein is a surrogate biomarker for acute myocardial infarction: Role of statins. J Lab Physicians 2017;9:163-9.
10. Niwa H, Miyazaki J, Smith AG. Quantitative expression of Oct-3/4 defines differentiation, dedifferentiation or self-renewal of ES cells. Nat Genet 2000;24:372-6.
11. Christophersen NS, Helin K. Epigenetic control of embryonic stem cell fate. J Exp Med 2010;207:2287-95.
12. Zeineddine D, Hammoud AA, Mortada M, Boeuf H. The Oct4 protein: More than a magic stemness marker. Am J Stem Cells 2014;3:74.
13. Xu K, Zhu Z, Zeng F, Dong J. Expression and significance of Oct4 in bladder cancer. J Huazhong Univ Sci Technol Med Sci 2007;27:675-7.
14. Al-Kuraishy HM, Al-Gareeb AI, Al-Maiahy TJ. Concept and connotation of oxidative stress in preeclampsia. J Lab Physicians 2018;10:276.
15. Asar A, Gabal S, Helmy N, Khalifa SE. Immunohistochemical study of the expression of Oct-4 in bladder urothelial carcinoma. Kasr Al Ainy Med J 2017;23:141.
16. Huang Z, Yu H, Zhang J, Jing H, Zhu W, Li X, et al. Correlation of cancer stem cell markers and immune cell markers in resected non-small cell lung cancer. J Cancer 2017;8:3190.
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How to Cite
MUROOJ JASSIM MOHAMMED, and BASIM SHEHAB AHMED. “EXPRESSION OF CANCER STEM CELL MARKER OCTAMER-BINDING TRANSCRIPTION FACTOR 4 IN HIGH-GRADE TRANSITIONAL CELL CARCINOMA”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 12, no. 6, May 2019, pp. 313-6, doi:10.22159/ajpcr.2019.v12i6.33189.
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