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Ranti D, Dey L, Bieber C, Grauer R, Rich J, Rosenzweig S, Koskela LR, Steineck G, Hosseini A, Egevad L, Patrakka J, Attalla K, Wiklund P, Sfakianos J, Waingankar N. Surveillance for Nonmuscle Invasive Bladder Cancer: Identifying the Point of Diminishing Returns. Urology 2023; 181:84-91. [PMID: 37604253 DOI: 10.1016/j.urology.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE To characterize first and second recurrence patterns using 26years of cohort-level follow-up and microsimulation modeling. METHODS Patients diagnosed with nonmuscle-invasive bladder cancer in Stockholm County between 1995 and 1996 were included. Clinical, pathological, and longitudinal follow-up data were gathered. Logistic regressions, Kaplan Meier curves, and Cox proportional hazards models were run to generate assumptions for a microsimulation model, simulating first and second recurrence and progression for 10,000 patients. RESULTS Three hundred eighty-six patients were included: 67.4% were male; >50% were TaLG; and 37.5% were American Urological Association high-risk. Median time to recurrence was 300days. Three patients had missing data. Cohort follow-up has been carried out for 26years. For simulated first-recurrences, low-risk patients recurred at 56.6% over 15years of follow-up, with 2.2% muscle-invasive (MI) progression; intermediate-risk patients recurred at 62.8%, with 4.3% MI progression; high-risk patients recurred at 48.7% over 15years, with MI progression at 14.3%. For second recurrences, 70.7%, 75.7%, and 84.7% of low, medium, and high-risk patients recurred. No patients were seen to have first recurrences after 9years, with low, but notable, rates beyond 5years. CONCLUSION These data suggest that low-, intermediate-, and high-risk patients without recurrence at 5years may be potentially transitioned to less invasive monitoring.
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Affiliation(s)
- Daniel Ranti
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Linda Dey
- Department of Pelvic Cancer, Karolinska University Hospital, Solna, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - Christine Bieber
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ralph Grauer
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jordan Rich
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Shoshana Rosenzweig
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lotta Renström Koskela
- Department of Pelvic Cancer, Karolinska University Hospital, Solna, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - Gunnar Steineck
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden; Department of Oncology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Abolfazl Hosseini
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - Lars Egevad
- Department of Oncology-Pathology, Karolinska Institutet, Solna, Sweden
| | - Jaakko Patrakka
- Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Sweden
| | - Kyrollis Attalla
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Peter Wiklund
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Pelvic Cancer, Karolinska University Hospital, Solna, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - John Sfakianos
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nikhil Waingankar
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
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2
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A Comparison of the Anesthetic Methods for Recurrence Rates of Bladder Cancer after Transurethral Resection of Bladder Tumors Using National Health Insurance Claims Data of South Korea. J Clin Med 2022; 11:jcm11041143. [PMID: 35207416 PMCID: PMC8878593 DOI: 10.3390/jcm11041143] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 02/17/2022] [Accepted: 02/20/2022] [Indexed: 12/26/2022] Open
Abstract
Bladder cancers have high recurrence rates and are usually removed via transurethral resection of bladder tumor (TURBT). Recently, some reports showed that the anesthetic method may affect the recurrence rates of bladder cancers. The purpose of this population-based study was to compare the effect of anesthetic methods with the recurrence rates of bladder cancers in South Korea. A total of 4439 patients were reviewed retrospectively using the data of the Korean National Health Insurance (NHI) claims database from January 2007 to December 2011. Patients were divided into 2 groups who received general (n = 3767) and regional anesthesia (n = 582), and were followed up until September 2017. Propensity score matching was conducted to reduce the effect of confounding factors. After using propensity score matching with a multivariable Cox regression model, age (p < 0.001), sex (p < 0.001), hypertension (p = 0.003), diabetes mellitus (p = 0.001), and renal disease (p < 0.001) were significantly associated with bladder cancer recurrence. However, there were no significant differences in the recurrence rates of bladder cancers in patients who received general anesthesia and spinal anesthesia for TURBTs. This study revealed that there is no relationship between the anesthetic method and bladder cancer recurrence. Either general anesthesia or regional anesthesia can be used depending on the situation in patients receiving TURBT. Future prospective studies are warranted to confirm the association between the anesthetic method and the recurrence rates of bladder cancer.
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Jackson J, Pandey R, Schmitt V. Part 1. Evaluation of Epigallocatechin Gallate or Tannic Acid Formulations of Hydrophobic Drugs for Enhanced Dermal and Bladder Uptake or for Local Anesthesia Effects. J Pharm Sci 2020; 110:796-806. [PMID: 33039439 DOI: 10.1016/j.xphs.2020.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 11/27/2022]
Abstract
Epigallocatechin gallate (EGCG) and tannic acid (TA) are known to increase the aqueous solubility and cellular uptake of the hydrophobic drugs docetaxel, paclitaxel, amphotericin B, and curcumin. In this study the practical application of gallate-based solubilization phenomena for the uptake of these drugs into dermal and bladder tissue and of lidocaine for wound healing application was studied. The penetration of all these drugs into pig skin or docetaxel into pig bladder using EGCG or TA formulations was measured. Overall, EGCG and TA particulate or propylene glycol paste formulations of drugs allowed for greatly increased levels of drug uptake into skin as compared to control formulations. EGCG/propylene glycol pastes allowed for rapid lidocaine uptake into skin. EGCG and TA formulations of docetaxel allowed for approximately 10 fold increases in bladder tissue uptake of docetaxel over tween based solutions. Morphologically, both EGCG and TA caused a mild, dose dependent exfoliation of the bladder wall. Both EGCG and TA formed injectable viscous pastes with propylene glycol which solidified in water and degraded and released lidocaine over 2-35 days. These data support the use of EGCG and TA based formulations of certain drugs for improved dermal, bladder and wound applications.
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Affiliation(s)
- John Jackson
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2045 Wesbrook Mall, Vancouver, BC, Canada.
| | - Rakhi Pandey
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2045 Wesbrook Mall, Vancouver, BC, Canada
| | - Veronika Schmitt
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2045 Wesbrook Mall, Vancouver, BC, Canada
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Matulay JT, Tabayoyong W, Duplisea JJ, Chang C, Daneshmand S, Gore JL, Holzbeierlein JM, Karsh LI, Kim SP, Konety BR, Li R, McKiernan JM, Messing EM, Steinberg GD, Williams SB, Kamat AM. Variability in adherence to guidelines based management of nonmuscle invasive bladder cancer among Society of Urologic Oncology (SUO) members. Urol Oncol 2020; 38:796.e1-796.e6. [PMID: 32430255 DOI: 10.1016/j.urolonc.2020.04.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/25/2020] [Accepted: 04/24/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE The American Urological Association (AUA) introduced evidence-based guidelines for the management of nonmuscle invasive bladder cancer (NMIBC) in 2016. We sought to assess the implementation of these guidelines among members of the Society of Urologic Oncology (SUO) with an aim to identifying addressable gaps. METHODS AND MATERIALS An SUO approved survey was distributed to 747 members from December 28, 2018 to February 2, 2019. This 14-question online survey (Qualtrics, SAP SE, Germany) consisted of 38 individual items addressing specific statements from the AUA NMIBC guidelines within 3 broad categories - initial diagnosis, surveillance, and imaging/biomarkers. Adherence to guidelines was assessed by dichotomizing responses to each item that was related to recommended action statement within the guidelines. Statistical analysis was applied using Pearson's chi-squared test, where a P-value of <0.05 was considered statistically significant. RESULTS A total of 121 (16.2%) members completed the survey. Members reported a mean of 71% guidelines adherence; adherence was higher for the intermediate- and high-risk subgroups (82% and 76%, respectively) compared to low-risk (58%). Specifically, adherence to guideline recommended cystoscopic surveillance intervals for low-risk disease differed based on clinical experience (60.9% [<10 years] vs. 36.8% [≥10 years], P = 0.01) and type of fellowship training (55.2% [urologic oncology] vs. 28.0% [none/other], P = 0.02). CONCLUSION Adherence to guidelines across risk-categories was higher for intermediate- and high-risk patients. Decreased adherence observed for low-risk patients resulted in higher than recommended use of cytology, imaging, and surveillance cystoscopy. These results identify addressable gaps and provide impetus for targeted interventions to support high-value care, especially for low-risk patients.
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Affiliation(s)
- Justin T Matulay
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - William Tabayoyong
- Department of Urology, University of Rochester Medical Center, Rochester, NY
| | - Jonathan J Duplisea
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Courtney Chang
- Division of Urology, Department of Surgery, UTHealth McGovern Medical School, Houston, TX
| | - Siamak Daneshmand
- USC Institute of Urology, University of Southern California, Los Angeles, CA
| | - John L Gore
- Department of Urology, University of Washington School of Medicine, Seattle, WA
| | | | | | - Simon P Kim
- Division of Urology, University of Colorado, Aurora, CO
| | | | - Roger Li
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - James M McKiernan
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Edward M Messing
- Department of Urology, University of Rochester Medical Center, Rochester, NY
| | - Gary D Steinberg
- Department of Urology, New York University Langone Medical Center, New York, NY
| | - Stephen B Williams
- Division of Urology, Department of Surgery, University of Texas Medical Branch-Galveston, Galveston, TX
| | - Ashish M Kamat
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX.
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Fukuokaya W, Kimura T, Miki J, Kimura S, Watanabe H, Bo F, Okada D, Aikawa K, Ochi A, Suzuki K, Shiga N, Abe H, Egawa S. Red cell distribution width predicts time to recurrence in patients with primary non-muscle-invasive bladder cancer and improves the accuracy of the EORTC scoring system. Urol Oncol 2020; 38:638.e15-638.e23. [PMID: 32184059 DOI: 10.1016/j.urolonc.2020.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate the clinical prognostic value of red cell distribution width (RDW) in patients with non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS We retrospectively evaluated 582 consecutive patients with primary NMIBC. The efficacy of preoperative RDW at predicting treatment outcome was assessed. A cut-off point for predicting recurrence was also identified. Uni- and multivariable analyses of time to recurrence (TTR) and progression were conducted. Harrell's concordance index (c-index) was used to evaluate the additive value of RDW to the European Organization of Research and Treatment of Cancer (EORTC) risk scoring model for recurrence. RESULTS According to the receiver operating characteristic curve of RDW for recurrence, a RDW ≥ 14.5% was classified as high. In the multivariable analysis, a high RDW could independently predict shorter TTR (subdistribution hazard ratio [SHR]: 2.65, 95% confidence interval [CI]: 1.83-3.84, P < 0.001), irrespective of tumor characteristics. No significant relationship was observed between RDW and time to progression (SHR: 1.75, 95% CI: 0.76-4.08, P = 0.19). Adding binary-coded RDW to the EORTC risk scoring model significantly improved its discriminatory performance in assessing recurrence risk (c-index: 0.62, improvement: 0.052, P < 0.001). High RDW was associated with shorter TTR in patients treated with bacillus Calmette-Guerin in the multivariable analysis (SHR: 2.0, 95% CI: 1.01-3.98, P = 0.047). CONCLUSIONS RDW was an independent, significant prognostic factor of TTR in patients with primary NMIBC. Adding RDW to the EORTC risk model significantly improved the model's predictability for tumor recurrence.
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Affiliation(s)
- Wataru Fukuokaya
- Department of Urology, Kameda Medical Center, Kamogawa City, Chiba, Japan; Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Jun Miki
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Shoji Kimura
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Hisaki Watanabe
- Department of Urology, Kameda Medical Center, Kamogawa City, Chiba, Japan; Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Fan Bo
- Department of Urology, Kameda Medical Center, Kamogawa City, Chiba, Japan
| | - Daigo Okada
- Department of Urology, Kameda Medical Center, Kamogawa City, Chiba, Japan
| | - Koichi Aikawa
- Department of Urology, Kameda Medical Center, Kamogawa City, Chiba, Japan; Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Atsuhiko Ochi
- Department of Urology, Kameda Medical Center, Kamogawa City, Chiba, Japan
| | - Koichiro Suzuki
- Department of Urology, Kameda Medical Center, Kamogawa City, Chiba, Japan
| | - Naoki Shiga
- Department of Urology, Kameda Medical Center, Kamogawa City, Chiba, Japan
| | - Hirokazu Abe
- Department of Urology, Kameda Medical Center, Kamogawa City, Chiba, Japan
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
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Khoo BL, Bouquerel C, Durai P, Anil S, Goh B, Wu B, Raman L, Mahendran R, Thamboo T, Chiong E, Lim CT. Detection of Clinical Mesenchymal Cancer Cells from Bladder Wash Urine for Real-Time Detection and Prognosis. Cancers (Basel) 2019; 11:cancers11091274. [PMID: 31480265 PMCID: PMC6770607 DOI: 10.3390/cancers11091274] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/12/2019] [Accepted: 08/15/2019] [Indexed: 12/19/2022] Open
Abstract
Bladder cancer (BC) is a disease that requires lifelong surveillance due to its high recurrence rate. An efficient method for the non-invasive rapid monitoring of patient prognosis and downstream phenotype characterization is warranted. Here, we develop an integrated procedure to detect aggressive mesenchymal exfoliated bladder cancer cells (EBCCs) from patients in a label-free manner. Using a combination of filtration and inertial focusing principles, the procedure allowed the focusing of EBCCs in a single stream-line for high-throughput separation from other urine components such as large squamous cells and blood cells using a microfluidic sorting device. Characterization of enriched cells can be completed within hours, suggesting a potential utility for real-time detection. We also demonstrate high efficiency of cancer cell recovery (93.3 ± 4.8%) and specific retrieval of various epithelial to mesenchymal transition (EMT) phenotype cell fractions from respective outlets of the microfluidic device. EMT is closely associated with metastasis, drug resistance and tumor-initiating potential. This procedure is validated with clinical samples, and further demonstrate the efficacy of bladder wash procedure to reduce EBCCs counts over time. Overall, the uniqueness of a rapid and non-invasive method permitting the separation of different EMT phenotypes shows high potential for clinical utility. We expect this approach will better facilitate the routine screening procedure in BC and greatly enhance personalized treatment.
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Affiliation(s)
- Bee Luan Khoo
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Che e Avenue, Kowloon Tong, Hong Kong 999077, China.
| | - Charlotte Bouquerel
- Institut Pierre Gilles de Gennes, 75005 Paris, France
- Mechanobiology Institute, National University of Singapore, Singapore 117411, Singapore
| | - Pradeep Durai
- Department of Urology, National University Hospital, Singapore 119074, Singapore
| | - Sarannya Anil
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore
| | - Benjamin Goh
- Department of Urology, National University Hospital, Singapore 119074, Singapore
| | - Bingcheng Wu
- Department of Pathology, National University Hospital, Singapore 119074, Singapore
| | - Lata Raman
- Department of Surgery, National University of Singapore, Singapore 119074, Singapore
| | - Ratha Mahendran
- Department of Surgery, National University of Singapore, Singapore 119074, Singapore
| | - Thomas Thamboo
- Department of Pathology, National University Hospital, Singapore 119074, Singapore
| | - Edmund Chiong
- Department of Urology, National University Hospital, Singapore 119074, Singapore
- Department of Surgery, National University of Singapore, Singapore 119074, Singapore
| | - Chwee Teck Lim
- Mechanobiology Institute, National University of Singapore, Singapore 117411, Singapore.
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore.
- BioSystems and Micromechanics (BioSyM) IRG, Singapore-MIT Alliance for Research and Technology (SMART) Centre, Singapore 138602, Singapore.
- Institute for Health Innovation & Technology (iHealthtech), National University of Singapore, Singapore 117599, Singapore.
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Xiao GQ, Barrett MM, Yang Q, Unger PD. Clinicopathologic and Immunohistochemical Study of Combined Small Cell Carcinoma and Urothelial Carcinoma Molecular Subtype. Pathol Oncol Res 2017; 25:889-895. [PMID: 29249035 DOI: 10.1007/s12253-017-0369-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
Muscle invasive bladder cancer, an aggressive disease with heterogeneous molecular profiles, has recently been subclassified into three major molecular subtypes -basal, luminal and "p53-like" urothelial carcinomas (UCas), which bear prognostic and therapeutic implication. Similar to breast cancer, basal and luminal subtype UCas are designated by basal (CK5/14) and luminal (CK20) markers. The "p53-like" subtype presents with wild-type p53 gene with upregulated p53 pathways and is implicated in chemoresistance. Urinary bladder is one of the most common primary sites of extrapulmonary small cell carcinoma (SmCC). Bladder SmCC frequently coexists with UCa; however, the relation of SmCC with specific UCa molecular subtypes has not been studied. The aim of this study is to investigate the clinicopathology and immunophenotypes of the combined SmCC and UCa molecular subtypes. A total of 22 combined SmCC and UCa cases were studied for the clinicopathology and immunohistochemical (IHC) profiles by luminal and basal cell markers as well as Her2/Neu and p53. Our results demonstrated that all the urinary bladder SmCCs were associated with high grade UCas. They were more commonly seen in older male patients with a smoking history and had a poor prognosis. Based on the reported molecular subtyping, the UCas could be immunohistochemically subclassified into luminal, basal, dual and null types, which showed different clinicopathologic and IHC features. Compared to non-SmCC associated UCa, the subtypes of UCa in the combined SmCCs and UCas were characterized by: 1) Although overall luminal type was still relatively more common in men, basal marker-expressing subtypes were significantly increased in incidence and were more common in women. 2) Her2/Neu overexpression was more commonly observed in luminal than basal cell marker-expressing UCas. 3) IHC overexpression of p53 was common in all the subtypes, with UCas and SmCCs sharing the same p53 expression pattern. Although limited by relatively a small number of cases, the results of this study will enhance our understanding of the combined SmCC and UCa entity and potentially lead to a future therapeutic management.
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Affiliation(s)
- Guang-Qian Xiao
- Department of Pathology, Keck Medical Center, University of Southern California, 1500 San Pablo Street, Los Angeles, CA, 90033, USA.
| | - Mary M Barrett
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
| | - Qi Yang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
| | - Pamela D Unger
- Department of Pathology, Lenox Hill Hospital-Northwell Health System, New York, NY, USA
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Correlation of Transabdominal Ultrasonography and Cystoscopy in Follow-up of Patients with Non-muscle Invasive Bladder Cancer. Indian J Surg Oncol 2017; 8:548-553. [PMID: 29203988 DOI: 10.1007/s13193-017-0678-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 07/11/2017] [Indexed: 10/19/2022] Open
Abstract
Cystoscopy (CS) is considered to be the gold standard in the follow-up of non-muscle invasive bladder cancer. However, CS is invasive, time-consuming, and expensive. On the other hand, modern sensitive transducers have improved the imaging of urinary tract rendering transabdominal ultrasonography (US) more effective in visualizing intraluminal filling defects in the bladder than it was in the past. Twenty-five follow-up patients of low-risk bladder cancer meeting the inclusion and exclusion criteria were included in study. Ultrasonography of the bladder was performed by a single senior radiologist, and subsequently, these patients were subjected to flexible cystoscopy under local anesthesia. Pain score was calculated for each of the cystoscopies done. Findings of transabdominal ultrasound of the bladder were correlated and compared with those of cystoscopy. Subjects with US and/or CS findings suggestive of recurrence underwent transurethral resection of bladder tumor (TURBT) under general anesthesia and confirmation of the bladder carcinoma was achieved by the histopathological examination. Mean patient age was 60.56 years with range of 29 to 77 years. The sensitivity of modern ultrasonographic techniques was found to be 84.61% with specificity of 91.7% taking flexible cystoscopy as the gold standard for detection of recurrence. The accuracy of US was 88% with positive predictive value of 91.7% and negative predictive value of 84.61%. Technological evolution has improved the accuracy of ultrasonography in diagnosis of bladder carcinoma. It represents a valuable surveillance tool in selected sub group of low risk non-muscle invasive bladder cancer patients.
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9
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Immunohistochemistry Biomarkers in Nonmuscle Invasive Bladder Cancer. Appl Immunohistochem Mol Morphol 2017; 25:178-183. [PMID: 26574637 DOI: 10.1097/pai.0000000000000280] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Bladder cancer (BCa) is the most frequent urinary tract neoplasm. BCa results in significant mortality when the disease presents as muscle invasive. Around 75% to 80% of patients present with nonmuscle invasive bladder cancer (NMIBC), but recurrence and progression are significant issues, compelling current guidelines to recommend long-term surveillance. There is therefore an urgent and unmet need to identify and validate accurate biomarkers for the detection of disease recurrence to improve quality of life for the patients and reduce costs for health care providers, while maintaining or improving current outcomes. In this review, 38 publications on immunohistochemistry prognostic biomarkers, that were studied may be related in nonmuscle invasive bladder cancer, have been analyzed. The studies were organized according to the evaluated marker and their findings. It was demonstrated that the combination of independent complementary biomarkers could allow a more accurate prognosis than an isolated marker. Biomarkers, including p53, Ki-67, and CK20, with classic and prognostic factors with recurrence and novel markers such as EN2 may provide a more accurate prediction of outcome compared with any single marker, improving risk stratification and clinical management of patients with BCa.
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10
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Laloglu E, Aksoy H, Aksoy Y, Ozkaya F, Akcay F. The determination of serum and urinary endocan concentrations in patients with bladder cancer. Ann Clin Biochem 2016; 53:647-653. [PMID: 26748103 DOI: 10.1177/0004563216629169] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Endocan (endothelial cell-specific molecule-1) is a proteoglycan and plays an important role in angiogenesis and inflammation. The aim of this study was to evaluate of serum and urinary concentrations of endothelial cell-specific molecule-1 in bladder cancer. Methods The study included 50 bladder cancer patients, 50 with urinary tract infection and 51 healthy volunteers. Serum and urinary endothelial cell-specific molecule-1 concentrations were measured with enzyme linked immunosorbent assay. Results In bladder cancer group, serum and urinary endothelial cell-specific molecule-1 concentrations were significantly higher than in the healthy subjects ( P = 0.003 and P < 0.0001). Urinary endothelial cell-specific molecule-1 concentrations in cases with urinary tract infection were higher than in healthy volunteers ( P = 0.002). There were no significant differences between bladder cancer and urinary tract infection groups in terms of serum and urinary endothelial cell-specific molecule-1 concentrations. Urinary endothelial cell-specific molecule-1 concentrations were higher than those of corresponding serum endothelial cell-specific molecule-1 concentrations ( P < 0.0001 for bladder cancer and urinary tract infection groups, P = 0.002 for healthy subjects). In bladder cancer group, there was a positive correlation between serum endothelial cell-specific molecule-1 and urinary endothelial cell-specific molecule-1 concentrations ( r = 0.32, P = 0.002). For serum endothelial cell-specific molecule-1, sensitivity and specificity were 50%, and 77%, and for urinary endothelial cell-specific molecule-1, 62%, and 71%, respectively. Conclusion Serum and urinary endothelial cell-specific molecule-1 concentrations increase in bladder cancer. This parameter also increases in serum and urine of cases with urinary tract infection. That urinary endothelial cell-specific molecule-1 values were higher than serum endothelial cell-specific molecule-1 values in all groups may be attributed to direct exfoliation of epithelial cells in bladder to urine.
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Affiliation(s)
- Esra Laloglu
- 1 Department of Medical Biochemistry, Medical School of Ataturk University, Erzurum, Turkey
| | - Hulya Aksoy
- 1 Department of Medical Biochemistry, Medical School of Ataturk University, Erzurum, Turkey
| | - Yılmaz Aksoy
- 2 Department of Urology, Medical School of Ataturk University, Erzurum, Turkey
| | - Fatih Ozkaya
- 2 Department of Urology, Medical School of Ataturk University, Erzurum, Turkey
| | - Fatih Akcay
- 1 Department of Medical Biochemistry, Medical School of Ataturk University, Erzurum, Turkey
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11
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Pandey R, Jackson JK, Mugabe C, Liggins R, Burt HM. Tissue Permeability Effects Associated with the Use of Mucoadhesive Cationic Nanoformulations of Docetaxel in the Bladder. Pharm Res 2016; 33:1850-61. [DOI: 10.1007/s11095-016-1920-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/01/2016] [Indexed: 10/21/2022]
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12
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Abstract
Urothelial cell carcinoma (UCC) of the bladder is one of the most common malignancies, causing considerable morbidity and mortality worldwide. It is unique among the epithelial carcinomas as two distinct pathways to tumourigenesis appear to exist: low grade, recurring papillary tumours usually contain oncogenic mutations in FGFR3 or HRAS whereas high grade, muscle invasive tumours with metastatic potential generally have defects in the pathways controlled by the tumour suppressors p53 and retinoblastoma. Over the last two decades, a number of transgenic mouse models of UCC, containing deletions or mutations of key tumour suppressor genes or oncogenes, have helped us understand the mechanisms behind tumour development. In this summary, I present my work investigating the role of the WNT signalling cascade in UCC.
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MESH Headings
- Animals
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Carcinoma, Transitional Cell/genetics
- Carcinoma, Transitional Cell/metabolism
- Carcinoma, Transitional Cell/pathology
- Gene Expression Regulation, Neoplastic
- Humans
- Mice
- Mice, Transgenic
- Mutation
- Neoplasms, Experimental/genetics
- Neoplasms, Experimental/metabolism
- Neoplasms, Experimental/pathology
- Signal Transduction
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/metabolism
- Urinary Bladder Neoplasms/pathology
- Wnt Proteins/genetics
- Wnt Proteins/metabolism
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Affiliation(s)
- I Ahmad
- University Hospitals of North Midlands NHS Trust , UK
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13
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Andersson E, Dahmcke CM, Steven K, Larsen LK, Guldberg P. Filtration Device for On-Site Collection, Storage and Shipment of Cells from Urine and Its Application to DNA-Based Detection of Bladder Cancer. PLoS One 2015; 10:e0131889. [PMID: 26151138 PMCID: PMC4495058 DOI: 10.1371/journal.pone.0131889] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 06/08/2015] [Indexed: 02/04/2023] Open
Abstract
Molecular analysis of cells from urine provides a convenient approach to non-invasive detection of bladder cancer. The practical use of urinary cell-based tests is often hampered by difficulties in handling and analyzing large sample volumes, the need for rapid sample processing to avoid degradation of cellular content, and low sensitivity due to a high background of normal cells. We present a filtration device, designed for home or point-of-care use, which enables collection, storage and shipment of urinary cells. A special feature of this device is a removable cartridge housing a membrane filter, which after filtration of urine can be transferred to a storage unit containing an appropriate preserving solution. In spiking experiments, the use of this device provided efficient recovery of bladder cancer cells with elimination of >99% of excess smaller-sized cells. The performance of the device was further evaluated by DNA-based analysis of urinary cells collected from 57 patients subjected to transurethral resection following flexible cystoscopy indicating the presence of a tumor. All samples were tested for FGFR3 mutations and seven DNA methylation markers (BCL2, CCNA1, EOMES, HOXA9, POU4F2, SALL3 and VIM). In the group of patients where a transitional cell tumor was confirmed at histopathological evaluation, urine DNA was positive for one or more markers in 29 out of 31 cases (94%), including 19 with FGFR3 mutation (61%). In the group of patients with benign histopathology, urine DNA was positive for methylation markers in 13 out of 26 cases (50%). Only one patient in this group was positive for a FGFR3 mutation. This patient had a stage Ta tumor resected 6 months later. The ability to easily collect, store and ship diagnostic cells from urine using the presented device may facilitate non-invasive testing for bladder cancer.
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Affiliation(s)
- Elin Andersson
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Christina M. Dahmcke
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Pathology, Copenhagen University Hospital, Herlev, Denmark
| | - Kenneth Steven
- Department of Urology, Copenhagen University Hospital, Herlev, Denmark
| | | | - Per Guldberg
- Danish Cancer Society Research Center, Copenhagen, Denmark
- * E-mail:
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14
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Zhuang CL, Fu X, Liu L, Liu YC, Huang WR, Cai ZM. Synthetic miRNA sponges driven by mutant hTERT promoter selectively inhibit the progression of bladder cancer. Tumour Biol 2015; 36:5157-63. [PMID: 25775949 DOI: 10.1007/s13277-015-3169-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/26/2015] [Indexed: 12/23/2022] Open
Abstract
The mutant promoter of human telomerase reverse transcriptase (hTERT) shows high transcriptional activity in bladder cancer cells. Some up-regulated microRNAs (miRNAs) are reported as oncogenic factors in bladder cancer. Previous studies report that miRNAs can be inhibited by base-pairing interactions. The purpose of this study is to construct a synthetic device driven by mutant hTERT promoter to suppress four up-regulated miRNAs and to verify its effects on phenotypes of bladder cancer cells and human normal cells. Tandem bulged miRNA binding sites targeting oncogenic miRNAs were inserted into the 3' untranslated region (3' UTR) of mutant hTERT promoter-driven Renilla luciferase gene to construct a synthetic tumor-specific device, miRNA sponges. A negative control was generated by using tandem repeated sequences without targeting any known miRNA. Bladder cancer cells (T24, 5637, UM-UC-3) and human fiber cells (HFC) were transfected with devices. Various functional assays were used to detect the effects of this device. The activity of the mutant hTERT promoter detected by luciferase assay was about three times as large as the wild-type hTERT promoter in bladder cancer cells, while it could not be measured in HFC. Other assays indicated that the synthetic device can significantly inhibit cell growth, decrease motility, and induce apoptosis in bladder cancer cells but not in HFC. A synthetic biology platform is employed to construct tumor-specific miRNA sponges that can be used to target oncogenic miRNAs to inhibit the progression of bladder cancer cells without affecting normal cells.
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Affiliation(s)
- Cheng-Le Zhuang
- Key Laboratory of Medical Reprogramming Technology, Shenzhen Second People's Hospital, Shenzhen, 518039, Guangdong, People's Republic of China
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15
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Size-based enrichment of exfoliated tumor cells in urine increases the sensitivity for DNA-based detection of bladder cancer. PLoS One 2014; 9:e94023. [PMID: 24732047 PMCID: PMC3986060 DOI: 10.1371/journal.pone.0094023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 03/12/2014] [Indexed: 01/23/2023] Open
Abstract
Bladder cancer is diagnosed by cystoscopy, a costly and invasive procedure that is associated with patient discomfort. Analysis of tumor-specific markers in DNA from sediments of voided urine has the potential for non-invasive detection of bladder cancer; however, the sensitivity is limited by low fractions and small numbers of tumor cells exfoliated into the urine from low-grade tumors. The purpose of this study was to improve the sensitivity for non-invasive detection of bladder cancer by size-based capture and enrichment of tumor cells in urine. In a split-sample set-up, urine from a consecutive series of patients with primary or recurrent bladder tumors (N = 189) was processed by microfiltration using a membrane filter with a defined pore-size, and sedimentation by centrifugation, respectively. DNA from the samples was analyzed for seven bladder tumor-associated methylation markers using MethyLight and pyrosequencing assays. The fraction of tumor-derived DNA was higher in the filter samples than in the corresponding sediments for all markers (p<0.000001). Across all tumor stages, the number of cases positive for one or more markers was 87% in filter samples compared to 80% in the corresponding sediments. The largest increase in sensitivity was achieved in low-grade Ta tumors, with 82 out of 98 cases positive in the filter samples (84%) versus 74 out of 98 in the sediments (75%). Our results show that pre-analytic processing of voided urine by size-based filtration can increase the sensitivity for DNA-based detection of bladder cancer.
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16
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Junqueira-Neto S, Vieira FQ, Montezuma D, Costa NR, Antunes L, Baptista T, Oliveira AI, Graça I, Rodrigues Â, Magalhães JS, Oliveira J, Henrique R, Jerónimo C. Phenotypic impact of deregulated expression of class I histone deacetylases in urothelial cell carcinoma of the bladder. Mol Carcinog 2013; 54:523-31. [DOI: 10.1002/mc.22117] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 11/05/2013] [Accepted: 11/07/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Susana Junqueira-Neto
- Cancer Epigenetics Group; Research Center of the Portuguese Oncology Institute-Porto; Porto Portugal
| | - Filipa Q. Vieira
- Cancer Epigenetics Group; Research Center of the Portuguese Oncology Institute-Porto; Porto Portugal
- School of Allied Health Sciences ESTSP; Polytechnic of Porto; Porto Portugal
| | - Diana Montezuma
- Cancer Epigenetics Group; Research Center of the Portuguese Oncology Institute-Porto; Porto Portugal
- Department of Pathology; Portuguese Oncology Institute; Porto Portugal
| | - Natália R. Costa
- Cancer Epigenetics Group; Research Center of the Portuguese Oncology Institute-Porto; Porto Portugal
| | - Luís Antunes
- Department of Epidemiology; Portuguese Oncology Institute; Porto Portugal
| | - Tiago Baptista
- Cancer Epigenetics Group; Research Center of the Portuguese Oncology Institute-Porto; Porto Portugal
| | - Ana Isabel Oliveira
- Cancer Epigenetics Group; Research Center of the Portuguese Oncology Institute-Porto; Porto Portugal
| | - Inês Graça
- Cancer Epigenetics Group; Research Center of the Portuguese Oncology Institute-Porto; Porto Portugal
- School of Allied Health Sciences ESTSP; Polytechnic of Porto; Porto Portugal
| | - Ângelo Rodrigues
- Department of Pathology; Portuguese Oncology Institute; Porto Portugal
| | - José S. Magalhães
- Department of Urology; Portuguese Oncology Institute; Porto Portugal
| | - Jorge Oliveira
- Department of Urology; Portuguese Oncology Institute; Porto Portugal
| | - Rui Henrique
- Cancer Epigenetics Group; Research Center of the Portuguese Oncology Institute-Porto; Porto Portugal
- Department of Pathology; Portuguese Oncology Institute; Porto Portugal
- Department of Pathology and Molecular Immunology; Institute of Biomedical Sciences Abel Salazar, University of Porto; Porto Portugal
| | - Carmen Jerónimo
- Cancer Epigenetics Group; Research Center of the Portuguese Oncology Institute-Porto; Porto Portugal
- Department of Pathology and Molecular Immunology; Institute of Biomedical Sciences Abel Salazar, University of Porto; Porto Portugal
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17
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Xie F, Su M, Qiu W, Zhang M, Guo Z, Su B, Liu J, Li X, Zhou L. Kaempferol promotes apoptosis in human bladder cancer cells by inducing the tumor suppressor, PTEN. Int J Mol Sci 2013; 14:21215-26. [PMID: 24284390 PMCID: PMC3856000 DOI: 10.3390/ijms141121215] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 10/16/2013] [Accepted: 10/18/2013] [Indexed: 01/21/2023] Open
Abstract
Kaempferol (Kae), a natural flavonoid, is widely distributed in fruits and vegetables. Previous studies have identified Kae as a possible cancer preventive and therapeutic agent. We found Kae to exhibit potent antiproliferation and anti-migration effects in human bladder cancer EJ cells. Kaempferol robustly induced apoptosis in EJ cells in a dose-dependent manner, as evidenced by increased cleavage of caspase-3. Furthermore, we found Kae-induced apoptosis in EJ cells to be associated with phosphatase and the tensin homolog deleted on the chromosome 10 (PTEN)/PI3K/Akt pathway. Kae significantly increased PTEN and decreased Akt phosphorylation. Kae-induced apoptosis was partially attenuated in PTEN-knockdown cells. Our findings indicate that Kae could be an alternative medicine for bladder cancer, based on a PTEN activation mechanism.
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Affiliation(s)
- Feng Xie
- Department of Urology, Peking University First Hospital & the Institute of Urology, Peking University, Beijing 100034, China; E-Mails: (F.X.); (W.Q.); (Z.G.); (B.S.); (J.L.); (X.L.)
- National Urological Cancer Center, Beijing 100034, China
| | - Ming Su
- Sino-German Laboratory for Molecular Medicine, State Key Laboratory of Cardiovascular Disease, FuWai Hospital & Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China; E-Mail:
| | - Wei Qiu
- Department of Urology, Peking University First Hospital & the Institute of Urology, Peking University, Beijing 100034, China; E-Mails: (F.X.); (W.Q.); (Z.G.); (B.S.); (J.L.); (X.L.)
- National Urological Cancer Center, Beijing 100034, China
| | - Min Zhang
- Department of Urology, Shanxi Medical University First Hospital, Taiyuan 030001, China; E-Mail:
| | - Zhongqiang Guo
- Department of Urology, Peking University First Hospital & the Institute of Urology, Peking University, Beijing 100034, China; E-Mails: (F.X.); (W.Q.); (Z.G.); (B.S.); (J.L.); (X.L.)
- National Urological Cancer Center, Beijing 100034, China
| | - Boxing Su
- Department of Urology, Peking University First Hospital & the Institute of Urology, Peking University, Beijing 100034, China; E-Mails: (F.X.); (W.Q.); (Z.G.); (B.S.); (J.L.); (X.L.)
- National Urological Cancer Center, Beijing 100034, China
| | - Jie Liu
- Department of Urology, Peking University First Hospital & the Institute of Urology, Peking University, Beijing 100034, China; E-Mails: (F.X.); (W.Q.); (Z.G.); (B.S.); (J.L.); (X.L.)
- National Urological Cancer Center, Beijing 100034, China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital & the Institute of Urology, Peking University, Beijing 100034, China; E-Mails: (F.X.); (W.Q.); (Z.G.); (B.S.); (J.L.); (X.L.)
- National Urological Cancer Center, Beijing 100034, China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital & the Institute of Urology, Peking University, Beijing 100034, China; E-Mails: (F.X.); (W.Q.); (Z.G.); (B.S.); (J.L.); (X.L.)
- National Urological Cancer Center, Beijing 100034, China
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +86-10-8357-2418; Fax: +86-10-6655-3761
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18
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Kandimalla R, Masius R, Beukers W, Bangma CH, Orntoft TF, Dyrskjot L, van Leeuwen N, Lingsma H, van Tilborg AAG, Zwarthoff EC. A 3-plex methylation assay combined with the FGFR3 mutation assay sensitively detects recurrent bladder cancer in voided urine. Clin Cancer Res 2013; 19:4760-9. [PMID: 23842048 DOI: 10.1158/1078-0432.ccr-12-3276] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE DNA methylation is associated with bladder cancer and these modifications could serve as useful biomarkers. FGFR3 mutations are present in 60% to 70% of non-muscle invasive bladder cancer (NMIBC). Low-grade bladder cancer recurs in more than 50% of patients. The aim of this study is to determine the sensitivity and specificity of a urine assay for the diagnosis of recurrences in patients with a previous primary NMIBC G1/G2 by using cystoscopy as the reference standard. EXPERIMENTAL DESIGN We selected eight CpG islands (CGI) methylated in bladder cancer from our earlier genome-wide study. Sensitivity of the CGIs for recurrences detection was investigated on a test set of 101 preTUR urines. Specificity was determined on 70 urines from healthy males aged more than 50 years. A 3-plex assay for the best combination was developed and validated on an independent set of 95 preTUR, recurrence free, and nonmalignant urines (n=130). RESULTS The 3-plex assay identified recurrent bladder cancer in voided urine with a sensitivity of 74% in the validation set. In combination with the FGFR3 mutation assay, a sensitivity of 79% was reached (specificity of 77%). Sensitivity of FGFR3 and cytology was 52% and 57%, respectively. CONCLUSION The combination of methylation and FGFR3 assays efficiently detects recurrent bladder cancer without the need for stratification of patients regarding methylation/mutation status of the primary tumor. We conclude that the sensitivity of this combination is in the same range as cystoscopy and paves the way for a subsequent study that investigates a modified surveillance protocol consisting of the urine test followed by cystoscopy only when the urine test is positive.
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Affiliation(s)
- Raju Kandimalla
- Department of Pathology, Erasmus MC, Rotterdam, the Netherlands
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19
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Woo Kim K, Shin Y, Promoda Perera A, Liu Q, Sheng Kee J, Han K, Yoon YJ, Kyoung Park M. Label-free, PCR-free chip-based detection of telomerase activity in bladder cancer cells. Biosens Bioelectron 2013; 45:152-7. [DOI: 10.1016/j.bios.2013.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 01/30/2013] [Accepted: 02/01/2013] [Indexed: 10/27/2022]
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20
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Anastasiadis A, Cordeiro E, Bus MT, Alivizatos G, de la Rosette JJ, de Reijke TM. Follow-up procedures for non-muscle-invasive bladder cancer: an update. Expert Rev Anticancer Ther 2013; 12:1229-41. [PMID: 23098122 DOI: 10.1586/era.12.98] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Bladder carcinoma is the most common malignancy of the urinary tract. Approximately 75-85% of patients present with a disease that is confined to the mucosa (stage Ta, carcinoma in situ) or submucosa (stage T1). The stratification of patients to low-, intermediate- and high-risk groups represents the cornerstone for the indication of adjuvant and follow-up treatment. Owing to the high recurrence rate of bladder tumors, a surveillance protocol is recommended to all patients. Currently, the combination of cystoscopy, imaging and urinary cytology represent the follow-up. A systematic review of the recent English literature on follow-up procedures of non-muscle-invasive bladder cancer is performed. The authors review the existing follow-up procedures, with a focus on novel molecular-targeted approaches. At the present time, the additional use and utility of urine-based molecular markers in the follow-up of patients remains unclear and we have to rely on cystoscopic evaluation adapted to risk group classification.
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21
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Choi JW, Kim Y, Lee JH, Kim YS. CD74 expression is increased in high-grade, invasive urothelial carcinoma of the bladder. Int J Urol 2012; 20:251-5. [PMID: 22905972 DOI: 10.1111/j.1442-2042.2012.03128.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to identify the clinicopathological features of bladder cancer patients with high CD74 expression, as milatuzumab humanized anti-CD74 antibody is being evaluated in clinical trials for hematological malignancies. Expression of CD74 was examined in 342 urothelial carcinomas of the bladder, and two urothelial carcinoma cell lines by immunohistochemistry and western blotting, respectively. CD74 was overexpressed in 192 (56.1%) of the 342 cancer tissues, although it was not expressed in the cancer cell lines. CD74 staining was intense in tumor cells and inflammatory cells in the tumor stroma, but not in normal urothelium. CD74 expression was significantly associated with older age at diagnosis (≥ 68 years, P=0.048), high World Health Organization grade (P=0.019), advanced stages (P=0.001) and non-papillary growth pattern (P=0.040). CD74 expression was also correlated with the absence of tumor-infiltrating inflammatory cells (P<0.001) and the presence of tumor-associated inflammatory cells (P=0.017). However, CD74 expression was not related to recurrence-free and overall survivals in primary and subgroup analyses. In conclusion, urothelial bladder carcinomas with high CD74 expression are characterized by older age, high World Health Organization grade, non-papillary growth and advanced stages.
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Affiliation(s)
- Jung-Woo Choi
- Department of Pathology, Korea University Ansan Hospital, Ansan, Korea
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22
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Burger M, Goebell PJ. Bladder cancer: validity of the 2004 system for grading Ta bladder cancer. Nat Rev Urol 2012; 9:126-7. [PMID: 22331092 DOI: 10.1038/nrurol.2012.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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