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Kardoust Parizi M, Margulis V, Compe Rat E, Shariat SF. The value and limitations of urothelial bladder carcinoma molecular classifications to predict oncological outcomes and cancer treatment response: A systematic review and meta-analysis. Urol Oncol 2020; 39:15-33. [PMID: 32900624 DOI: 10.1016/j.urolonc.2020.08.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/28/2020] [Accepted: 08/10/2020] [Indexed: 01/08/2023]
Abstract
AIM To evaluate the predictive value of molecular subtypes on oncological outcomes and response to cancer treatment in patients with urothelial bladder carcinoma (UBC). MATERIALS AND METHODS A literature search using PubMed, Scopus, and Cochrane Library was conducted on April 2020 to identify relevant studies according to the preferred reporting items for systematic review and meta-analysis guidelines. The pooled overall survival (OS), cancer-specific survival (CSS), and progression-free survival were calculated using a fixed or random effects model. RESULTS We identified 66 studies (including 21,447 molecular subtype records) evaluating the impact of molecular classification on oncologic outcomes in patients with UBC. We found significant association of different molecular subtypes with OS, CSS, progression-free survival, recurrence-free survival, and response to treatment. Totally, 11 studies were included in the meta-analysis. Basal group and NE-like subtypes were associated with worse OS (pooled HR: 1.78, 95%CI: 1.49-2.12, and pooled HR: 2.67, 95%CI: 1.08-6.60, respectively) in patients with muscle invasive bladder cancer. Luminal group was also associated with worse CSS (pooled HR of 3.67, 95%CI: 2.19-6.14). CONCLUSIONS Based on these data, UBC molecular classifications are significant predictors of oncological outcomes and identify patients who are most likely to benefit from intensified or different therapies. The optimal consensus on molecular classification remains to be verified in well-designed prospective studies to allow precise prognostic and predictive value assessment.
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Affiliation(s)
- Mehdi Kardoust Parizi
- Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Eva Compe Rat
- Department of Pathology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, UPMC Paris VI, Paris, France
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Departments of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan; European Association of Urology Research Foundation, Arnhem, Netherlands.
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Afferi L, Moschini M, Cumberbatch MG, Catto JW, Scarpa RM, Porpiglia F, Mattei A, Sanchez-Salas R, Esperto F. Biomarkers predicting oncological outcomes of high-risk non-muscle-invasive bladder cancer. MINERVA UROL NEFROL 2020; 72:265-278. [PMID: 32298067 DOI: 10.23736/s0393-2249.20.03786-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The European Organization for Research and Treatment of Cancer (EORTC) and the Spanish Urological Club for Oncological Treatment (CUETO) scoring systems show limited accuracy for the prediction of disease recurrence and progression of non-muscle-invasive bladder cancer (NMIBC). This aspect is even more relevant in the category of HR NMIBC. Biomarkers might potentially help to further categorize the outcomes of these patients. Therefore, we sought to review the evidence available on tissue-based, urinary, and serum biomarkers for the prediction of recurrence, progression, and survival in HR NMIBC. EVIDENCE ACQUISITION A systematic literature review without time restrictions was performed using PubMed/EMBASE, Web of Science, SCOPUS, and the Cochrane Libraries. The search was filtered for articles in the English, Italian, German, French, and Spanish languages, involving patients with more than 18 years of age. Relevant papers on tissue-based, serum and urinary biomarkers related to the prediction of oncological outcomes for high-risk bladder cancer patients were included in the analyses. EVIDENCE SYNTHESIS Overall, 71 studies were eligible for inclusion in this review. The majority of the investigations performed so far focused on immunohistochemical analyses on tumoral tissue. Overall, p53 was the most studied biomarker, but results regarding its prognostic and predictive role were contradictory. Ki67 seems to be a promising biomarker in the prediction of recurrence. Recently, PD-L1 has been associated with the prediction of recurrence free survival and of treatment-refractory disease. Markers developed un urine samples are focused on commercially available kits, which currently do not unequivocally show strongly superior levels of accuracy to cytology. However, they have demonstrated to be potentially helpful in the prediction of recurrence. Blood-based biomarkers represent an emerging reality with promising future applications. CONCLUSIONS Despite a long history of attempts to discover accurate biomarkers predicting oncological outcomes for HR NMIBC, contradictory or uncertain findings render the adoption of this ancillary techniques in clinical practice still unlikely. Future attempts should be directed to the development of prospective trials and the definition of standardized cut-off levels to render findings worthy of comparison.
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Affiliation(s)
- Luca Afferi
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Marco Moschini
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland - .,Department of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | | | - James W Catto
- Unit of Academic Urology, University of Sheffield, Sheffield, UK
| | - Roberto M Scarpa
- Department of Urology, Campus Bio-Medico University, Rome, Italy
| | - Francesco Porpiglia
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Agostino Mattei
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Rafael Sanchez-Salas
- Department of Urology, Institut Mutualiste Montsouris and Universitè Paris Descartes, Paris, France
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Heo J, Noh B, Lee S, Lee H, Kim Y, Lim J, Ju H, Yu HY, Ryu C, Lee PCW, Jeong H, Oh Y, Kim K, Kim S, Son J, Hong B, Kim JS, Cho YM, Shin D. Phosphorylation of TFCP2L1 by CDK1 is required for stem cell pluripotency and bladder carcinogenesis. EMBO Mol Med 2020; 12:e10880. [PMID: 31709755 PMCID: PMC6949511 DOI: 10.15252/emmm.201910880] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/10/2019] [Accepted: 10/14/2019] [Indexed: 12/28/2022] Open
Abstract
Molecular programs involved in embryogenesis are frequently upregulated in oncogenic dedifferentiation and metastasis. However, their precise roles and regulatory mechanisms remain elusive. Here, we showed that CDK1 phosphorylation of TFCP2L1, a pluripotency-associated transcription factor, orchestrated pluripotency and cell-cycling in embryonic stem cells (ESCs) and was aberrantly activated in aggressive bladder cancers (BCs). In murine ESCs, the protein interactome and transcription targets of Tfcp2l1 indicated its involvement in cell cycle regulation. Tfcp2l1 was phosphorylated at Thr177 by Cdk1, which affected ESC cell cycle progression, pluripotency, and differentiation. The CDK1-TFCP2L1 pathway was activated in human BC cells, stimulating their proliferation, self-renewal, and invasion. Lack of TFCP2L1 phosphorylation impaired the tumorigenic potency of BC cells in a xenograft model. In patients with BC, high co-expression of TFCP2L1 and CDK1 was associated with unfavorable clinical characteristics including tumor grade, lymphovascular and muscularis propria invasion, and distant metastasis and was an independent prognostic factor for cancer-specific survival. These findings demonstrate the molecular and clinical significance of CDK1-mediated TFCP2L1 phosphorylation in stem cell pluripotency and in the tumorigenic stemness features associated with BC progression.
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Affiliation(s)
- Jinbeom Heo
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
- Department of PhysiologyUniversity of Ulsan College of MedicineSeoulKorea
| | - Byeong‐Joo Noh
- Department of PathologyGangneung Asan HospitalUniversity of Ulsan College of MedicineGangneungKorea
| | - Seungun Lee
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
- Department of PhysiologyUniversity of Ulsan College of MedicineSeoulKorea
| | - Hye‐Yeon Lee
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
- Department of PhysiologyUniversity of Ulsan College of MedicineSeoulKorea
| | - YongHwan Kim
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
- Department of PhysiologyUniversity of Ulsan College of MedicineSeoulKorea
| | - Jisun Lim
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
- Department of PhysiologyUniversity of Ulsan College of MedicineSeoulKorea
| | - Hyein Ju
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
- Department of PhysiologyUniversity of Ulsan College of MedicineSeoulKorea
| | - Hwan Yeul Yu
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
- Department of PhysiologyUniversity of Ulsan College of MedicineSeoulKorea
| | - Chae‐Min Ryu
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
- Department of PhysiologyUniversity of Ulsan College of MedicineSeoulKorea
| | - Peter CW Lee
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
| | - Hwangkyo Jeong
- Department of Convergence MedicineAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
| | - Yumi Oh
- Department of Convergence MedicineAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
| | - Kyunggon Kim
- Department of Convergence MedicineAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
| | - Sang‐Yeob Kim
- Department of Convergence MedicineAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
| | - Jaekyoung Son
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
| | - Bumsik Hong
- Department of UrologyAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
| | - Jong Soo Kim
- Department of Stem Cell BiologySchool of MedicineKonkuk UniversitySeoulKorea
| | - Yong Mee Cho
- Department of PathologyAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
| | - Dong‐Myung Shin
- Department of Biomedical SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
- Department of PhysiologyUniversity of Ulsan College of MedicineSeoulKorea
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Shelekhova KV, Krykow KA, Mescherjakov IA, Mitin NP. Molecular Pathologic Subtyping of Urothelial Bladder Carcinoma in Young Patients. Int J Surg Pathol 2019; 27:483-491. [PMID: 30854907 DOI: 10.1177/1066896919830509] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Urothelial cancer is a heterogeneous disease with different molecular pathways that produce distinct molecular subtypes with specific characteristics and patient survival outcomes that require different therapeutic methods. Urothelial tumors in young patients appear to have distinct genetic features compared with their counterparts in older patients. Using a Lund subtype-specific immunohistochemistry panel, we performed molecular subtype profiling of an urothelial carcinoma case series (n = 49) in patients younger than 45 years of age. We demonstrate that the urothelial carcinoma in young patients tends to be of molecular urothelial-like A subtype (80%) and is associated with favorable, recurrent-free survival (P = .022). In the urothelial-like cluster, we identified a portion of patients (10%) with high-grade non-muscle-invasive cancers (so-called urothelial-like D type) that showed significantly higher levels of squamous differentiation and p16, E2F3, and ki67 expression in addition to aberrant expression of Ck20 and a trend toward lower recurrent-free survival (P = .057). Segregation of the cohort according to the decade of occurrence revealed that all tumors (n = 8) of patients younger than 30 years were clearly classified as urothelial-like A subtype. Statistically more aggressive molecular subtypes, such as urothelial-like D and basal/squamous-like (6%) subtypes, were identified in patients older than 30 years of age. Genomically unstable (2%) and mesenchymal-like (2%) subtypes were classified in the 40- to 44-year age group only. These data suggest that more aggressive molecular subtypes of bladder carcinoma appear and become more frequent with age. Further investigations are needed to validate this hypothesis.
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Affiliation(s)
- Ksenya V Shelekhova
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia.,2 Saint-Petersburg Medico-Social Institute, Saint Petersburg, Russia
| | - Kirill A Krykow
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia
| | - Igor A Mescherjakov
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia
| | - Nikolay P Mitin
- 1 Clinical Research and Practical Center for Specialized Oncological Care, Saint Petersburg, Russia
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HDAC inhibition as a treatment concept to combat temsirolimus-resistant bladder cancer cells. Oncotarget 2017; 8:110016-110028. [PMID: 29299126 PMCID: PMC5746361 DOI: 10.18632/oncotarget.22454] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/12/2017] [Indexed: 12/16/2022] Open
Abstract
Introduction Although the mechanistic target of rapamycin (mTOR) might be a promising molecular target to treat advanced bladder cancer, resistance develops under chronic exposure to an mTOR inhibitor (everolimus, temsirolimus). Based on earlier studies, we proposed that histone deacetylase (HDAC) blockade might circumvent resistance and investigated whether HDAC inhibition has an impact on growth of bladder cancer cells with acquired resistance towards temsirolimus. Results The HDAC inhibitor valproic acid (VPA) significantly inhibited growth, proliferation and caused G0/G1 phase arrest in RT112res and UMUC-3res. cdk1, cyclin B, cdk2, cyclin A and Skp1 p19 were down-regulated, p27 was elevated. Akt-mTOR signaling was deactivated, whereas acetylation of histone H3 and H4 in RT112res and UMUC-3res increased in the presence of VPA. Knocking down cdk2 or cyclin A resulted in a significant growth blockade of RT112res and UMUC-3res. Materials And Methods Parental (par) and resistant (res) RT112 and UMUC-3 cells were exposed to the HDAC inhibitor VPA. Tumor cell growth, proliferation, cell cycling and expression of cell cycle regulating proteins were then evaluated. siRNA blockade was used to investigate the functional impact of the proteins. Conclusions HDAC inhibition induced a strong response of temsirolimus-resistant bladder cancer cells. Therefore, the temsirolimus-VPA-combination might be an innovative strategy for bladder cancer treatment.
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EZH2 upregulation correlates with tumor invasiveness, proliferation, and angiogenesis in human pituitary adenomas. Hum Pathol 2017; 66:101-107. [PMID: 28666925 DOI: 10.1016/j.humpath.2017.03.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 03/10/2017] [Accepted: 03/23/2017] [Indexed: 02/06/2023]
Abstract
Enhancer of zeste homolog 2 (EZH2) is a critical component of the polycomb repressive complex 2, which epigenetically represses genes involved in tumorigenesis and is highly expressed in tumors. However, no studies have investigated EZH2 expression and its clinical significance in human pituitary adenomas (PAs). Therefore, we examined the expression pattern of EZH2 in PAs and studied the correlations between protein expression and invasiveness, proliferation, angiogenesis, hormone functioning, and some other factors. We measured EZH2 and MMP-14 protein and EZH2 mRNA expression in 62 samples of PAs by immunohistochemistry staining and quantitative real-time polymerase chain reaction and correlated protein expression relative to clinicopathologic features. The immunopositive rate of EZH2 was 88.7% (55/62). The extent of expression was associated with invasiveness, microvessel density, and proliferation (Ki-67 index). Moreover, EZH2 expression correlated with MMP-14 expression. We did not find any correlation between EZH2 overexpression and hormone-secreting function or patient age or sex. The quantitative real-time polymerase chain reaction analysis revealed that the amount of EZH2 mRNA was significantly higher in invasive than in noninvasive adenomas. This is the first report to describe EZH2 overexpression in human PAs, especially invasive adenomas. Thus, EZH2 is a potentially useful diagnostic marker and pharmacotherapeutic target for invasive PAs.
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Nicolazzo C, Busetto GM, Del Giudice F, Sperduti I, Giannarelli D, Gradilone A, Gazzaniga P, de Berardinis E, Raimondi C. The long-term prognostic value of survivin expressing circulating tumor cells in patients with high-risk non-muscle invasive bladder cancer (NMIBC). J Cancer Res Clin Oncol 2017; 143:1971-1976. [PMID: 28555356 DOI: 10.1007/s00432-017-2449-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 05/25/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Long-term follow-up study to evaluate the impact on disease-free survival and cancer-specific survival of survivin expression in tissue and CTCs from T1G3 bladder cancer patients. PATIENTS AND METHODS The study was conducted using tumor tissue and blood samples from 54 patients with a primary diagnosis of T1G3 NMIBC. Survivin was evaluated by reverse transcription-polymerase chain reaction in tumor tissues. CTCs were isolated from blood by CELLection™ Dynabeads (Invitrogen, Carlsbad, CA, USA). Cells were lysed and cDNA was synthesized and analysed for the expression of CD45, CK8 and survivin. The endpoints of this long-termanalysis were disease-free survival, DFS and cancer-specific survival, CSS. RESULTS Here, we report that, at 9 years of median follow-up, disease-free survival and cancer-specific survival are both significantly influenced by the expression of survivin in tumor tissue (p = 0.006), by the presence of CTCs (p < 0.0001) and by the expression of survivin in CTCs (p < 0.0001). CONCLUSION The statistically significant impact of survivin expressing CTCs on cancer-specific survival that we observed might be interpreted as the result of the persistence of a subpopulation of highlander cells in the blood of T1G3 bladder patients over time.
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Affiliation(s)
- Chiara Nicolazzo
- Dipartimento Medicina Molecolare, Sapienza Università di Roma, Rome, Italy
| | - Gian Maria Busetto
- Dipartimento Scienze Ginecologico-Ostetriche e Scienze Urologiche, Sapienza Università di Roma, Viale Regina Elena, 324, 00161, Rome, Italy.
| | - Francesco Del Giudice
- Dipartimento Scienze Ginecologico-Ostetriche e Scienze Urologiche, Sapienza Università di Roma, Viale Regina Elena, 324, 00161, Rome, Italy
| | | | | | - Angela Gradilone
- Dipartimento Medicina Molecolare, Sapienza Università di Roma, Rome, Italy
| | - Paola Gazzaniga
- Dipartimento Medicina Molecolare, Sapienza Università di Roma, Rome, Italy
| | - Ettore de Berardinis
- Dipartimento Scienze Ginecologico-Ostetriche e Scienze Urologiche, Sapienza Università di Roma, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Cristina Raimondi
- Dipartimento Medicina Molecolare, Sapienza Università di Roma, Rome, Italy
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Gupta S, Kushwaha VS, Verma S, Khan H, Bhatt MLB, Husain N, Negi MPS, Bhosale VV, Ghatak A. Understanding molecular markers in recurrent oral squamous cell carcinoma treated with chemoradiation. Heliyon 2016; 2:e00206. [PMID: 27981249 PMCID: PMC5148783 DOI: 10.1016/j.heliyon.2016.e00206] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/04/2016] [Accepted: 11/24/2016] [Indexed: 01/02/2023] Open
Abstract
Introduction Oral cancer accounts for approximately 2.1% of all cancers worldwide. In India, oral squamous cell carcinoma (OSCC) is the most common cancer with half a million new cases diagnosed every year. More than 50% of patients eventually develop local recurrence or metastasis usually within the first 2-years following completion of treatment. It is beneficial to analyze the prognostic significance of Cyclin D1, p53 and EGFR which are critical mediators in the pathogenesis of OSCC. The objective of this study was to assess the association of expression of these markers with recurrence and pattern of recurrence in OSCC patients undergoing chemoradiation. Materials and Methods A Total 290 OSCC cases of locally advanced stage (III, IV) oral cancer with World Health Organization (W.H.O.) performance status of grade 0/1 in the year 2009–2012 were enrolled in the study. Treatment response was assessed according to W.H.O. criteria. Cyclin D1, EGFR and p53 expression in tumor tissue was estimated by immunohistochemical (IHC) method and quantified as percentage positive nuclei. Results During the 2-years follow up, 56 (19.3%) patients recurred, out of which, 47 (83.9%) were locoregional and 9 (16.1%) distant sites. On correlating, χ2 test showed significant (P < 0.05 or P < 0.01 or P < 0.001) association of marker expressions (Cyclin D1, EGFR and p53) with recurrence. The strong positive expressions of all three markers showed significant association with early time of recurrence. The multivariate logistic regression analysis showed significant (P < 0.05 or P < 0.01 or P < 0.001) association of recurrence with primary site, differentiation, Cyclin D1 and p53 expressions indicating these as an independent predictors of recurrence in OSCC. The Cyclin D1, EGFR and p53 expressions also showed significant (P < 0.001) poor survivals (OS, DFS and RFS) in patients with positive/strong positive expressions than negative expression suggesting their prognosis in OSCC. Conclusion Our results signifies that tumors over expressing Cyclin D1, EGFR and p53 are resistant to chemoradiation and are associated with increased risk of locoregional recurrence and metastasis in OSCC patients undergoing chemoradiation.
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Affiliation(s)
- Seema Gupta
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vandana Singh Kushwaha
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sandeep Verma
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Huma Khan
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - M L B Bhatt
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nuzhat Husain
- Department of Pathology, RMLIMS, Lucknow, Uttar Pradesh, India
| | - Mahendra Pal Singh Negi
- Clinical and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Vivek Vidyadhar Bhosale
- Clinical and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Ashim Ghatak
- Clinical and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
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T1 high-grade bladder carcinoma outcome: the role of p16, topoisomerase-IIα, survivin, and E-cadherin. Hum Pathol 2016; 57:78-84. [PMID: 27473264 DOI: 10.1016/j.humpath.2016.06.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/05/2016] [Accepted: 06/28/2016] [Indexed: 12/15/2022]
Abstract
High-grade papillary urothelial carcinoma with subepithelial connective tissue invasion (T1HG) is an aggressive disease at high risk of progression after transurethral resection/Bacillus Calmette-Guerin standardized therapy. The European Organization for Research and Treatment of Cancer has identified T1HG bladder carcinoma that is single and ≤3 cm in the largest dimension at first diagnosis as a category in which the prognosis cannot be further stratified based on conventional criteria. This category may benefit from biomarker analysis as a valuable tool to determine the patient's outcome. To further the issue of biomarkers in predicting aggressiveness in single T1HG bladder carcinoma ≤3 cm in greatest dimension at first diagnosis, we have conducted a validation study of the biomarker risk score set previously reported by our group. The study set included immunohistochemical detection of galectin-3, CD44, E-cadherin (E-CAD), CD138, p16, survivin, HYAL-1, and topoisomerase-IIα in 92 randomly selected specimens at participating institutions. Topoisomerase-IIα expression was identified as a predictor of disease-free survival. p16, survivin, and E-CAD expression predicted progression-free survival, but p16 and E-CAD also predicted overall survival. The current study validates a panel of immunohistochemical markers with the potential of being implemented in practice and supports the use of biomarkers in predicting aggressiveness in patients with first diagnosis of single T1HG bladder carcinoma ≤3 cm in greatest dimension and therefore in identifying patients who need closer surveillance or earlier aggressive treatment.
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