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Zhang P, Song D, Fang Z, Sun D, Wang L, Shi L, Gao L, Jiang X. Cardamomin Inhibits the Proliferation and Tumorigenesis of Bladder Cancer by ESR1 in PI3K/AKT Pathway. Biochem Genet 2024:10.1007/s10528-024-10854-x. [PMID: 38867088 DOI: 10.1007/s10528-024-10854-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/29/2023] [Indexed: 06/14/2024]
Abstract
Cardamomin has been widely studied in cancer, but its role in cancer bladder cancer has not been mentioned. In this study, we validated the anti-cancer effect of cardamom and whether its potential mechanism is related to the PI3K/AKT pathway. After treating with different doses of cardamomin, the cytotoxicity was studied by CCK8. Secondly, we analyzed the effect of cardamomin on the proliferation, apoptosis and cell movement. Next, we analyzed the regulation of ESR1 by western blot and its impact on the PI3K/AKT pathway. We also transfected ESR1 overexpression and silencing vectors, and verified the transfection efficiency through RT-qPCR. Further, the specific mechanism of the drug's inhibitory effect on bladder cancer was also determined. We constructed the subcutaneous tumor model in vivo. After cardamomin administration, we mainly analyzed the positive expression of KI67 in tumor tissues by immunohistochemistry, and the apoptotic cells in tumor tissues by TUNEL, and related proteins in PI3K/AKT pathway by western blot. In this paper, cardamomin inhibited cell proliferation and invasion ability, blocked the transition of G0/G1 phase to S phase, and increased apoptotic rate of 5637 and HT1376 cells, as well as raised ESR1 expression. Cardamomin exerted anti-tumor effect through PI3K/AKT pathway. In vivo animal experiments indicated the inhibitory effect of cardamomin on subcutaneous implanted tumor. Cardamomin inhibited the positive expression of KI67 and promoted the TUNEL-positive cells in tumor tissues. Consistent with in vitro assay, cardamomin increased the expression of ESR1 and downregulated the PI3K/AKT pathway. Cardamomin has a significant inhibitory effect on bladder cancer, and upregulate the expression of ESR1 in bladder cancer through PI3K/AKT.
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Affiliation(s)
- Peng Zhang
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Dapeng Song
- Department of Surgery, Yantai Haiyang Traditional Chinese Medicine Hospital, Yantai, Shandong, China
| | - Zhidong Fang
- Department of Urology, People's Hospital of Rongcheng, Weihai, Shandong, China
| | - Dekang Sun
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Lin Wang
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Lei Shi
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Liang Gao
- Department of Surgery, Rushan Hospital of Traditional Chinese Medicine, Xinhua Street 47, Weihai, 264599, Shandong, China.
| | - Xudong Jiang
- Department of Surgery, Rushan Hospital of Traditional Chinese Medicine, Xinhua Street 47, Weihai, 264599, Shandong, China.
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Abdel-Hafiz HA, Kailasam Mani SK, Huang W, Gouin KH, Chang Y, Xiao T, Ma Q, Li Z, Knott SR, Theodorescu D. Single-cell profiling of murine bladder cancer identifies sex-specific transcriptional signatures with prognostic relevance. iScience 2023; 26:107703. [PMID: 37701814 PMCID: PMC10494466 DOI: 10.1016/j.isci.2023.107703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/18/2023] [Accepted: 08/21/2023] [Indexed: 09/14/2023] Open
Abstract
Bladder cancer (BLCA) is more common in men but more aggressive in women. Sex-based differences in cancer biology are commonly studied using a murine model with BLCA generated by N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN). While tumors in the BBN model have been profiled, these profiles provide limited information on the tumor microenvironment. Here, we applied single-cell RNA sequencing to characterize cell-type specific transcriptional differences between male and female BBN-induced tumors. We found proportional and gene expression differences in epithelial and non-epithelial subpopulations between male and female tumors. Expression of several genes predicted sex-specific survival in several human BLCA datasets. We identified novel and clinically relevant sex-specific transcriptional signatures including immune cells in the tumor microenvironment and it validated the relevance of the BBN model for studying sex differences in human BLCA. This work highlights the importance of considering sex as a biological variable in the development of new and accurate cancer markers.
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Affiliation(s)
- Hany A. Abdel-Hafiz
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | | | - Wesley Huang
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kenneth H. Gouin
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Yuzhou Chang
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – The James, Columbus, OH 43210, USA
| | - Tong Xiao
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – The James, Columbus, OH 43210, USA
| | - Qin Ma
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – The James, Columbus, OH 43210, USA
| | - Zihai Li
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center – The James, Columbus, OH 43210, USA
| | - Simon R.V. Knott
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Dan Theodorescu
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Prognostic significance of age, sex, race, and socioeconomic status in patients with stage III-IV upper tract urothelial carcinoma. Actas Urol Esp 2022; 46:413-422. [PMID: 35717441 DOI: 10.1016/j.acuroe.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 09/26/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the trend of incidence and survival stratified by age, race, gender and SES and the differences in time between groups in stage III-IV upper tract urothelial carcinoma (UTUC) patients. METHODS 7,505 stage III-IV UTUC patients between 2004 and 2015 were extracted from the Surveillance, Epidemiology and End Results (SEER) database. The overall survival (OS) and the cancer-specific survival (CSS) rates were assessed using the Kaplan-Meier curve and log-rank test as well as multivariate Cox regression analysis. RESULTS Among the 7,505 patients, 3,584 were classified as young, 2,464 were classified as middle-aged, and 1,461 were classified as elderly. The years of diagnosis were divided into three periods including 2004-2007, 2008-2011 and 2012-2015. The incidence rates for UTUC were 0.69, 0.74, and 0.77 per 100,000 in the first, second, and third period, respectively. Disparities in the long-term survival rate between male and female patients and among patients of different races narrowed over time. There was no difference in prognosis between races (p = 0.078 for OS and p = 0.167 for CSS). The difference in survival rate between the poor and rich groups narrowed along with the three time periods. CONCLUSIONS Survival rate disparities according to sex, race, and socioeconomic status narrowed in time, except in patients aged 74-82 years. Increased age, black race, and poverty are associated with worse survival outcomes. In general, the long-term survival rate improved continuously across the three periods.
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Li YD, Gao L, Gou YQ, Tan W, Liu C. Age of menarche and primary bladder cancer risk: A meta-analysis and systematic review. Urol Oncol 2022; 40:346.e17-346.e26. [DOI: 10.1016/j.urolonc.2022.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/20/2022] [Accepted: 02/28/2022] [Indexed: 10/18/2022]
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Significación pronóstica de la edad, el sexo, la raza y el nivel socioeconómico en pacientes con carcinoma urotelial del tracto urinario superior en estadio III-IV. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Viswambaram P, Hayne D. Gender discrepancies in bladder cancer: potential explanations. Expert Rev Anticancer Ther 2020; 20:841-849. [PMID: 32896196 DOI: 10.1080/14737140.2020.1813029] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Gender differences in urothelial carcinoma of the bladder (UCB) exist. Although men have a higher incidence of UCB, women tend to have poorer outcomes. We have explored and summarized the evidence for gender differences of UCB diagnosis and prognosis, together with reasons for these disparities. AREAS COVERED The incidence of UCB is 3-4 times higher in men than women. However, women are more likely to be diagnosed with advanced disease. Women have a higher stage-for-stage mortality compared to men, and their greatest risk of death appears to be within the first 2 years of diagnosis. Survival outcomes following radical cystectomy (RC) and radiotherapy are also poorer in women. Delays in diagnosis, differences in female anatomy, as well as poorer surgical outcomes post-RC appear to contribute significantly to the disparities noted between genders. Other factors such as exposure to risk factors, differential hormone signaling, and carcinogen breakdown may also have a role. EXPERT OPINION The gender divide in UCB outcomes has to be addressed. Improved medical and patient education and centralization of RC are recommended.
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Affiliation(s)
- Pravin Viswambaram
- Urology Research Registrar, Fiona Stanley Hospital; Master of Surgery Student, UWA Medical School, University of Western Australia (UWA) , Australia
| | - Dickon Hayne
- Head of Urology, Fiona Stanley Hospital; Professor of Urology, UWA Medical School, University of Western Australia (UWA); Chair of Bladder Urothelial and Penile Cancer Sub-committee, Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group , Australia
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Lujan-Barroso L, Botteri E, Caini S, Ljungberg B, Roswall N, Tjønneland A, Bueno-de-Mesquita B, Gram IT, Tumino R, Kiemeney LA, Liedberg F, Stocks T, Gunter MJ, Murphy N, Cervenka I, Fournier A, Kvaskoff M, Häggström C, Overvad K, Lund E, Waaseth M, Fortner RT, Kühn T, Menéndez V, Sánchez MJ, Santiuste C, Perez-Cornago A, Zamora-Ros R, Cross AJ, Trichopoulou A, Karakatsani A, Peppa E, Palli D, Krogh V, Sciannameo V, Mattiello A, Panico S, van Gils CH, Onland-Moret NC, Barricarte A, Amiano P, Khaw KT, Boeing H, Weiderpass E, Duell EJ. Menstrual Factors, Reproductive History, Hormone Use, and Urothelial Carcinoma Risk: A Prospective Study in the EPIC Cohort. Cancer Epidemiol Biomarkers Prev 2020; 29:1654-1664. [PMID: 32467345 DOI: 10.1158/1055-9965.epi-20-0184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/07/2020] [Accepted: 05/19/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Urothelial carcinoma is the predominant (95%) bladder cancer subtype in industrialized nations. Animal and epidemiologic human studies suggest that hormonal factors may influence urothelial carcinoma risk. METHODS We used an analytic cohort of 333,919 women from the European Prospective Investigation into Cancer and Nutrition Cohort. Associations between hormonal factors and incident urothelial carcinoma (overall and by tumor grade, tumor aggressiveness, and non-muscle-invasive urothelial carcinoma) risk were evaluated using Cox proportional hazards models. RESULTS During a mean of 15 years of follow-up, 529 women developed urothelial carcinoma. In a model including number of full-term pregnancies (FTP), menopausal status, and menopausal hormone therapy (MHT), number of FTP was inversely associated with urothelial carcinoma risk (HR≥5vs1 = 0.48; 0.25-0.90; P trend in parous women = 0.010) and MHT use (compared with nonuse) was positively associated with urothelial carcinoma risk (HR = 1.27; 1.03-1.57), but no dose response by years of MHT use was observed. No modification of HRs by smoking status was observed. Finally, sensitivity analyses in never smokers showed similar HR patterns for the number of FTP, while no association between MHT use and urothelial carcinoma risk was observed. Association between MHT use and urothelial carcinoma risk remained significant only in current smokers. No heterogeneity of the risk estimations in the final model was observed by tumor aggressiveness or by tumor grade. A positive association between MTH use and non-muscle-invasive urothelial carcinoma risk was observed. CONCLUSIONS Our results support that increasing the number of FTP may reduce urothelial carcinoma risk. IMPACT More detailed studies on parity are needed to understand the possible effects of perinatal hormone changes in urothelial cells.
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Affiliation(s)
- Leila Lujan-Barroso
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Gran Via de L'Hospitalet 199-203, L'Hospitalet de Llobregat, Barcelona, Spain.
- Bellvitge Biomedical Research Institute - IDIBELL, Gran Via de L'Hospitalet 199-203, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Nursing of Public Health, Mental Health and Maternity and Child Health School of Nursing, Universitat de Barcelona, Carrer de la Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Edoardo Botteri
- Cancer Registry of Norway, Oslo University Hospital, Ullernchausseen 64, Oslo, Norway
- Norwegian National Advisory Unit for Women's Health, Women's Clinic, Oslo University Hospital, Sognsvannsveien 20, Oslo, Norway
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy
| | - Börje Ljungberg
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Nina Roswall
- Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen, Denmark
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, Denmark
| | - Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, United Kingdom
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, Kuala Lumpur, Malaysia
| | - Inger T Gram
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Rosario Tumino
- Department of Cancer Registry and Histopathology, "Civic -M.P. Arezzo" Hospital, ASP Ragusa, Ragusa, Italy
| | - Lambertus A Kiemeney
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Fredrik Liedberg
- Department of Urology, Skåne University Hospital and Institution of Translational Medicine, Lund University, Jan Waldenströms gata 5, Malmö, Sweden
| | - Tanja Stocks
- Department of Clinical Sciences Lund, Lund University, Barngatan 4, Lund, Sweden
| | - Marc J Gunter
- International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Neil Murphy
- International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Iris Cervenka
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health across Generations" Team, Gustave Roussy 114 rue Edouard Vaillant, Villejuif, France
| | - Agnès Fournier
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health across Generations" Team, Gustave Roussy 114 rue Edouard Vaillant, Villejuif, France
| | - Marina Kvaskoff
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health across Generations" Team, Gustave Roussy 114 rue Edouard Vaillant, Villejuif, France
| | - Christel Häggström
- Department of Biobank Research, Umeå University, Umeå, Sweden
- Department of Surgical Sciences, Uppsala University, Akademiska sjukhuset entrence 70, Uppsala, Sweden
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Eiliv Lund
- Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Marit Waaseth
- Department of Pharmacy, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Renée Turzanski Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DFKZ), Im Neuenheimer Feld 280, Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DFKZ), Im Neuenheimer Feld 280, Heidelberg, Germany
| | - Virginia Menéndez
- Public Health Directorate, C/Ciriaco Miguel Virgil 9, Oviedo, Asturias, Spain
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), Cuesta del Observatorio 4, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de las Fuerzas Armadas 2, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Madrid, Spain
- Universidad de Granada, Av. del Hospicio 1, Granada, Spain
| | - Carmen Santiuste
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante 11, Murcia, Spain
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford, Oxford, United Kingdom
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Gran Via de L'Hospitalet 199-203, L'Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute - IDIBELL, Gran Via de L'Hospitalet 199-203, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Amanda J Cross
- Faculty of Medicine, Imperial College London, Norfolk Place, London, United Kingdom
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, Athens, Greece
- 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece
| | - Eleni Peppa
- Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos, Athens, Greece
| | - Domenico Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, Florence, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumouri, Via Venezian 1, Milano, Italy
| | - Veronica Sciannameo
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco (Turin), Italy
| | - Amalia Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Via Pansini 5, Naples, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Via Pansini 5, Naples, Italy
| | - Carla H van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Aurelio Barricarte
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Madrid, Spain
- Navarra Public Health Institute, C/Leyre 15, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), C/Irunlarrea 3, Pamplona, Spain
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Madrid, Spain
- Ministry of Health of the Basque Government, Public Health Division of Gipuzkoa, Biodonostia Research Institute, Paseo Doctor Begiristain s/N, 20014 Donostia/Gipuzkoa, Gipuzkoa, Spain
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Heiner Boeing
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114 - 116, Nuthetal, Germany
| | - Elisabete Weiderpass
- International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Eric J Duell
- Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Gran Via de L'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain
- ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), Gran Via de L'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain
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Jing C, Wang Z, Fu X. Effect of diabetes mellitus on survival in patients with gallbladder Cancer: a systematic review and meta-analysis. BMC Cancer 2020; 20:689. [PMID: 32709224 PMCID: PMC7379826 DOI: 10.1186/s12885-020-07139-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 07/06/2020] [Indexed: 12/20/2022] Open
Abstract
Background Increasing evidences indicated that diabetes might increase the incidence of gallbladder cancer. However, no sufficient data has ever clarified the impact of diabetes on the survival of patients with gallbladder cancer. Methods We comprehensively searched PubMed, Embase, and the Cochrane Library databases through July 2019 in order to find sufficient eligible researches. The pooled hazard risks (HRs) and relative risks (RRs) with 95% confidence intervals (CIs) were calculated with either fix-effects or random-effects model. Due to the low gallbladder cancer mortality in general population, the RRs and standard mortality ratios (SMRs) were considered the similar estimates of the HRs. Results Ten eligible studies were included in this meta-analysis. Analysis of eight cohorts found that diabetes was closely associated with the mortality of gallbladder cancer (HR = 1.10; 95% CI: 1.06–1.14; P < 0.00001). However, the mortality in male diabetes patients was not higher than female patients (RR = 1.08, 95%CI = 0.57–2.04, P = 0.80). Conclusions These findings indicated that diabetes patients had a higher mortality of gallbladder cancer compared with non-diabetes.
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Affiliation(s)
- Chen Jing
- School of Nursing and Health, Nanfang College of Sun Yat-sen University, Guangzhou, 510970, Guangdong Province, China
| | - Zhengyi Wang
- School of Nursing and Health, Nanfang College of Sun Yat-sen University, Guangzhou, 510970, Guangdong Province, China
| | - Xue Fu
- School of Nursing and Health, Nanfang College of Sun Yat-sen University, Guangzhou, 510970, Guangdong Province, China.
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D'Andrea D, Black PC, Zargar H, Zargar-Shoshtari K, Zehetmayer S, Fairey AS, Mertens LS, Dinney CP, Mir MC, Krabbe LM, Cookson MS, Jacobsen NE, Montgomery JS, Vasdev N, Yu EY, Xylinas E, Campain NJ, Kassouf W, Dall'Era MA, Seah JA, Ercole CE, Horenblas S, Sridhar SS, McGrath JS, Aning J, Wright JL, Thorpe AC, Morgan TM, Holzbeierlein JM, Bivalacqua TJ, North S, Barocas DA, Lotan Y, Grivas P, Stephenson AJ, Shah JB, van Rhijn BW, Daneshmand S, Spiess PE, Shariat SF. Impact of sex on response to neoadjuvant chemotherapy in patients with bladder cancer. Urol Oncol 2020; 38:639.e1-639.e9. [DOI: 10.1016/j.urolonc.2020.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 12/24/2019] [Accepted: 01/21/2020] [Indexed: 12/13/2022]
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10
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Bilski K, Dobruch J, Kozikowski M, Skrzypczyk MA, Oszczudłowski M, Ostrowski J. Urobiome in Gender-Related Diversities of Bladder Cancer. Int J Mol Sci 2020; 21:ijms21124488. [PMID: 32599810 PMCID: PMC7349933 DOI: 10.3390/ijms21124488] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/20/2020] [Accepted: 06/22/2020] [Indexed: 12/18/2022] Open
Abstract
Bladder cancer (BC) remains the most common malignancy of urinary tract. Sex-related differences in BC epidemiology, diagnosis, therapy, and outcomes have been reported. Throughout the recent years, extensive research has been devoted to genetic and molecular alterations in BC. Apart from the molecular background, another related concept which has been speculated to contribute to gender diversities in BC is the role of urinary pathogens in bladder carcinogenesis. Microbiome studies, fueled by the availability of high-throughput DNA-based techniques, have shown that perturbation in the microbiome is associated with various human diseases. The aim of this review is to comprehensively analyze the current literature according to sex-related differences in the microbiome composition in BC.
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Affiliation(s)
- Konrad Bilski
- Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Professor W. Orlowski, 00-416 Warsaw, Poland; (J.D.); (M.K.); (M.A.S.); (M.O.)
- Correspondence:
| | - Jakub Dobruch
- Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Professor W. Orlowski, 00-416 Warsaw, Poland; (J.D.); (M.K.); (M.A.S.); (M.O.)
| | - Mieszko Kozikowski
- Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Professor W. Orlowski, 00-416 Warsaw, Poland; (J.D.); (M.K.); (M.A.S.); (M.O.)
| | - Michał A. Skrzypczyk
- Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Professor W. Orlowski, 00-416 Warsaw, Poland; (J.D.); (M.K.); (M.A.S.); (M.O.)
| | - Maciej Oszczudłowski
- Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Professor W. Orlowski, 00-416 Warsaw, Poland; (J.D.); (M.K.); (M.A.S.); (M.O.)
| | - Jerzy Ostrowski
- Department of Genetics, Maria Sklodowska-Curie Institute-Oncology Center, 02-781 Warsaw, Poland;
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Li Y, Hendryx MS, Xun P, He K, Shadyab AH, Pan K, Qi L, Luo J. The association between type 2 diabetes mellitus and bladder cancer risk among postmenopausal women. Cancer Causes Control 2020; 31:503-510. [PMID: 32193704 DOI: 10.1007/s10552-020-01294-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 03/06/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Evidence on the association between diabetes and risk of bladder cancer has been controversial. In addition, findings on the associations between duration of diabetes, diabetes treatment, and risk of bladder cancer have been inconsistent. METHODS A total of 148,208 participants in Women's Health Initiative study were included. Information on diabetes status, diabetes duration, and treatment was collected both at baseline and during follow-up. Information on potential confounders including age, race/ethnicity, education, occupation, family history of cancer, smoking status, alcohol consumption, total physical activity, body mass index, and daily dietary intake were collected at baseline. Bladder cancer cases were collected and confirmed by a centralized review of pathology reports. Cox proportional hazard models with time-varying covariates were used to examine associations of diabetes status, duration of diabetes, and diabetes treatment with bladder cancer risk. RESULTS During a median follow-up of 18.5 years, 865 bladder cancer cases were identified. There were no significant associations of diabetes, duration of diabetes, or diabetes treatment with risk of bladder cancer. Participants with prevalent diabetes did not have significantly higher risk of bladder cancer compared with those without diabetes. CONCLUSION Diabetes was not significantly associated with risk of bladder cancer among postmenopausal women.
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Affiliation(s)
- Yueyao Li
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, 1025 E. 7th Street, Bloomington, IN, 47405, USA.
| | - Michael S Hendryx
- Department of Environmental and Occupational Health, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, 1025 E. 7th Street, Bloomington, IN, 47405, USA
| | - Ka He
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Aladdin H Shadyab
- Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Kathy Pan
- The Division of Medical Oncology and Hematology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Lihong Qi
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, 1025 E. 7th Street, Bloomington, IN, 47405, USA
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Abstract
PURPOSE OF REVIEW Although smoking and gender are well-established bladder cancer (BCa) risk factors, a significant interaction with other risk factors could help in the identification of patterns for early detection and prevention strategies. RECENT FINDINGS Smoking appears to be more strongly associated with BCa risk in women than in men, which could be related to differences in metabolism, smoking behavior, exposure patterns, and DNA repair mechanisms. BMI is associated with a higher risk of BCa with negligible difference between genders. The risk for BCa is increased in postmenopausal women, specifically in women with earlier menopausal age (<45 years). Other potential risk factors such as alcohol, arsenic exposure, and particulate matter inhalation seem to affect the genders differently.Female smokers experience a higher risk of disease recurrence after bacillus Calmette-Guérin therapy than their male counterparts. Lastly, smoking appears to negatively affect the outcome of radiotherapy in women, but not that of men. SUMMARY Several lines of evidence point to an interaction between smoking and gender, whereas their impact on other potential risk factors remains to be elucidated. Identifying such differential effects could allow for gender-specific prevention, early detection, and treatment strategies.
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Li Y, Tindle HA, Hendryx MS, Xun P, He K, Liang X, Luo J. Smoking Cessation and the Risk of Bladder Cancer among Postmenopausal Women. Cancer Prev Res (Phila) 2019; 12:305-314. [PMID: 31043379 DOI: 10.1158/1940-6207.capr-18-0441] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/01/2019] [Accepted: 02/26/2019] [Indexed: 11/16/2022]
Abstract
Smoking is the strongest established risk factor for bladder cancer. Former smokers have a lower risk of bladder cancer compared with current smokers, but findings on the dose-response relationship between years after quitting and the risk of bladder cancer are inconsistent. A total of 143,279 postmenopausal women from the Women's Health Initiative Study were included. Cox proportional hazards regression models were applied for estimating age- and multivariable-adjusted HRs and their 95% confidence intervals (CI). There were 870 bladder cancer cases identified over an average of 14.8 years of follow-up. After adjusting for pack-years of smoking, bladder cancer risk among former smokers declined by 25% within the first 10 years of cessation and continued to decrease as cessation time increased but remained higher than never smokers after 30 years of quitting (HR, 1.92; 95% CI, 1.43-2.58). Smokers who quit smoking had a lower risk of bladder cancer compared with current smokers (HR, 0.61; 95% CI, 0.40-0.94). We conclude that among postmenopausal women, there is a significant reduction in the risk of bladder cancer after quitting smoking. In addition to primary prevention, smoking cessation is critical to prevent the incidence of bladder cancer in older women.
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Affiliation(s)
- Yueyao Li
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana.
| | - Hilary A Tindle
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and Geriatric Research Education and Clinical Centers (GRECC), Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Michael S Hendryx
- Department of Environmental and Occupational Health, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana
| | - Ka He
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana
| | - Xiaoyun Liang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana
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Williams WV, Mitchell LA, Carlson SK, Raviele KM. Association of Combined Estrogen-Progestogen and Progestogen-Only Contraceptives with the Development of Cancer. LINACRE QUARTERLY 2019; 85:412-452. [PMID: 32431377 DOI: 10.1177/0024363918811637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Combined estrogen-progestogen contraceptives (oral contraceptives or OCs) and progestogen-only contraceptives (POCs) are synthetic steroids that bind to steroid hormone receptors, which are widespread throughout the body. They have a profound effect on cellular physiology. Combined OCs have been classified by the International Agency for Research on Cancer (IARC) as Group 1 carcinogens, but their findings have not been updated recently. In order to update the information and better understand the impact that OCs and POCs have on the risk of development of cancers, a comprehensive literature search was undertaken, focusing on more recently published papers. In agreement with the IARC, the recent literature confirms an increased risk of breast cancer and cervical cancer with the use of OCs. The recent literature also confirms the IARC conclusion that OCs decrease the risk of ovarian and endometrial cancers. However, there is little support from recent studies for the IARC conclusion that OCs decrease the risk of colorectal cancer or increase the risk of liver cancer. For liver cancer, this may be due to the recent studies having been performed in areas where hepatitis is endemic. In one large observational study, POCs also appear to increase the overall risk of developing cancer. OCs and POCs appear to increase the overall risk of cancer when carefully performed studies with the least intrinsic bias are considered. Summary OCs have been classified as cancer-causing agents, especially leading to increases in breast cancer and cervical cancer. A review of the recent scientific literature was performed to see whether this still appears to be the case. The recent literature supports the cancer-causing role of OCs especially for breast cancer and cervical cancer. Studies also indicate that progesterone-only contraceptives (such as implants and vaginal rings) also can cause cancer. This is especially true for breast cancer and cervical cancer.
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Affiliation(s)
- William V Williams
- BriaCell Therapeutics Corporation, West Vancouver, British Columbia, Canada.,University of Pennsylvania, Philadelphia, PA, USA
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15
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Michels KA, Brinton LA, Pfeiffer RM, Trabert B. Oral Contraceptive Use and Risks of Cancer in the NIH-AARP Diet and Health Study. Am J Epidemiol 2018; 187:1630-1641. [PMID: 29394309 DOI: 10.1093/aje/kwx388] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/21/2017] [Indexed: 12/23/2022] Open
Abstract
Although use of oral contraceptives (OCs) is common, their influence on carcinogenesis is not fully understood. We used Cox proportional hazards models to examine OC use (never/<1 year (referent), 1-4, 5-9, ≥10 years) and development of incident cancers across body sites within the same base population: women in the prospective National Institutes of Health-AARP Diet and Health Study (enrolled 1995-1996 and followed until 2011). Adjustment for confounding varied by outcome; all models accounted for age, race, body mass index, and smoking status, and included at least 100,000 women. Any OC use conferred a 3% reduction in the risk for any cancer (hazard ratio = 0.97, 95% confidence interval: 0.95, 0.99). Expected risk reductions that strengthened with duration of use were identified for ovarian and endometrial cancers and were suggested for kidney cancer (all P for trend < 0.05). Non-Hodgkin lymphoma risk (hazard ratio = 0.79, 95% confidence interval: 0.64, 0.97) was reduced with 10 or more years of OC use. There was a 37% reduced risk for bladder cancer and 46% increased risk for pancreatic cancer among long-term OC users who were 60 years of age or younger at baseline. OC use did not influence risks for most other cancers evaluated. Given the high prevalence of use and changing formulations, additional studies are warranted to fully understand the chemopreventive effects of these medications.
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Affiliation(s)
- Kara A Michels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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de Brot S, Robinson BD, Scase T, Grau-Roma L, Wilkinson E, Boorjian SA, Gardner D, Mongan NP. The dog as an animal model for bladder and urethral urothelial carcinoma: Comparative epidemiology and histology. Oncol Lett 2018; 16:1641-1649. [PMID: 30008848 PMCID: PMC6036476 DOI: 10.3892/ol.2018.8837] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 02/21/2018] [Indexed: 12/18/2022] Open
Abstract
Despite the recent approval of several novel agents for patients with metastatic urothelial carcinoma (UC), survival in this setting remains poor. As such, continued investigation into novel therapeutic options remains warranted. Pre-clinical development of novel treatments requires an animal model that accurately simulates the disease in humans. The aim of the present study was to evaluate the dog as an animal model for human UC. A total of 260 cases of spontaneous, untreated canine primary urethral and urinary bladder UC, were epidemiologically and histologically assessed and classified based on the current 2016 World Health Organization (WHO) tumor classification system. Canine data was compared with human data available from scientific literature. The mean age of dogs diagnosed with UC was 10.22 years (range, 4–15 years), which is equivalent to 60–70 human years. The results revealed a high association between UC diagnosis with the female sex [odds ratio (OR) 3.51; 95% confidence interval (CI) 2.57–4.79; P<0.001], surgical neutering (OR 4.57; 95% CI 1.87–11.12; P<0.001) and breed (OR 15.11 for Scottish terriers; 95% CI 8.99–25.41; P<0.001). Based on the 2016 WHO tumor (T), node and metastasis staging system, the primary tumors were characterized as T1 (38%), T2a (28%), T2b (13%) and T3 (22%). Non-papillary, flat subgross tumor growth was strongly associated with muscle invasion (OR 31.00; P<0.001). Irrespective of subgross growth pattern, all assessable tumors were invading beyond the basement membrane compatible with infiltrating UC. Conventional, not further classifiable infiltrating UC was the most common type of tumor (90%), followed by UC with divergent, squamous and/or glandular differentiation (6%). Seven out of the 260 (2.8%) cases were classified as non-urothelial based on their histological morphology. These cases included 5 (2%) squamous cell carcinomas, 1 (0.4%) adenocarcinoma and 1 (0.4%) neuroendocrine tumor. The 2 most striking common features of canine and human UC included high sex predilection and histological tumor appearance. The results support the suitability of the dog as an animal model for UC and confirm that dogs also spontaneously develop rare UC subtypes and bladder tumors, including plasmacytoid UC and neuroendocrine tumor, which are herein described for the first time in a non-experimental animal species.
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Affiliation(s)
- Simone de Brot
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, LE12 5RD, UK
| | - Brian D Robinson
- Department of Pathology, Weill Cornell Medical College, New York, NY 10065, USA
| | - Tim Scase
- Bridge Pathology Ltd., Bristol, BS7 0BJ, UK
| | - Llorenç Grau-Roma
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, LE12 5RD, UK
| | - Eleanor Wilkinson
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, LE12 5RD, UK
| | | | - David Gardner
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, LE12 5RD, UK
| | - Nigel P Mongan
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, LE12 5RD, UK.,Department of Pathology, Weill Cornell Medical College, New York, NY 10065, USA
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Li YP, Jia XP, Jiang YQ, Wang W, Wang YL, Wang XL, Guo YX. Differential expression of cytokeratin 14 and 18 in bladder cancer tumorigenesis. Exp Biol Med (Maywood) 2018; 243:344-349. [PMID: 29350066 DOI: 10.1177/1535370218754493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
It has been previously suggested that cytokeratins (CKs) are important diagnostic and prognostic biomarkers for urothelial lesions. Hence it is imperative to understand the expression pattern of cytokeratins during formation of papillary bladder cancer, which was the objective of the current study. Expression pattern of CK14 and CK18 were examined using immunohistochemical staining in a mice model of papillary bladder cancer. Twenty female mice were divided into two groups-group 1 (NT) and group 2, which received N-butyl- N-(4-hydroxybutyl) nitrosamine (BBN) for 20 weeks plus one week without treatment. Following histological classification of bladder lesions, CK14 and CK18 immunostaining was assessed according to its distribution and intensity. In NT animals, both basal cells and umbrella cells showed sporadic positive staining for CK14 and CK18, respectively. In BBN group, hyperplastic lesions showed significantly more CK14 and significantly less CK18 staining ( P < 0.05 in each case). Invasive carcinomas showed increased CK14 immunostaining in all epithelial layers. Cumulatively, our data indicate that altered CK14 (high) and CK18 (low) expression is perhaps an early event in bladder cancer tumorigenesis in females at least and is characteristic of both urothelial superficial pre-neoplastic and neoplastic lesions. Impact statement Studies have shown that expression of cytokeratins (CKs) or their altered distribution affects the bladder cancer pathogenesis and disease outcome, while the underlying mechanisms are not clear. The present study aims to explore the expression pattern of CK14 and CK18 during formation of papillary bladder cancer. The results showed that hyperplastic lesions showed significantly more CK14 and significantly less CK18 staining and invasive carcinomas showed increased CK14 immunostaining in all epithelial layers in N-butyl- N-(4-hydroxybutyl)nitrosamine (BBN)-induced mouse model. The results indicate that altered CK14 (high) and CK18 (low) expression is perhaps an early event in bladder cancer tumorigenesis and is characteristic of both urothelial superficial pre-neoplastic and neoplastic lesions, which may provide the early diagnosis index.
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Affiliation(s)
- Yun-Peng Li
- 1 Department of Urology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Xiao-Peng Jia
- 1 Department of Urology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Yu-Qing Jiang
- 1 Department of Urology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Wei Wang
- 1 Department of Urology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Yun-Liang Wang
- 1 Department of Urology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Xiu-Li Wang
- 2 Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
| | - Yue-Xian Guo
- 1 Department of Urology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China
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Xu Y, Huo R, Chen X, Yu X. Diabetes mellitus and the risk of bladder cancer: A PRISMA-compliant meta-analysis of cohort studies. Medicine (Baltimore) 2017; 96:e8588. [PMID: 29145273 PMCID: PMC5704818 DOI: 10.1097/md.0000000000008588] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Epidemiologic studies have reported inconsistent results regarding the relationship between diabetes mellitus (DM) and the incidence of bladder cancer. This comprehensive systematic review and meta-analysis explored and evaluated this relationship in participants with different characteristics. METHODS Studies indexed in the PubMed, Embase, and the Cochrane Library databases that compared bladder cancer incidence mortality between DM and non-DM participants were included in the present study. The relative risks (RRs) of a random-effects model were used to assess these associations. RESULTS The final analysis included 21 cohort studies, involving a total of 13,505,643 participants. Overall, DM was associated with an increased risk of bladder cancer or cancer mortality when compared with non-DM participants (RR: 1.23; 95% confidence interval [CI]: 1.12-1.35; P < .001). Furthermore, DM had a harmful impact on subsequent bladder cancer risk in men compared with those without DM (RR: 1.23; 95% CI: 1.06-1.42; P = .005), whereas no significant relationship was observed between DM and bladder cancer in women (RR: 1.24; 95% CI: 0.95-1.61; P = .119). There was no significant gender difference for this relationship (ratio of RR: 0.99; 95% CI: 0.73-1.34; P = .958). In addition, cancer incidence (RR: 1.21; 95% CI: 1.09-1.35; P < .001) and cancer mortality (RR: 1.25; 1.17-1.35; P < .001) both increased in DM patients. Finally, smoking status and follow-up duration might also affect this relationship in men and women. CONCLUSIONS The findings of this study indicated that DM was associated with elevated bladder cancer or cancer mortality risk, especially in men. This relationship in women requires further exploration.
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Hassan MM, Botrus G, Abdel-Wahab R, Wolff RA, Li D, Tweardy D, Phan AT, Hawk E, Javle M, Lee JS, Torres HA, Rashid A, Lenzi R, Hassabo HM, Abaza Y, Shalaby AS, Lacin S, Morris J, Patt YZ, Amos CI, Khaderi SA, Goss JA, Jalal PK, Kaseb AO. Estrogen Replacement Reduces Risk and Increases Survival Times of Women With Hepatocellular Carcinoma. Clin Gastroenterol Hepatol 2017; 15:1791-1799. [PMID: 28579181 PMCID: PMC5901750 DOI: 10.1016/j.cgh.2017.05.036] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/18/2017] [Accepted: 05/21/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Environmental factors have been identified that affect risk of hepatocellular carcinoma (HCC), but little is known about the effects of sex hormones on liver cancer development or outcome. The authors investigated whether menopause hormone therapy (MHT) affects risk, age at onset, or outcome of HCC. METHODS We performed a case-control study of 234 female patients treated for HCC at a tertiary medical center and with 282 healthy women (controls) from January 1, 2004 through May 31, 2015. We collected detailed information on environmental exposures, ages of menarche and menopause, hysterectomies, and uses of birth control and MHT. We performed multivariable logistic and Cox regression analyses to determine the independent effects of factors associated with women on risk and clinical outcome in HCC. The primary outcomes were effect of MHT on HCC risk, the relationship between MHT with hepatitis virus infection on HCC development, and effect of MHT on age at HCC onset or survival after diagnosis of HCC. RESULTS The estimated adjusted odds ratio (AOR) for HCC in women who ever used estrogen was 0.53 (95% confidence interval [CI], 0.32-0.88). This association was supported by the older age of HCC onset among estrogen users (mean, 64.5 ± 0.9 years) vs nonusers (mean 59.2 ± 1.1 years; P = .001) and the reduced risk of HCC among long-term users (more than 5 years) (AOR, 0.36; 95% CI, 0.20-0.63). Users of estrogen also had a reduced risk for hepatitis-associated HCC: AOR for users, 4.37 (95% CI, 1.67-11.44) vs AOR for nonusers, 17.60 (95% CI, 3.88-79.83). Estrogen use reduced risk of death from HCC (hazard ratio, 0.55; 95% CI, 0.40-0.77; P = .01). Median overall survival times were 33.5 months for estrogen users (95% CI, 25.7-41.3 months) and 24.1 months for nonusers (95% CI, 19.02-29.30 months; P = .008). CONCLUSION In a case-control study of women with HCC vs female control subjects at a single center, we associated use of estrogen MHT with reduced risk of HCC and increased overall survival times of patients with HCC. Further studies are needed to determine the benefits of estrogen therapy for women and patients with HCC, and effects of tumor expression of estrogen receptor.
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Affiliation(s)
- Manal M Hassan
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Gehan Botrus
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Reham Abdel-Wahab
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Clinical Oncology, Assiut University Hospital, Assiut, Egypt
| | - Robert A Wolff
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David Tweardy
- Division of Internal Medicine, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Ernest Hawk
- Division of Cancer Prevention and Population Science, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Milind Javle
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ju-Seog Lee
- Department of System Biology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Harrys A Torres
- Department of Infectious Diseases, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Asif Rashid
- Department of Pathology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Renato Lenzi
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hesham M Hassabo
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yasmin Abaza
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ahmed S Shalaby
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sahin Lacin
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Medical Oncology, Hacettepe University, Ankara, Turkey
| | - Jeffrey Morris
- Department of Biostatistics, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yehuda Z Patt
- University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Christopher I Amos
- Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire
| | - Saira A Khaderi
- Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, Houston, Texas; Department of Surgery, Texas Children's Hospital, Houston, Texas
| | - John A Goss
- Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, Houston, Texas; Department of Surgery, Texas Children's Hospital, Houston, Texas
| | - Prasun K Jalal
- Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, Houston, Texas
| | - Ahmed O Kaseb
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, Texas
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McCarthy CE, Field JK, Marcus MW. Age at menopause and hormone replacement therapy as risk factors for head and neck and oesophageal cancer. Oncol Rep 2017; 38:1915-1922. [DOI: 10.3892/or.2017.5867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 02/16/2017] [Indexed: 11/06/2022] Open
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21
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Bai Y, Wang X, Yang Y, Tang Y, Wang J, Han P. Parity and bladder cancer risk: a dose-response meta-analysis. BMC Cancer 2017; 17:31. [PMID: 28061845 PMCID: PMC5219774 DOI: 10.1186/s12885-016-3023-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 12/20/2016] [Indexed: 02/05/2023] Open
Abstract
Background Multiple studies have reported evidence of an inverse association between parity and bladder cancer risk. However, a comprehensive and quantitative assessment of this association has never been conducted. We conducted this study to clarify this issue. Methods Systematic search of PubMed and Embase was performed to identify all the studies. Studies were selected based on strict screening with inclusion and exclusion criteria. Summary relative risks (RR) with 95% confidence intervals (CI) were calculated by using a fixed-effect model, and the generalized least squares trend estimation was employed to compute study-specific RR and 95% CI per live birth increase. Heterogeneity and publication bias were also evaluated. Results Twelve studies (6,214 cases and 2,693,350 non-cases) were eligible in this meta-analysis. The pooled RR of bladder cancer for parous versus nulliparous women was 0.76 (95% CI: 0.70–0.82). Results were similar in the studies that adjusted for BMI(RR = 0.66; 95% CI: 0.53–0.81), cigarette smoking (RR = 0.67; 95% CI: 0.57–0.79), and age (RR = 0.77; 95% CI: 0.71–0.84). The dose-response meta-analysis showed a lower bladder cancer risk (RR = 0.95; 95% CI: 0.92–0.98) for each live birth increase in parous women. No evidence of publication bias or significant heterogeneity was detected in the above-mentioned analyses. Conclusions The finding from current meta-analysis suggest that parity may be related to decreased risk of bladder cancer. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-3023-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yunjin Bai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Guoxue Xiang#37, Chengdu, Sichuan, 610041, China
| | - Xiaoming Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Guoxue Xiang#37, Chengdu, Sichuan, 610041, China
| | - Yubo Yang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Guoxue Xiang#37, Chengdu, Sichuan, 610041, China
| | - Yin Tang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Guoxue Xiang#37, Chengdu, Sichuan, 610041, China
| | - Jia Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Guoxue Xiang#37, Chengdu, Sichuan, 610041, China
| | - Ping Han
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Guoxue Xiang#37, Chengdu, Sichuan, 610041, China.
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22
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Parity, Age at First Birth, and Risk of Death from Bladder Cancer: A Population-Based Cohort Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13121197. [PMID: 27918463 PMCID: PMC5201338 DOI: 10.3390/ijerph13121197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/23/2016] [Accepted: 11/23/2016] [Indexed: 11/30/2022]
Abstract
The evidence is limited on the relationship between reproductive factors and bladder cancer (BC). We studied 1,292,462 women who had a first and singleton delivery between 1 January 1978 and 31 December 1987. Each woman in the study cohort was tracked from their first childbirth to 31 December 2009. Vital status of the women was determined by crosswalking records with a computerized mortality database. We used Cox proportional hazard regression models to estimate the hazard ratios (HRs) of death from BC associated with maternal age at first birth and parity. The data showed 63 BC deaths during 34,980,246 person-years of follow-up. BC mortality rate was 0.90 cases for every 100,000 person-years. Compared with women who gave birth under the age of 23, the adjusted HR was 1.24 (95% confidence interval (CI) = 0.66–2.35) for women who gave birth between age 23 and 26 and 2.30 (95% CI = 1.21–4.39) for women who gave birth over the age of 26. Increasing age at first birth (p for trend = 0.01) is associated with a trend in increasing risk of BC mortality. Relative to women who had a single childbirth, the adjusted HRs were 1.17 (95% CI = 0.51–2.69) for women who gave birth to two children, and 1.31 (95% CI = 0.56–3.10) for women with three or more childbirths, respectively. These results were not statistically significant. Study results suggests that giving birth at an early age may confer a protective effect on the risk of death from BC.
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Read J, Symmons J, Palmer JM, Montgomery GW, Martin NG, Hayward NK. Increased incidence of bladder cancer, lymphoid leukaemia, and myeloma in a cohort of Queensland melanoma families. Fam Cancer 2016; 15:651-63. [PMID: 27108303 DOI: 10.1007/s10689-016-9907-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Familial cancer risk has been proposed as a shared feature of many cancers, and overall susceptibility is influenced by combinations of low to moderate risk polymorphisms, rare high penetrance germline mutations, and modulation of risk by environmental and genetic factors. Clustering of melanoma occurs in approximately 10 % of families, and an over-representation of additional cancers has been noticed in some 'melanoma' families. The degree to which other cancers aggregate in families affected by melanoma has not been well defined. Therefore, this study aimed to assess the risk of cancers other than melanoma in a cohort of 178 'intermediate risk' melanoma families, not selected for specific genetic mutations. Families designated as 'intermediate risk' had two first degree relatives (FDRs) affected by melanoma when ascertained between 1982 and 1990, and were followed up over a 33 year period to assess new occurrences of cancer. We included 414 melanoma cases and 529 FDRs, comprising 25,264 person years of observation. Standardised incidence ratios and their 95 % confidence intervals were calculated for all invasive cancers, comparing observed to expected cases of cancer based on age and sex specific incidence rates for the Queensland population. Statistically significant increases were found for bladder cancer in females (observed, 7; expected, 1.99; SIR, 3.52; 95 % CI 1.41-7.25), lymphoid leukaemia in females (observed, 6; expected, 1.75; SIR, 3.43; 95 % CI 1.26-7.46), and myeloma in female melanoma cases (observed, 4; expected, 0.82; SIR, 4.89; 95 % CI 1.33-12.52). Over-representation of bladder cancer, lymphoid leukaemia, and myeloma in females of the cohort may suggest sex-dependent co-modifiers, and it is possible that specific combinations of polymorphisms predispose to certain cancer types.
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Affiliation(s)
- Jazlyn Read
- QIMR Berghofer Medical Research Institute, PO Royal Brisbane Hospital, Herston, Brisbane, QLD, 4029, Australia.
- The University of Queensland, Brisbane, QLD, Australia.
| | - Judith Symmons
- QIMR Berghofer Medical Research Institute, PO Royal Brisbane Hospital, Herston, Brisbane, QLD, 4029, Australia
| | - Jane M Palmer
- QIMR Berghofer Medical Research Institute, PO Royal Brisbane Hospital, Herston, Brisbane, QLD, 4029, Australia
| | - Grant W Montgomery
- QIMR Berghofer Medical Research Institute, PO Royal Brisbane Hospital, Herston, Brisbane, QLD, 4029, Australia
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, PO Royal Brisbane Hospital, Herston, Brisbane, QLD, 4029, Australia
| | - Nicholas K Hayward
- QIMR Berghofer Medical Research Institute, PO Royal Brisbane Hospital, Herston, Brisbane, QLD, 4029, Australia
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Eylert MF, Hounsome LS, Persad RA, Bahl A, Jefferies ER, Verne J, Mostafid H. Falling bladder cancer incidence from 1990 to 2009 is not producing universal mortality improvements. JOURNAL OF CLINICAL UROLOGY 2016. [DOI: 10.1177/2051415813492724] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective The objective of this article is to obtain up-to-date epidemiological statistics of bladder cancer in England. Methods We collected incidence from the National Cancer Data Repository (NCDR), survival from the national Cancer Information System (CIS), ethnicity information from the Hospital Episode Statistics (HES), mortality and smoking rates from the Office for National Statistics (ONS). Results Incidence of bladder cancer has fallen continuously. Mortality has reduced less, leading to worsening survival. Bladder cancer mainly affects men, the most deprived, and the elderly. The gender gap is decreasing, and the deprivation gap is unchanged. Mortality is unchanged in the youngest, oldest and least deprived females. Mortality has recently increased in the oldest males. The highest incidence and mortality is found in industrial areas. This study is limited by i) its retrospective design using existing databases, allowing identification of associations and statistical differences, but not causation; and ii) very restricted ethnicity data. onclusion Reductions in bladder cancer incidence and mortality in England coincide with a decrease in high-risk occupations and public health measures to reduce smoking. Some risk factors in modern living may as yet be unidentified. It remains paramount to ensure equity of access and treatment regardless of gender, age, region and social deprivation to further improve mortality.
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Affiliation(s)
- MF Eylert
- Department of Urology, Morriston Hospital, UK
| | | | - RA Persad
- Department of Urology, Bristol Royal Infirmary, UK
| | - A Bahl
- Bristol Haematology and Oncology Centre, UK
| | - ER Jefferies
- Department of Urology, Royal United Hospital, UK
| | - J Verne
- South West Public Health Observatory, UK
| | - H Mostafid
- Department of Urology, The Royal Berkshire Hospital, UK
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25
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White-Gilbertson S, Davis M, Voelkel-Johnson C, Kasman LM. Sex differences in the MB49 syngeneic, murine model of bladder cancer. Bladder (San Franc) 2016; 3. [PMID: 26998503 PMCID: PMC4795170 DOI: 10.14440/bladder.2016.73] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The MB49 syngeneic, murine model of bladder cancer has been widely used for more than 35 years. In humans, bladder cancer is one third as prevalent in women as in men, with a trend toward lower prevalence in parous compared to nulliparous women. Our objective was to determine if the MB49 bladder cancer model reproduces the sex differences observed in humans, and to determine its sensitivity to testosterone and the pregnancy hormone, human chorionic gonadotropin (hCG). METHODS Male and female C57BL/6 mice were implanted with MB49 murine bladder cancer cells, and observed for tumor growth. MB49 dose responses to hCG and dihydrotestosterone were determined in vitro. RESULTS MB49 tumor growth was significantly greater in male mice than female mice. Pregnancy did not affect MB49 tumor growth in female mice. MB49 cells did not proliferate in response to hCG in vitro and the functional receptor for gonadotropins was absent. Dihydrotestosterone strongly stimulated growth of MB49 cells in vitro. CONCLUSIONS The MB49 murine model of bladder cancer reproduced some aspects of the sex differences observed in humans. Our results suggest that testosterone may stimulate MB49 cell proliferation, which may explain the more rapid MB49 tumor growth observed in male mice.
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Affiliation(s)
- Shai White-Gilbertson
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Ave., MSC 504, Charleston, SC 29425, USA
| | - Megan Davis
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Ave., MSC 504, Charleston, SC 29425, USA
| | - Christina Voelkel-Johnson
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Ave., MSC 504, Charleston, SC 29425, USA
| | - Laura M Kasman
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Ave., MSC 504, Charleston, SC 29425, USA
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26
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Dabi Y, Rouscoff Y, Delongchamps NB, Sibony M, Saighi D, Zerbib M, Peyraumore M, Xylinas E. [Negative prognostic impact of female gender on oncological outcomes following radical cystectomy]. Prog Urol 2016; 26:83-8. [PMID: 26796347 DOI: 10.1016/j.purol.2015.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/25/2015] [Accepted: 12/11/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To confirm gender specific differences in pathologic factors and survival rates of urothelial bladder cancer patients treated with radical cystectomy. PATIENTS AND METHODS We conducted a retrospective monocentric study on 701 patients treated with radical cystectomy and pelvic lymphadenectomy for muscle invasive bladder cancer. Impact of gender on recurrence rate, specific and non-specific mortality rate were evaluated using Cox regression models in univariate and multivariate analysis. RESULTS We collected data on 553 males (78.9%) and 148 females (21.1%) between 1998 and 2011. Both groups were comparable at inclusion regarding age, pathologic stage, nodal status and lymphovascular invasion. Mean follow-up time was 45 months (interquartile 23-73) and by that time, 163 patients (23.3%) had recurrence of their tumor and 127 (18.1%) died from their disease. In multivariable Cox regression analyses, female gender was independently associated with disease recurrence (RR: 1.73; 95% CI 1.22-2.47; P=0.02) and cancer-specific mortality (RR=2.50, 95% CI=1.71-3.68; P<0.001). CONCLUSION We confirmed female gender to be an independent negative prognosis factor for patients following a radical cystectomy and lymphadenectomy for an invasive muscle bladder cancer.
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Affiliation(s)
- Y Dabi
- Service d'urologie, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - Y Rouscoff
- Service d'urologie, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - N B Delongchamps
- Service d'urologie, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - M Sibony
- Service d'urologie, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - D Saighi
- Service d'urologie, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - M Zerbib
- Service d'urologie, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - M Peyraumore
- Service d'urologie, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - E Xylinas
- Service d'urologie, hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
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Abstract
Bladder cancer incidence is higher in old men, shows geographic variation, and is mostly an environmental disease. Cigarette smoking, occupational exposures, water arsenic, Schistosoma haematobium infestation, and some medications are the best established risk factors. Low-penetrance genetic factors also contribute to its origin, some through interaction with environmental factors. Bladder cancer has high prevalence and a low mortality, being largely a chronic disease. Data on environmental and genetic factors involved in the disease outcome are inconclusive.
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Affiliation(s)
- Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain.
| | - Francisco X Real
- Epithelial Carcinogenesis Group, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona 08003, Spain
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Dobruch J, Daneshmand S, Fisch M, Lotan Y, Noon AP, Resnick MJ, Shariat SF, Zlotta AR, Boorjian SA. Gender and Bladder Cancer: A Collaborative Review of Etiology, Biology, and Outcomes. Eur Urol 2015; 69:300-10. [PMID: 26346676 DOI: 10.1016/j.eururo.2015.08.037] [Citation(s) in RCA: 392] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 08/24/2015] [Indexed: 12/14/2022]
Abstract
CONTEXT The incidence of bladder cancer is three to four times greater in men than in women. However, women are diagnosed with more advanced disease at presentation and have less favorable outcomes after treatment. OBJECTIVE To review the literature on potential biologic mechanisms underlying differential gender risk for bladder cancer, and evidence regarding gender disparities in bladder cancer presentation, management, and outcomes. EVIDENCE ACQUISITION A literature search of English-language publications that included an analysis of the association of gender with bladder cancer was performed using Pubmed. Ninety-seven articles were selected for analysis with the consensus of all authors. EVIDENCE SYNTHESIS It has been shown that the gender difference in bladder cancer incidence is independent of differences in exposure risk, including smoking status. Potential molecular mechanisms include disparate metabolism of carcinogens by hepatic enzymes between men and women, resulting in differential exposure of the urothelium to carcinogens. In addition, the activity of the sex steroid hormone pathway may play a role in bladder cancer development, with demonstration that both androgens and estrogens have biologic effects in bladder cancer in vitro and in vivo. Importantly, gender differences exist in the timeliness and completeness of hematuria evaluation, with women experiencing a significantly greater delay in urologic referral and undergoing guideline-concordant imaging less frequently. Correspondingly, women have more advanced tumors at the time of bladder cancer diagnosis. Interestingly, higher cancer-specific mortality has been noted among women even after adjusting for tumor stage and treatment modality. CONCLUSIONS Numerous potential biologic and epidemiologic factors probably underlie the gender differences observed for bladder cancer incidence, stage at diagnosis, and outcomes. Continued evaluation to define clinical applications for manipulation of the sex steroid pathway and to improve the standardization of hematuria evaluation in women may improve future patient outcomes and reduce these disparities. PATIENT SUMMARY We describe the scientific basis and clinical evidence to explain the greater incidence of bladder cancer in men and the adverse presentation and outcomes for this disease in women. We identify goals for improving patient survival and reducing gender disparities in bladder cancer.
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Affiliation(s)
- Jakub Dobruch
- Department of Urology, Centre of Postgraduate Medical Education, European Health Centre Otwock, Poland.
| | - Siamak Daneshmand
- Institute of Urology, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Margit Fisch
- Department of Urology, University Medical-Center Hamburg-Eppendorf, Hamburg, Germany
| | - Yair Lotan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Aidan P Noon
- Department of Surgery, Division of Urology, University of Toronto, Mount Sinai Hospital and University Health Network, Toronto, Canada
| | - Matthew J Resnick
- Department of Urologic Surgery, Vanderbilt University Medical Center and the Tennessee Valley VA Health Care System, Nashville, TN, USA
| | | | - Alexandre R Zlotta
- Department of Surgery, Division of Urology, University of Toronto, Mount Sinai Hospital and University Health Network, Toronto, Canada
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29
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Werntz R, Gakis G, Koppie T, Stenzl A. Cystectomy in the female patient. Bladder Cancer 2015. [DOI: 10.1002/9781118674826.ch12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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30
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Hsu I, Yeh CR, Slavin S, Miyamoto H, Netto GJ, Tsai YC, Muyan M, Wu XR, Messing EM, Guancial EA, Yeh S. Estrogen receptor alpha prevents bladder cancer via INPP4B inhibited akt pathway in vitro and in vivo. Oncotarget 2015; 5:7917-35. [PMID: 25277204 PMCID: PMC4202170 DOI: 10.18632/oncotarget.1421] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Clinical reports show males have a higher bladder cancer (BCa) incidence than females. The sexual difference of BCa occurrence suggests that estrogen and its receptors may affect BCa development. Estrogen receptor alpha (ERα) is the classic receptor to convey estrogen signaling, however, the function of ERα in BCa development remains largely unknown. To understand the in vivo role of ERα in BCa development, we generated total and urothelial specific ERα knockout mice (ERαKO) and used the pre- carcinogen BBN to induce BCa. Earlier reports showed that ERα promotes breast and ovarian cancers in females. Surprisingly and of clinical importance, our results showed that ERα inhibits BCa development and loss of the ERα gene results in an earlier onset and higher incidence of BBN-induced in vivo mouse BCa. Supportively, carcinogen induced malignant transformation ability was reduced in ERα expressing urothelial cells as compared to ERα negative cells. Mechanism studies suggest that ERα could control the expression of INPP4B to reduce AKT activity and consequently reduce BCa cell growth. In addition, IHC staining of clinical sample analyses show that INPP4B expression, in correlation with reduced ERα, is significantly reduced in human BCa specimens. Together, this is the first report using the in vivo cre-loxP gene knockout mouse model to characterize ERα roles in BCa development. Our studies provide multiple in vitro cell studies and in vivo animal model data as well as human BCa tissue analyses to prove ERα plays a protective role in BCa initiation and growth at least partly via modulating the INPP4B/Akt pathway.
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Affiliation(s)
- Iawen Hsu
- Departments of Urology and Pathology, University of Rochester Medical Center, Rochester, NY 14642. Contributed equally
| | - Chiuan-Ren Yeh
- Departments of Urology and Pathology, University of Rochester Medical Center, Rochester, NY 14642. Contributed equally
| | - Spencer Slavin
- Departments of Urology and Pathology, University of Rochester Medical Center, Rochester, NY 14642
| | - Hiroshi Miyamoto
- Departments of Pathology, Urology, and Oncology, The Johns Hopkins Hospital, Baltimore, MD 21231
| | - George J Netto
- Departments of Pathology, Urology, and Oncology, The Johns Hopkins Hospital, Baltimore, MD 21231
| | - Yu-Chieh Tsai
- Departments of Urology and Pathology, University of Rochester Medical Center, Rochester, NY 14642
| | - Mesut Muyan
- Department of Biochemistry and Biophysics, University of Rochester Medical Center, Rochester, NY 14642
| | - Xue-Ru Wu
- Department of Urology, New York University, School of Medicine, NY 10016
| | - Edward M Messing
- Departments of Urology and Pathology, University of Rochester Medical Center, Rochester, NY 14642
| | - Elizabeth A Guancial
- Departments of Hematology and Oncology, University of Rochester Medical Center, Rochester, NY 14642
| | - Shuyuan Yeh
- Departments of Urology and Pathology, University of Rochester Medical Center, Rochester, NY 14642
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Högnäs E, Kauppila A, Hinkula M, Tapanainen JS, Pukkala E. Incidence of cancer among grand multiparous women in Finland with special focus on non-gynaecological cancers: A population-based cohort study. Acta Oncol 2015. [PMID: 26217985 DOI: 10.3109/0284186x.2015.1063775] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Many studies have previously revealed evidence of an association between grand multiparity (five or more deliveries) and gynaecological cancer. Oestrogen has an impact on cancer formation and the amount of circulating oestrogen is significantly higher during pregnancy. Also the lifestyle of grand multiparous women differs somewhat from the average population. Considering these factors it is plausible that also non-gynaecological cancers are associated with multiparity. The aim of our study was to determine cancer incidence among grand multiparous women, with special attention to non-gynaecological cancers. MATERIAL AND METHODS All 102 541 women alive in 1974-2011 and having had at least five deliveries were identified in the Finnish Population Register and followed up for cancer incidence through the Finnish Cancer Registry to the end of 2011. Standardised incidence ratios (SIRs) were defined as ratios between observed and expected numbers of cases, the latter ones based on incidence in the entire Finnish female population. RESULTS The overall incidence of non-gynaecological cancers was the same as in the reference population (SIR 0.98, 95% confidence interval 0.90-1.06). The incidence of cancers of the gall-bladder (SIR 1.42, 1.26-1.58), biliary tract (1.19, 1.04-1.35) and kidney (1.22, 1.14-1.31) was increased. There were significantly fewer cases than expected of urinary bladder cancer (SIR 0.70, 0.61-0.78), lung cancer (0.87, 0.81-0.92), colon cancer (0.94, 0.89-0.99) and all types of skin cancers. As a consequence of the decreased incidence of gynaecological cancers (SIR 0.74, 0.71-0.77) and breast cancer (0.60, 0.58-0.61), the SIR for cancer overall was 0.84 (0.83-0.85). CONCLUSION The study demonstrated that grand multiparous women have a similar overall risk of non-gynaecological cancers as other women, despite significant differences in some specific forms of cancer.
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Affiliation(s)
- Emma Högnäs
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Antti Kauppila
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Marianne Hinkula
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Juha S. Tapanainen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
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The impact of female gender on bladder cancer-specific death risk after radical cystectomy: a meta-analysis of 27,912 patients. Int Urol Nephrol 2015; 47:951-8. [DOI: 10.1007/s11255-015-0980-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 04/09/2015] [Indexed: 01/17/2023]
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The Estrogen Pathway: Estrogen Receptor-α, Progesterone Receptor, and Estrogen Receptor-β Expression in Radical Cystectomy Urothelial Cell Carcinoma Specimens. Clin Genitourin Cancer 2015; 13:476-84. [PMID: 25981333 DOI: 10.1016/j.clgc.2015.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/09/2015] [Accepted: 04/09/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Bladder cancer has the sixth highest incidence in the United States. Treatment of metastatic bladder cancer is difficult, and mortality is certain. There are certain pathways in cancer growth and progression that are important in bladder cancer development. Recently, the estrogen pathway has been found to be a potential target for therapy. METHODS We identified 410 patients treated with radical cystectomy for urothelial cell carcinoma between 1990 and 1994. We obtained representative paraffin-embedded tissue blocks for 336 (82.0%) of these cases and evaluated the expression and intensity of estrogen receptor (ER)-α, ER-β, and progesterone receptor by immunohistochemistry. RESULTS Among the 12 ER-α-positive cases, median tumor ER-α expression was 10% (range, 10%-50%). In contrast to ER-α, all cases were ER-β-positive. Median tumor ER-β expression was 90% (range, 20%-100%). Nearly all cases had ER-β expression of ≥ 90% (175 [55.9%] with 90% and 103 [32.9%] with 100%). However, the intensity of ER-β staining varied from focal to moderate to marked in 64 (20.5%), 167 (53.4%), and 82 (26.2%) cases, respectively. Progesterone receptor expression was noted to be negative in all cases. CONCLUSIONS ER-β is highly expressed in bladder cancer. Prospective validation of these data might further elucidate the utility of ER-β as a marker for prognosis or possible target for therapy.
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Mitra AP, Skinner EC, Schuckman AK, Quinn DI, Dorff TB, Daneshmand S. Effect of gender on outcomes following radical cystectomy for urothelial carcinoma of the bladder: A critical analysis of 1,994 patients. Urol Oncol 2014; 32:52.e1-9. [DOI: 10.1016/j.urolonc.2013.08.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 08/14/2013] [Accepted: 08/16/2013] [Indexed: 10/26/2022]
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35
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Yavuzcan A, Caglar M, Kayikci MA, Basaran E, Tekin A, Ozdemir E, Dilbaz S, Ustun Y, Cam HK. Can reproductive characteristics predict bladder cancer in women with haematuria? Asian Pac J Cancer Prev 2013; 14:5107-10. [PMID: 24175784 DOI: 10.7314/apjcp.2013.14.9.5107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Among women with haematuria, defining individuals under high risk for bladder cancer based on reproductive factors prior to cystoscopy would be of great benefit in the management of this condition. The aim of this study was to compare age and reproductive factors such as menopausal status, parity, age at first delivery and age at the last delivery between women who have haematuria with or without bladder cancer. MATERIALS AND METHODS A total of 463 patients underwent diagnostic cystoscopy in Duzce University Faculty of Medicine between 1 June 2008 and 1 June 2013. Female patients who presented with persistent microscopic or macroscopic haematuria and underwent standard evaluation for haematuria including urinalysis, urine culture, urine cytology, urinary tract imaging with excretory urography or computerized tomography with contrast enhancement and endoscopic evaluation of the urethra and bladder were included in this study. Exclusion criteria were tobacco use and high risk occupations for bladder cancer such as textile, dry cleaning, painting and etc. Fourteen women had hematuria due to benign conditions, and 18 due to bladder cancer. Data were retrospectively retrieved from the medical records of Duzce University Hospital. RESULTS Patients with haematuria due to benign reasons did not significantly differ from patients who were found to have bladder cancer in terms of age (p=0.28), menopausal status (p=0.29), mean parity (p=0.38), being nulliparous (p=0.57), parity ≥ 3 (p=0.22), age ≤ 18 years at first delivery (p=1.00), age ≥ 30 years at last delivery (p=0.26), age ≥ 35 years at last delivery (p=0.23) and percentage of the patients with advanced age (≥ 65 years) (p=0.18). CONCLUSIONS It is difficult to predict a high risk for developing bladder cancer in women with haematuria based solely on reproductive factors.
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Affiliation(s)
- Ali Yavuzcan
- Department of Obstetrics and Gynaecology, Duzce University Faculty of Medicine, Duzce, Turkey E-mail :
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Park SY, Ollberding NJ, Woolcott CG, Wilkens LR, Henderson BE, Kolonel LN. Fruit and vegetable intakes are associated with lower risk of bladder cancer among women in the Multiethnic Cohort Study. J Nutr 2013; 143:1283-92. [PMID: 23739308 PMCID: PMC3709993 DOI: 10.3945/jn.113.174920] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Fruits and vegetables have been examined for their possible effects on the risk of bladder cancer, as they contain numerous nutrients, phytochemicals, and antioxidants with potentially anticarcinogenic properties. In a prospective analysis of 185,885 older adults participating in the Multiethnic Cohort Study, we examined whether the consumption of fruits and vegetables, or of nutrients concentrated in fruits and vegetables, was associated with bladder cancer risk. Cox proportional hazards models were used to calculate HRs and 95% CIs for bladder cancer in relation to dietary intakes. A total of 581 invasive bladder cancer cases (429 men and 152 women) were diagnosed over a mean follow-up period of 12.5 y. In women, total fruits and vegetables [HR = 0.35 (95% CI: 0.22, 0.56); highest vs. lowest quartile], total vegetables [HR = 0.49 (95% CI: 0.29, 0.83)], yellow-orange vegetables [HR = 0.48 (95% CI: 0.30, 0.77)], total fruits [HR = 0.54 (95% CI: 0.34, 0.85)], and citrus fruits [HR = 0.56 (95% CI: 0.34, 0.90)] were inversely associated with the risk of invasive bladder cancer in risk factor-adjusted models. In addition, women with the highest intakes of vitamins A, C, and E; the carotenoids α-carotene, β-carotene, and β-cryptoxanthin; and folate had a lower risk of bladder cancer. For men, no associations for fruits, vegetables, or nutrients were found overall, although inverse associations were observed for vegetable intake among current smokers, and in ethnic-specific analyses, for fruit and vegetable intake among Latinos specifically. Our findings suggest that greater consumption of fruits and vegetables may lower the risk of invasive bladder cancer among women and highlight the need for specific subgroup analyses in future studies.
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Affiliation(s)
- Song-Yi Park
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.
| | - Nicholas J. Ollberding
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Christy G. Woolcott
- Departments of Obstetrics, Gynecology, and Pediatrics, Dalhousie University, Halifax, NS, Canada; and
| | - Lynne R. Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI
| | - Brian E. Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Laurence N. Kolonel
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI
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Daugherty SE, Lacey JV, Pfeiffer RM, Park Y, Hoover RN, Silverman DT. Reproductive factors and menopausal hormone therapy and bladder cancer risk in the NIH-AARP Diet and Health Study. Int J Cancer 2013; 133:462-72. [PMID: 23319449 PMCID: PMC3646919 DOI: 10.1002/ijc.28022] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 12/13/2012] [Indexed: 11/06/2022]
Abstract
The incidence of bladder cancer among women is at least one-third to one-fourth that observed among men in many countries. Even after accounting for known risk factors, the reason for this gender disparity remains unexplained. We conducted a comprehensive evaluation of reproductive factors and exogenous hormone use with a primary focus on menopausal hormone therapy use and risk of bladder cancer in women in the NIH-AARP Diet and Health Study. Reproductive and hormonal factors were ascertained on the baseline questionnaire in 1995-1996 among 201,492 females who were followed until December 31, 2006. During follow-up, 651 cases of bladder cancer were diagnosed. A subset of women provided detailed information on use of MHT in a second questionnaire in 1996-1997. In this analysis, 127,361 females were followed through June 30, 2002 and 198 incident bladder cancer cases were identified. Cox proportional hazard models, adjusted for smoking status, cigarettes per day and body mass index using age as the time metric, were used to obtain hazard ratios (HRs). A reduced risk was observed among parous women (HR=0.76; 95% CI 0.62-0.93) and women who reported late age at menarche (≥15 years) (HR=0.57; 95% CI 0.39-0.84). Women who reported ever using estrogen and progestin therapy had a decreased risk (HR=0.53; 95% CI: 0.34-0.83) compared with women who did not report MHT use. No association was observed for estrogen only users (HR=0.82; 95% CI: 0.58-1.15). Our results suggest a putative role for sex hormones in the etiology of bladder cancer among women.
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Affiliation(s)
- Sarah E Daugherty
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
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Age-specific effect of gender on upper tract urothelial carcinoma outcomes. Med Oncol 2013; 30:640. [PMID: 23780658 DOI: 10.1007/s12032-013-0640-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
The research is to evaluate the age-specific differential effects of gender on outcomes in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). Between August 1998 and October 2010, we retrospectively reviewed the data from 285 (67.7%) men and 136 (32.3%) women treated with RNU for UTUC at our two institutions. Kaplan-Meier survival estimates the age-specific effect of gender on cancer-specific survival (CSS). Cox proportional hazards regression analyses were used to address the effect of gender on CSS. No significant sex-related differences were found in age and diagnosis, clinicopathologic features, and treatment (all P values >0.05). Women had a 18.7% increased risk of death from UTUC than men (hazard ratio [HR] 1.187; 95% confidence interval [95% CI] 1.017-1.893; P = 0.021). The survival disadvantage was only present in patients aged 59 years and older (P < 0.001). Conversely, the survival advantage for women was found in women aged 42 to 58 years (P = 0.011) and in the age group <42 years (P = 0.019). On multivariable Cox regression analyses that adjusted for the effects of clinicopathologic features, the female gender was associated with decreased CSS (P = 0.036). In conclusion, the impact of gender on UTUC outcomes after RNU is age-specific. Females who aged 59 years and older experienced worse outcomes than their male counterparts, while women in the age group <42 years and 42-58 years have better outcomes than men. Further research is needed to elucidate the molecular mechanisms underlying the age-specific differential effect of gender on UTUC outcomes.
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Chemoprevention of BBN-Induced Bladder Carcinogenesis by the Selective Estrogen Receptor Modulator Tamoxifen. Transl Oncol 2013; 6:244-55. [PMID: 23730403 DOI: 10.1593/tlo.13247] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 03/02/2013] [Accepted: 03/04/2013] [Indexed: 12/31/2022] Open
Abstract
Bladder cancer is the fifth most frequent tumor in men and ninth in women in the United States. Due to a high likelihood of recurrence, effective chemoprevention is a significant unmet need. Estrogen receptors (ERs), primarily ERβ, are expressed in normal urothelium and urothelial carcinoma, and blocking ER function with selective ER modulators such as tamoxifen inhibits bladder cancer cell proliferation in vitro. Herein, the chemoprotective potential of tamoxifen was evaluated in female mice exposed to the bladder-specific carcinogen, N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN). Carcinogen treatment resulted in a 76% tumor incidence and increased mean bladder weights in comparison to controls. In contrast, mice receiving tamoxifen concurrent (8-20 weeks) or concurrent and subsequent (8-32 weeks) to BBN administration had no change in bladder weight and only 10% to 14% incidence of tumors. Non-muscle-invasive disease was present in animals treated with tamoxifen before (5-8 weeks) or after (20-32 weeks) BBN exposure, while incidence of muscle-invasive bladder carcinoma was reduced. ERβ was present in all mice and thus is a potential mediator of the tamoxifen chemoprotective effect. Surprisingly, ERα expression, which was detected in 74% of the mice exposed to BBN alone but not in any controlmice, was correlated with tumor incidence, indicating a possible role for this receptor in carcinogen-induced urothelial tumorigenesis. Thus, these data argue that both ERα and ERβ play a role in modulating carcinogen-induced bladder tumorigenesis. Administration of tamoxifen should be tested as a chemopreventive strategy for patients at high risk for bladder cancer recurrence.
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Ellsworth P, Marschall-Kehrel D, King S, Lukacz E. Bladder health across the life course. Int J Clin Pract 2013; 67:397-406. [PMID: 23574100 DOI: 10.1111/ijcp.12127] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 01/07/2013] [Indexed: 12/22/2022] Open
Abstract
Influences on bladder health begin during infancy and continue throughout the lifespan. Bladder anatomy and physiology change as individuals age, and the risk and propensity for bladder conditions, including lower urinary tract symptoms, throughout life are related to factors specific to age, sex, and life events. Bladder habits and dysfunctions at one stage of life may affect bladder health in subsequent stages. However, bladder problems are neither a normal part of aging nor inevitable at any stage of life. Many of the factors that negatively impact bladder health at all ages may be modifiable, and healthy bladder habits may prevent or reverse bladder dysfunctions that can occur naturally or in response to life events. There are opportunities to further define and promote healthy bladder habits through focused research and heightened public awareness of the importance of bladder health, which may lead to improvements in overall health and quality of life. It is our hope that this paper will inform and encourage public health initiatives and research programs aimed at this goal.
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Affiliation(s)
- P Ellsworth
- University Urological Associates Inc., Brown University, Providence, RI 02905, USA.
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Hsu I, Vitkus S, Da J, Yeh S. Role of oestrogen receptors in bladder cancer development. Nat Rev Urol 2013; 10:317-26. [PMID: 23588401 DOI: 10.1038/nrurol.2013.53] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Early studies documented the existence of sexual dimorphism in bladder cancer occurrence and progression, with a greater bladder cancer incidence in males than females. However, the progression of bladder cancer after diagnosis is much quicker in females than males. These findings can be explained by the effects of female hormones (predominantly oestrogens) and their binding receptors, including oestrogen receptor 1 (ESR1; also known as ERα), oestrogen receptor 2 (ESR2; also known as ERβ), and GPR30 protein on bladder cancer incidence and progression. Results from studies using various in vitro cell lines and in vivo mouse models demonstrate differential roles of oestrogen receptors in cancer initiation and progression. ERα suppresses bladder cancer initiation and invasion, whereas ERβ promotes bladder cancer initiation and progression. Mechanistic studies suggest that ERα and ERβ exert these effects via modulation of the AKT pathway and DNA replication complex, respectively. Targeting these signalling pathways--for example, with ERα agonists, ERβ antagonists, or selective oestrogen receptor modulators such as 4-[2-phenyl-5,7-bis(trifluoromethyl)pyrazolo[1,5-a]pyrimidin-3-yl]phenol (also known as PHTPP)--could lead to the development of new therapeutic approaches for controlling bladder cancer progression.
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Affiliation(s)
- Iawen Hsu
- Department of Urology, George Whipple Lab for Cancer Research, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA
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Childbearing and the Risk of Bladder Cancer: A Nationwide Population-based Cohort Study. Eur Urol 2013; 63:733-8. [DOI: 10.1016/j.eururo.2013.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 01/06/2013] [Indexed: 11/23/2022]
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Rampersaud EN, Klatte T, Bass G, Patard JJ, Bensaleh K, Böhm M, Allhoff EP, Cindolo L, De La Taille A, Mejean A, Soulie M, Bellec L, Christophe Bernhard J, Pfister C, Colombel M, Belldegrun AS, Pantuck AJ, George D. The effect of gender and age on kidney cancer survival: younger age is an independent prognostic factor in women with renal cell carcinoma. Urol Oncol 2013; 32:30.e9-13. [PMID: 23422777 DOI: 10.1016/j.urolonc.2012.10.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Revised: 09/19/2012] [Accepted: 10/25/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Gender-specific differences in incidence of renal cell carcinoma (RCC) and its outcome have previously been reported. We used age as a surrogate to test whether this might be hormone-related in a large international RCC cohort. METHODS AND MATERIALS This study included patients treated by nephrectomy at 10 international academic centers. Clinicopathologic features were assessed using chi-square and the Student t-tests. Kaplan-Meier survival estimates and Cox proportional hazards models addressed the effect of gender and age on disease-specific survival. RESULTS Of the 5,654 patients, 3,777 (67%) were men and 1,877 (33%) were women. Generally, women presented at lower T stages (P<0.001), had fewer metastases (P<0.001), and had lower-grade tumors (P<0.001). Women more frequently had clear-cell (87% vs. 82%) and less frequently had papillary RCC (7% vs. 12%) than men (P<0.001). Women had a 19% reduced risk of death from RCC than men (hazard ratio 0.81, 95% confidence interval 0.73-0.90, P<0.001). The survival advantage for women was present to the greatest degree in the age group<42 years (P = 0.0136) and in women aged 42 to 58 years (P<0.001), but was not apparent in patients aged 59 years and older (P = 0.248). Age was an independent predictor of disease-specific survival in women (hazard ratio 1.011, 95% confidence interval 1.004-1.019, P = 0.004), but not in men. CONCLUSIONS As a group, women present with less advanced tumors, leading to a 19% reduced risk of RCC-specific death compared with men. This survival difference is present only in patients aged<59 years. Because this gender-based survival difference is not related to pathologic features, the role of hormonal effects on the development and progression of RCC needs to be investigated.
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Affiliation(s)
- Edward N Rampersaud
- Institute of Urologic Oncology, David Geffen School of Medicine, UCLA, CA; Division of Hematology/Oncology, Duke University Medical Center, NC
| | - Tobias Klatte
- Department of Urology, Medical University of Vienna, Austria
| | - Geoffrey Bass
- Division of Hematology/Oncology, Duke University Medical Center, NC
| | - Jean-Jacques Patard
- Department of Urology, Bicêtre Hospital, Paris XI University, Kremlin Bicêtre, France
| | - Karim Bensaleh
- Department of Urology, Rennes University Hospital, Rennes, France
| | - Malte Böhm
- Department of Urology, University of Magdeburg, Germany
| | | | - Luca Cindolo
- Department of Urology, S. Pio da Pietrelcina Hospital, Vasto, Italy
| | | | - Arnaud Mejean
- Department of Urology, European Georges Pompidou Hospital, Paris, France
| | - Michel Soulie
- Department of Urology, University of Toulouse, France
| | | | | | | | - Marc Colombel
- Department of Urology, Lyon University, Lyon, France
| | - Arie S Belldegrun
- Institute of Urologic Oncology, David Geffen School of Medicine, UCLA, CA
| | - Allan J Pantuck
- Institute of Urologic Oncology, David Geffen School of Medicine, UCLA, CA.
| | - Daniel George
- Division of Hematology/Oncology, Duke University Medical Center, NC
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Andrew AS, Hu T, Gu J, Gui J, Ye Y, Marsit CJ, Kelsey KT, Schned AR, Tanyos SA, Pendleton EM, Mason RA, Morlock EV, Zens MS, Li Z, Moore JH, Wu X, Karagas MR. HSD3B and gene-gene interactions in a pathway-based analysis of genetic susceptibility to bladder cancer. PLoS One 2012; 7:e51301. [PMID: 23284679 PMCID: PMC3526593 DOI: 10.1371/journal.pone.0051301] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 10/31/2012] [Indexed: 12/30/2022] Open
Abstract
Bladder cancer is the 4(th) most common cancer among men in the U.S. We analyzed variant genotypes hypothesized to modify major biological processes involved in bladder carcinogenesis, including hormone regulation, apoptosis, DNA repair, immune surveillance, metabolism, proliferation, and telomere maintenance. Logistic regression was used to assess the relationship between genetic variation affecting these processes and susceptibility in 563 genotyped urothelial cell carcinoma cases and 863 controls enrolled in a case-control study of incident bladder cancer conducted in New Hampshire, U.S. We evaluated gene-gene interactions using Multifactor Dimensionality Reduction (MDR) and Statistical Epistasis Network analysis. The 3'UTR flanking variant form of the hormone regulation gene HSD3B2 was associated with increased bladder cancer risk in the New Hampshire population (adjusted OR 1.85 95%CI 1.31-2.62). This finding was successfully replicated in the Texas Bladder Cancer Study with 957 controls, 497 cases (adjusted OR 3.66 95%CI 1.06-12.63). The effect of this prevalent SNP was stronger among males (OR 2.13 95%CI 1.40-3.25) than females (OR 1.56 95%CI 0.83-2.95), (SNP-gender interaction P = 0.048). We also identified a SNP-SNP interaction between T-cell activation related genes GATA3 and CD81 (interaction P = 0.0003). The fact that bladder cancer incidence is 3-4 times higher in males suggests the involvement of hormone levels. This biologic process-based analysis suggests candidate susceptibility markers and supports the theory that disrupted hormone regulation plays a role in bladder carcinogenesis.
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Affiliation(s)
- Angeline S. Andrew
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Ting Hu
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Jian Gu
- MD Anderson Cancer Center, University of Texas, Houston, Texas, United States of America
| | - Jiang Gui
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Yuanqing Ye
- MD Anderson Cancer Center, University of Texas, Houston, Texas, United States of America
| | - Carmen J. Marsit
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Karl T. Kelsey
- Departments of Epidemiology and Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, United States of America
| | - Alan R. Schned
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Sam A. Tanyos
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Eben M. Pendleton
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Rebecca A. Mason
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Elaine V. Morlock
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Michael S. Zens
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Zhongze Li
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Jason H. Moore
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Xifeng Wu
- MD Anderson Cancer Center, University of Texas, Houston, Texas, United States of America
| | - Margaret R. Karagas
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
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Raloxifene inhibits growth of RT4 urothelial carcinoma cells via estrogen receptor-dependent induction of apoptosis and inhibition of proliferation. Discov Oncol 2012; 4:24-35. [PMID: 22965848 DOI: 10.1007/s12672-012-0123-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 08/28/2012] [Indexed: 12/28/2022] Open
Abstract
Bladder cancer is the fifth most common type of cancer in the USA, with over 70,000 new cases diagnosed each year. Treatment often involves invasive surgical therapies, as chemotherapy alone is often ineffective and associated with high recurrence rates. Identification of estrogen receptor-β (ERβ) in up to 75 % of urinary tumors raises the question of whether this receptor could be targeted to effectively treat bladder cancer. In this study, a panel of five bladder cancer cell lines representing a variety of disease stage and grades were treated with the antiestrogens 4-hydroxytamoxifen, raloxifene, or the pure antagonist ICI 182,780. All cell lines were ERβ positive while only a few expressed estrogen receptor-α (ERα). Notably, all but the TCCSUP cell line were growth inhibited 20-100 % by at least two antiestrogens. Using RT4 cells, we demonstrate that growth inhibition by raloxifene is ER dependent and either ERα or ERβ can mediate this response. Activation of caspase-3 and its effector poly-ADP ribose polymerase (PARP) demonstrate that raloxifene-induced growth inhibition is in part the result of increased apoptosis; this PARP cleavage was ER dependent. Moreover, changes in the expression of cell cycle genes indicate that cell proliferation is also affected. Specifically, raloxifene treatment results in the stabilization of p27 protein, likely via the downregulation of S-phase kinase-associated protein (SKP2). Expression of the negative cell cycle regulator B-cell translocation gene (BTG2) is also increased, while cyclin D1 transcription is reduced. These results indicate that antiestrogens may be useful therapeutics in the treatment of bladder cancer by targeting ER and inhibiting growth via multiple mechanisms.
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Steroid profiles as potential biomarkers in patients with urogenital tract cancer for diagnostic investigations analyzed by liquid chromatography coupled to mass spectrometry. J Pharm Biomed Anal 2012; 73:108-15. [PMID: 22475516 DOI: 10.1016/j.jpba.2012.03.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 03/08/2012] [Indexed: 11/20/2022]
Abstract
Large discrepancy remains for the hormone-responsible cancers with regards to the conditions generating the optimal opportunity for cancerogenesis. In the research, altered steroid profiles were observed in patients with urogenital tract cancer diseases, namely bladder, kidney, prostate and testis ones. The presented steroid profiles from 154 subjects, including 77 urogenital tract cancer patient and 77 healthy controls were determined by liquid chromatography coupled to mass spectrometry method. Because the original experimental data obtained as a result of analytical experiment in order to interpret them in better way required the appropriate pre-treatment, the data were standardized by scaling and centering. In order to determine which samples form a collection for a high-capacity predictive model, Kennard-Stone's algorithm was used. A principal component analysis of preprocessed data provided better consistency of the steroid profiles with health status of subjects than PCA profiles without data preprocessing and showed a tendency to separate clusters of cancer patients from healthy subjects. The discriminant analysis was also performed and the percent of correct classification of cancer patients and control group was calculated. Finally, detailed studies examined the role of steroid profiles measured in urine, and considered as potential biomarkers related to urogenital cancer and associated renal dysfunctions.
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Davis-Dao CA, Henderson KD, Sullivan-Halley J, Ma H, West D, Xiang YB, Gago-Dominguez M, Stern MC, Castelao JE, Conti DV, Pike MC, Bernstein L, Cortessis VK. Lower risk in parous women suggests that hormonal factors are important in bladder cancer etiology. Cancer Epidemiol Biomarkers Prev 2011; 20:1156-70. [PMID: 21493870 DOI: 10.1158/1055-9965.epi-11-0017] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Urinary bladder cancer is two to four times more common among men than among women, a difference in risk not fully explained by established risk factors. Our objective was to determine whether hormonal and reproductive factors are involved in female bladder cancer. METHODS We analyzed data from two population-based studies: the Los Angeles-Shanghai Bladder Cancer Study, with 349 female case-control pairs enrolled in Los Angeles and 131 female cases and 138 frequency-matched controls enrolled in Shanghai, and the California Teachers Study (CTS), a cohort of 120,857 women with 196 incident cases of bladder urothelial carcinoma diagnosed between 1995 and 2005. We also conducted a meta-analysis summarizing associations from our primary analyses together with published results. RESULTS In primary data analyses, parous women experienced at least 30% reduced risk of developing bladder cancer compared with nulliparous women (Shanghai: OR = 0.38, 95% CI: 0.13-1.10; CTS: RR = 0.69, 95% CI: 0.50-0.95) consistent with results of a meta-analysis of nine studies (summary RR = 0.73, 95% CI: 0.63-0.85). The CTS, which queried formulation of menopausal hormone therapy (HT), revealed a protective effect for use of combined estrogen and progestin compared with no HT (RR = 0.60, 95% CI: 0.37-0.98). Meta-analysis of three studies provided a similar effect estimate (summary RR = 0.65, 95% CI: 0.48-0.88). CONCLUSIONS A consistent pattern of reduced bladder cancer risk was found among parous women and those who used estrogen and progestin for HT. IMPACT These results suggest that more research is warranted to investigate hormonal and reproductive factors as possible contributors to bladder cancer risk.
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Affiliation(s)
- Carol A Davis-Dao
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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