CCL2 is associated with metastasis and poor prognosis of bladder cancer

Background: Chemokine (C-C motif) ligand 2 (CCL2) is an important immune factor, which may be important in cancer progression by promoting proliferation, invasion metastasis and the tumor microenvironment. Recent researches have demonstrated that overexpression of CCL2 is associated with unfavorable prognosis in various cancer types. In this study, we aim to determine the prognostic value of CCL2 expression in patients with bladder cancer (BC). Methods: We retrospectively enrolled 154 patients with bladder cancer at Renji Hospital, Shanghai Jiaotong University between 2005 and 2007. CCL2 expression was assessed by immunohistochemical staining and its association with clinicopathologic features and prognosis were evaluated. Kaplan-Meier method was applied to compare survival curves. Cox regression models were fitted to analyze the effect of prognostic factors on Overall survival (OS). Results: CCL2 protein had high expression in 73 of 154 cases of BC (47%). CCL2 overexpression was significantly associated with tumor grade (P<0.001), stage (P=0.005), and lymph node metastasis (P=0.025). The Kaplan–Meier survival analysis demonstrated that CCL2 expression was significantly associated with DSS and OS (both P< 0.001). Multivariate analysis further demonstrated that CCL2 was an independent prognostic factor for patients with BC. Conclusion: CCL2 might be a new molecular marker to predict the prognosis of patients with BC. The novel risk classification based on combining CCL2 and TNM is more reliable than using either alone.