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Aizpurua XP, Gardiner JIM, Popescu OB, González EB, Sánchez LC, Granados MC, I Jaumot JJT, de Castroviejo Blanco JR, Ospina FO, Benavente RC, Enguita CG. A Systematic Review on the Current Landscape of T1 Bladder Cancer Substaging. Urology 2024:S0090-4295(24)00880-X. [PMID: 39389368 DOI: 10.1016/j.urology.2024.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 09/25/2024] [Accepted: 10/01/2024] [Indexed: 10/12/2024]
Abstract
OBJECTIVE To conduct a systematic review on the current state of T1 bladder tumor substaging. These neoplasms display significant heterogeneity in oncological behavior and prognosis, leading to the proposal of various substaging methods. Our aim was to investigate the potential diagnostic and prognostic value of substaging in stage T1 bladder cancer for better oncologic outcomes. METHODS A literature search using MEDLINE, EMBASE and Cochrane Library databases was conducted in March 2024 to identify relevant studies on T1 urothelial bladder cancer staging. A systematic review of included articles was performed following the PRISMA guideline statement. Literature search was conducted in English. RESULTS Overall, 63 studies published between 1990 and 2024 were included for final review including a total number of 8207 bladder tumor patients subject to T1 substaging. Various substaging methods have been developed, broadly classified into histometric (anatomy-based) and micrometric (semiquantitative) techniques. Advanced stages have been consistently associated with worse prognosis and need for a more radical therapeutic approach. A standardized, validated, unified substaging report system is lacking. CONCLUSIONS T1 substaging is a strong predictor of oncologic outcomes. Micrometric methods seem to be more reproducible and precise than histometric techniques in terms of feasibility and prognostic value. Standardization and validation of the technique could potentially enhance the bladder cancer treatment algorithm. We would like to provide an explanation regarding why our systematic review was not prospectively registered in the PROSPERO database. Initially, this review was conceived as part of a doctoral thesis (PhD) project, and there was no intention to publish it. Although we strictly adhered to the PRISMA guidelines from the beginning, the decision to publish the review was made only after most of the data had been extracted. At that point, retrospectively registering it in PROSPERO would have been somewhat unethical, which is why we chose not to register it. We fully recognize the importance of actively registering systematic reviews, as it is the proper and ethical way to proceed in these cases. We remain committed to transparency and best practices in research and believe that prospective registration is crucial for ensuring the integrity and credibility of systematic reviews.
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Affiliation(s)
- Xabier Pérez Aizpurua
- Department of Urology. Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos 2 28040 Madrid, Spain.
| | - Juan Ignacio Monzó Gardiner
- Department of Urology. Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos 2 28040 Madrid, Spain
| | - Oana Beatrice Popescu
- Department of Pathology. Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos 2 28040 Madrid, Spain
| | - Elena Buendía González
- Department of Urology. Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos 2 28040 Madrid, Spain
| | - Leslie Cuello Sánchez
- Department of Urology. Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos 2 28040 Madrid, Spain
| | - María Cañadas Granados
- Department of Urology. Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos 2 28040 Madrid, Spain
| | - Jaime Jorge Tufet I Jaumot
- Department of Urology. Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos 2 28040 Madrid, Spain
| | | | - Felipe Osorio Ospina
- Department of Urology. Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos 2 28040 Madrid, Spain
| | - Ramiro Cabello Benavente
- Department of Urology. Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos 2 28040 Madrid, Spain
| | - Carmen González Enguita
- Department of Urology. Hospital Universitario Fundación Jiménez Díaz, Avda. Reyes Católicos 2 28040 Madrid, Spain
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Haas M, Engelmann SU, Mayr R, Gossler C, Pickl C, Kälble S, Yang Y, Otto W, Hartmann V, Burger M, Hartmann A, Breyer J, Eckstein M. A novel grading approach predicts worse outcomes in stage pT1 non-muscle-invasive bladder cancer. BJU Int 2024; 134:249-257. [PMID: 38409965 DOI: 10.1111/bju.16298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
OBJECTIVE To develop a prognostically relevant scoring system for stage pT1 non-muscle-invasive bladder cancer (NMIBC) incorporating tumour budding, growth pattern and invasion pattern because the World Health Organisation grading system shows limited prognostic value in such patients. PATIENTS AND METHODS The tissue specimens and clinical data of 113 patients with stage pT1 NMIBC who underwent transurethral resection of bladder tumour were retrospectively investigated. Tumour budding, and growth and invasion patterns were evaluated and categorised into two grade groups (GGs). GGs and other clinical and histopathological variables were investigated regarding recurrence-free survival (RFS), progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) using univariable and multivariable Cox regression analyses. RESULTS The integration of two tumour budding groups, two growth patterns, and two invasion patterns yielded an unfavourable GG (n = 28; 24.7%) that had a high impact on oncological outcomes. The unfavourable GG was identified as an independent RFS and OS predictor (P = 0.004 and P = 0.046, respectively) and linked to worse PFS (P = 0.001) and CSS (P = 0.001), irrespective of the European Association of Urology risk group. The unfavourable GG was associated with higher rates of BCG-unresponsive tumours (P = 0.006). Study limitations include the retrospective, single-centre design, diverse therapies and small cohort. CONCLUSIONS We present a morphology-based grading system for stage pT1 NMIBC that correlates with disease aggressiveness and oncological patient outcomes. It therefore identifies a highest risk group of stage pT1 NMIBC patients, who should be followed up more intensively or receive immediate radical cystectomy. The grading incorporates objective variables assessable on haematoxylin and eosin slides and immunohistochemistry, enabling an easy-to-use low-cost approach that is applicable in daily routine. Further studies are needed to validate and confirm these results.
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Affiliation(s)
- Maximilian Haas
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Simon U Engelmann
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Roman Mayr
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Christopher Gossler
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Christoph Pickl
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Sebastian Kälble
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Yushan Yang
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Wolfgang Otto
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Valerie Hartmann
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Arndt Hartmann
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Johannes Breyer
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Markus Eckstein
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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Mane A, Patil NJ, Hulwan AB, Koley A. Clinicohistopathological Correlation and Prognostic Significance of Molecular Biomarkers in Urinary Bladder Neoplasms: A Comprehensive Analysis. Cureus 2024; 16:e66088. [PMID: 39229422 PMCID: PMC11368705 DOI: 10.7759/cureus.66088] [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: 06/06/2024] [Accepted: 07/31/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Urinary bladder neoplasms constitute a heterogeneous group of tumors with diverse clinical behaviors and outcomes. Understanding the correlation between clinicopathological characteristics and the prognostic significance of molecular biomarkers in bladder cancer is vital for personalized treatment strategies and improved patient outcomes. OBJECTIVE This prospective observational study aimed to comprehensively investigate the clinicopathological correlations and prognostic significance of molecular biomarkers in urinary bladder neoplasms. METHODS A cohort of 174 patients diagnosed with urinary bladder neoplasm participated in this study. Clinicopathological data, including demographic information, medical history, imaging findings, and histopathological reports, were collected from the patient records. Tissue samples obtained from transurethral resection or biopsy were subjected to molecular biomarker analysis using immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and molecular profiling techniques. Longitudinal follow-up assessments were conducted to monitor disease progression, recurrence, and overall survival. RESULT Out of 174 patients diagnosed with bladder neoplasms, the mean age of the patients was 62.4 years (±8.7), indicating that the study cohort primarily comprised elderly individuals. The majority of patients were male (126, 72.4%), reflecting the higher prevalence of bladder cancer among men compared to women. Preliminary analysis revealed significant associations between clinicopathological parameters, molecular biomarker expression profiles, and clinical outcomes in patients with urinary bladder neoplasms. Elevated expression levels of specific biomarkers such as tumor protein p53 (p53), Ki-67, and estimated glomerular filtration rate (EGFR) were observed in advanced tumor stages (p < 0.001) and higher histological grades (p < 0.05), indicating their potential prognostic significance. Furthermore, genetic alterations detected using molecular profiling techniques, including chromosomal gains and losses, were significantly correlated with aggressive disease phenotypes and increased recurrence risk (p < 0.01). Longitudinal follow-up data demonstrated that patients with elevated biomarker expression levels or genetic alterations had poorer treatment responses and shorter overall survival durations than those with lower biomarker expression levels. CONCLUSION This study highlights the importance of integrating clinicopathological parameters and molecular biomarker data for the risk stratification, treatment selection, and prognostic assessment of urinary bladder neoplasms.
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Affiliation(s)
- Avinash Mane
- Department of Pathology, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Nanda J Patil
- Department of Pathology, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Atul B Hulwan
- Department of Pathology, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Avishek Koley
- Department of General Surgery, Sarojini Naidu Medical College, Agra, IND
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Csűry TD, Csűry AZ, Balk M, Kist AM, Rupp R, Mueller SK, Sievert M, Iro H, Eckstein M, Gostian A. The modified Polsby-Popper score, a novel quantitative histomorphological biomarker and its potential to predict lymph node positivity and cancer-specific survival in oral tongue squamous cell carcinoma. Cancer Med 2024; 13:e6824. [PMID: 38132808 PMCID: PMC10807609 DOI: 10.1002/cam4.6824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The significance of different histological spreading patterns of tumor tissue in oral tongue squamous cell carcinoma (TSCC) is well known. Our aim was to construct a numeric parameter on a continuous scale, that is, the modified Polsby-Popper (MPP) score, to describe the aggressiveness of tumor growth and infiltration, with the potential to analyze hematoxylin and eosin-stained whole slide images (WSIs) in an automated manner. We investigated the application of the MPP score in predicting survival and cervical lymph node metastases as well as in determining patients at risk in the context of different surgical margin scenarios. METHODS We developed a semiautomated image analysis pipeline to detect areas belonging to the tumor tissue compartment. Perimeter and area measurements of all detected tissue regions were derived, and a specific mathematical formula was applied to reflect the perimeter/area ratio in a comparable, observer-independent manner across digitized WSIs. We demonstrated the plausibility of the MPP score by correlating it with well-established clinicopathologic parameters. We then performed survival analysis to assess the relevance of the MPP score, with an emphasis on different surgical margin scenarios. Machine learning models were developed to assess the relevance of the MPP score in predicting survival and occult cervical nodal metastases. RESULTS The MPP score was associated with unfavorable tumor growth and infiltration patterns, the presence of lymph node metastases, the extracapsular spread of tumor cells, and higher tumor thickness. Higher MPP scores were associated with worse overall survival (OS) and tongue carcinoma-specific survival (TCSS), both when assessing all pT-categories and pT1-pT2 categories only; moreover, higher MPP scores were associated with a significantly worse TCSS in cases where a cancer-free surgical margin of <5 mm could be achieved on the main surgical specimen. This discriminatory capacity remained constant when examining pT1-pT2 categories only. Importantly, the MPP score could successfully define cases at risk in terms of metastatic disease in pT1-pT2 cancer where tumor thickness failed to exhibit a significant predictive value. Machine learning (ML) models incorporating the MPP score could predict the 5-year TCSS efficiently. Furthermore, we demonstrated that machine learning models that predict occult cervical lymph node involvement can benefit from including the MPP score. CONCLUSIONS We introduced an objective, quantifiable, and observer-independent parameter, the MPP score, representing the aggressiveness of tumor growth and infiltration in TSCC. We showed its prognostic relevance especially in pT1-pT2 category TSCC, and its possible use in ML models predicting TCSS and occult lymph node metastases.
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Affiliation(s)
- Tamás Dániel Csűry
- Department of Otolaryngology, Head & Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Comprehensive Cancer Center EMNUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Bavarian Cancer Research Center (Bayerisches Zentrum für Krebsforschung, BZKF)ErlangenGermany
| | | | - Matthias Balk
- Department of Otolaryngology, Head & Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Comprehensive Cancer Center EMNUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Bavarian Cancer Research Center (Bayerisches Zentrum für Krebsforschung, BZKF)ErlangenGermany
| | - Andreas M. Kist
- Department Artificial Intelligence in Biomedical EngineeringFriedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
| | - Robin Rupp
- Department of Otolaryngology, Head & Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Comprehensive Cancer Center EMNUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Bavarian Cancer Research Center (Bayerisches Zentrum für Krebsforschung, BZKF)ErlangenGermany
| | - Sarina K. Mueller
- Department of Otolaryngology, Head & Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Comprehensive Cancer Center EMNUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Bavarian Cancer Research Center (Bayerisches Zentrum für Krebsforschung, BZKF)ErlangenGermany
| | - Matti Sievert
- Department of Otolaryngology, Head & Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Comprehensive Cancer Center EMNUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Bavarian Cancer Research Center (Bayerisches Zentrum für Krebsforschung, BZKF)ErlangenGermany
| | - Heinrich Iro
- Department of Otolaryngology, Head & Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Comprehensive Cancer Center EMNUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Bavarian Cancer Research Center (Bayerisches Zentrum für Krebsforschung, BZKF)ErlangenGermany
| | - Markus Eckstein
- Comprehensive Cancer Center EMNUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Bavarian Cancer Research Center (Bayerisches Zentrum für Krebsforschung, BZKF)ErlangenGermany
- Institute of PathologyUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
| | - Antoniu‐Oreste Gostian
- Department of Otolaryngology, Head & Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Comprehensive Cancer Center EMNUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Bavarian Cancer Research Center (Bayerisches Zentrum für Krebsforschung, BZKF)ErlangenGermany
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Lopez-Beltran A, Raspollini MR, Hansel D, Compérat E, Williamson SR, Liedberg F, Iczkowski KA, Bubendorf L, van der Kwast TH, Cheng L. International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer: Working Group 3: Subcategorization of T1 Bladder Cancer. Am J Surg Pathol 2024; 48:e24-e31. [PMID: 37737692 DOI: 10.1097/pas.0000000000002121] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Emerging data on T1 bladder cancer subcategorization (aka substaging) suggests a correlation with oncological outcomes. The International Society of Urological Pathology (ISUP) organized the 2022 consensus conference in Basel, Switzerland to focus on current issues in bladder cancer and tasked working group 3 to make recommendations for T1 subcategorization in transurethral bladder resections. For this purpose, the ISUP developed and circulated a survey to their membership querying approaches to T1 bladder cancer subcategorization. In particular, clinical relevance, pathological reporting, and endorsement of T1 subcategorization in the daily practice of pathology were surveyed. Of the respondents of the premeeting survey, about 40% do not routinely report T1 subcategory. We reviewed literature on bladder T1 subcategorization, and screened selected articles for clinical performance and practicality of T1 subcategorization methods. Published literature offered evidence of the clinical rationale for T1 subcategorization and at the conference consensus (83% of conference attendants) was obtained to report routinely T1 subcategorization of transurethral resections. Semiquantitative T1 subcategorization was favored (37%) over histoanatomic methods (4%). This is in line with literature findings on practicality and prognostic impact, that is, a shift of publications from histoanatomic to semiquantitative methods or by reports incorporating both methodologies is apparent over the last decade. However, 59% of participants had no preference for either methodology. They would add a comment in the report briefly stating applied method, interpretation criteria (including cutoff), and potential limitations. When queried on the terminology of T1 subcategorization, 34% and 20% of participants were in favor of T1 (microinvasive) versus T1 (extensive) or T1 (focal) versus T1 (nonfocal), respectively.
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Affiliation(s)
- Antonio Lopez-Beltran
- Department of Morphological Sciences, Cordoba University Medical School, Cordoba, Spain
| | | | - Donna Hansel
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Fredrik Liedberg
- Institution of Translational Medicine, Lund University, Malmö, Sweden
| | | | - Lukas Bubendorf
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Theodorus H van der Kwast
- Laboratory Medicine Program, University Health Network and Princess Margaret Cancer Center, Toronto, ON, Canada
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Brown University Warren Alpert Medical School; Lifespan Academic Medical Center, and the Legorreta Cancer Center at Brown University, Providence, RI
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Ozer SP. Tumor budding in invasive breast carcinoma: correlation with clinicopathological parameters, hormone receptor status, and survival: an observational study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230191. [PMID: 37792866 PMCID: PMC10547490 DOI: 10.1590/1806-9282.20230191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Tumor budding is currently thought to be associated with worse prognosis. This study aims to examine tumor budding in invasive ductal-type breast carcinoma and its relationship with other clinicopathological parameters and overall survival. METHODS All the H&E slides of 198 patients were re-evaluated for the histological grade, angiolymphatic invasion, perineural invasion, lymph node status, extranodal extension, multicentricity, pT, presence of the tumor budding, tumor budding score (i.e., low, intermediate, or high). Overall survival was considered the period after surgery until death. SPSS was used for statistical analysis. RESULTS Tumor budding was identified in 98 (49.5%) patients. Tumor budding score was low in 41 (41.8%) of 98 cases, intermediate in 25 (25.5%), and high in 32 (32.7%). We determined a strong correlation between tumor budding and poor prognostic variables such as tumor size, pT stage, angiolymphatic invasion, perineural invasion, number of metastatic axillary lymph nodes, overall survival, and extranodal tumor extension in metastatic lymph nodes. This strong correlation was also present for the tumor budding score. CONCLUSION Tumor budding may be a prognostic indicator for breast cancer.
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Affiliation(s)
- Songul Peltek Ozer
- Bolu Abant Izzet Baysal Training and Research Hospital, Department of Pathology – Bolu, Turkey
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Shi R, Le Tan MT, Lim GH, Du J, Zhang L, Zeng L, Tan PH. Prognostic Value of Tumor Budding in Urothelial Carcinoma: A Meta-Analysis and Systematic Review. J Transl Med 2023; 103:100136. [PMID: 36990153 DOI: 10.1016/j.labinv.2023.100136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Recently, tumor budding (TB) has been suggested as a strong prognostic marker in urinary tract urothelial carcinoma (UC). The aim of this systematic review is to test the prognostic value of TB in UC by a meta-analysis of previously published studies. We systematically reviewed the literature related to TB by using the databases of Scopus, PubMed, and Web of Science. The search was limited to publications in the English language up to July 2022. There were 790 patients from 7 retrospective studies in which TB has been evaluated in UC. Two authors independently extracted the results from eligible studies. The meta-analysis of eligible studies revealed that TB is a significant prognosticator for progression-free survival in UC, with a hazard ratio (HR) of 3.51 (95% CI, 1.86-6.62; P < .001) in univariate analysis and a HR of 2.78 (95% CI, 1.57-4.93; P < .001) in multivariate analysis; a significant prognosticator for overall survival and cancer-specific survival in UC, with a HR of 3.07 (95% CI, 2.04-4.64; P < .001) and a HR of 2.18 (95% CI, 1.11-4.29; P = .02) respectively in univariate analysis. Our findings confirm that UC with a high TB count is at a high risk of progress. TB could be considered as an element in pathology reports and future oncologic staging systems.
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Affiliation(s)
- Ruoyu Shi
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Mark Ting Le Tan
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Gek Hsiang Lim
- Health Service Research Unit, Singapore General Hospital, Singapore
| | - Jingzeng Du
- Department of Urology, Singapore General Hospital, Singapore
| | - Limin Zhang
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Lixia Zeng
- Department of Anatomical Pathology, Singapore General Hospital, Singapore; Department of Pathology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Puay Hoon Tan
- Luma Medical Centre, Singapore; Kandang Kerbau Women's and Children's Hospital, Singapore; Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Pathology, University of Western Sydney, Sydney Australia.
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Shahidi M, Abazari O, Dayati P, Reza JZ, Modarressi MH, Tofighi D, Haghiralsadat BF, Oroojalian F. Using chitosan-stabilized, hyaluronic acid-modified selenium nanoparticles to deliver CD44-targeted PLK1 siRNAs for treating bladder cancer. Nanomedicine (Lond) 2023; 18:259-277. [PMID: 37125618 DOI: 10.2217/nnm-2022-0198] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Aims: Achieving an effective biocompatible system for siRNAs delivery to the tumor site remains a significant challenge. Materials & methods: Selenium nanoparticles (SeNPs) modified by chitosan (CS) and hyaluronic acid (HA) were fabricated for PLK1 siRNAs (siPLK1) delivery to the bladder cancer cells. The HA-CS-SeNP@siPLK1 efficacy was evaluated using in vitro and in vivo models. Results: HA-CS-SeNP@siPLK1 was selectively internalized into T24 cells through clathrin-mediated endocytosis. Treatment with HA-CS-SeNP@siPLK1 successfully silenced the PLK1 gene, inhibited cell proliferation and induced cell cycle arrest in vitro. HA-CS-SeNP@siPLK1 could also inhibit tumor growth in vivo without causing systemic toxicity. Conclusion: Our results suggest that HA-CS-SeNPs may provide a good vehicle for delivering siPLK1 to the bladder tumor site.
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Affiliation(s)
- Maryamsadat Shahidi
- Department of Clinical Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences & Health Services, Yazd, 89151, Iran
| | - Omid Abazari
- Department of Clinical Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences & Health Services, Yazd, 89151, Iran
| | - Parisa Dayati
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 14115, Iran
| | - Javad Zavar Reza
- Department of Clinical Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences & Health Services, Yazd, 89151, Iran
| | - Mohammad Hossein Modarressi
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, 14176, Iran
| | - Davood Tofighi
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Bibi Fatemeh Haghiralsadat
- Medical Nanotechnology & Tissue Engineering Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, 89151, Iran
| | - Fatemeh Oroojalian
- Department of Advanced Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnūrd, 94149, Iran
- Natural Products & Medicinal Plants Research Center, North Khorasan University of Medical Sciences Bojnūrd, 94149, Iran
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Yang Y, Xu H, Zhu H, Yuan D, Zhang H, Liu Z, Zhao F, Liang G. EPDR1 levels and tumor budding predict and affect the prognosis of bladder carcinoma. Front Oncol 2022; 12:986006. [PMID: 36276104 PMCID: PMC9585273 DOI: 10.3389/fonc.2022.986006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Bladder carcinoma is a common malignancy of the urinary system. The previous study showed that EPDR1 expression was significantly related to the carcinogenesis and progression of bladder carcinoma Methods We retrospectively reviewed the records of 621 patients who were newly diagnosed with bladder carcinoma between January 2018 and August 2020 at The Affiliated Hospital of Zunyi Medical University. We conducted immunohistochemistry of EPDR1 in tumor tissues. Meanwhile, tumor budding evaluation was also carried out by 2 independent experienced pathologists. Results 80 patients were included in this study with a median age of 66 years (range; 42–88 years). 45% of the patients (36/80) were non-muscle-invasive bladder carcinoma patients, while 55% of muscle-invasive bladder carcinoma(44/80). The follow-up time was from 6 months to 36 months. We found that there were significant differences in expression of EPDR1 in the tumor pT stages(p<0.05), pM stages(p<0.05), and pN stages(p<0.05). Meanwhile, a higher expression of EPDR1 indicated a worse outcome for the patient(p<0.05). A tendency toward a worse status of the patient was accompanied by a high positive rate (p<0.001). Moreover, the IOD of EPDR1 had a positive relationship with TB (p<0.05). Furthermore, we found that EPDR1 and tumor budding could be crucial factors for affecting the prognosis of bladder carcinoma, even better than pTMN(Riskscore=(0.724)* pT_stage +(4.960) *EPDR1+(4.312)*TB). Conclusion In conclusion, bladder cancer patients with higher expression levels of EPDR1 had worse survival outcomes. The combination of TB and EPDR1 levels could predict the prognosis for muscle-invasive bladder cancer patients.
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Affiliation(s)
- Yue Yang
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Urology, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, China
- Medical College of Soochow University, Suzhou, China
| | - Hong Xu
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Han Zhu
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Dan Yuan
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Hanchao Zhang
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Urology, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, China
- Medical College of Soochow University, Suzhou, China
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zhengdao Liu
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Medical College of Soochow University, Suzhou, China
| | - Faliang Zhao
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Medical College of Soochow University, Suzhou, China
| | - Guobiao Liang
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Medical College of Soochow University, Suzhou, China
- *Correspondence: Guobiao Liang,
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Xiang Z, He Q, Huang L, Xiong B, Xiang Q. Breast Cancer Classification Based on Tumor Budding and Stem Cell-Related Signatures Facilitate Prognosis Evaluation. Front Oncol 2022; 11:818869. [PMID: 35083162 PMCID: PMC8784696 DOI: 10.3389/fonc.2021.818869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background Tumor budding (TB) is emerging as a prognostic factor in multiple cancers. Likewise, the stemness of cancer cells also plays a vital role in cancer progression. However, nearly no research has focused on the interaction of TB and tumor stemness in cancer. Methods Tissue microarrays including 229 cases of invasive breast cancer (BC) were established and subjected to pan-cytokeratin immunohistochemical staining to evaluate molecular expression. Univariate and multivariate analyses were applied to identify prognostic factors of BC, and the Chi-square test was used for comparison of categorical variables. Results High-grade TB was significantly associated with T stage, lymph node metastasis, tumor node metastasis (TNM) stage, epithelial-mesenchymal transition, and poor disease-free survival (DFS) of BC patients. We also found that the prognostic value of TB varied widely among different subtypes and subgroups. Cox regression analysis then showed that TB grade was an independent prognostic factor. Moreover, cancer stem cell (CSC) markers CD44 and ALDH1A1 were significantly higher in high-grade TB tumors. Consequently, patients were classified into high CSC score subgroup and low CSC score subgroups. Further research found that CSC scores correlated with clinicopathological features and DFS of BC patients. Based on TB grade and CSC scores, we classified BC patients into TBlow-CSCslow (type I), TBlow-CSCshigh (type II), TBhigh-CSCslow (type III), and TBhigh-CSCshigh (type IV) subgroups. Survival analysis showed that patients in the type I subgroup had the best DFS, whereas those in the type IV subgroup had the worst DFS. Finally, a TB-CSC-based nomogram for use in BC was established. The nomogram was well calibrated to predict the probability of 5-year DFS, and the C-index was 0.837. Finally, the area under the curve value for the nomogram (0.892) was higher than that of the TNM staging system (0.713). Conclusion The combination of TB grade with CSC score improves the prognostic evaluation of BC patients. A novel nomogram containing TB grade and CSC score provides doctors with a candidate tool to guide the individualized treatment of cancer patients.
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Affiliation(s)
- Zhenxian Xiang
- Department of Gastrointestinal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Gastric and Colorectal Surgical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China
| | - Qiuming He
- Department of Gastrointestinal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Gastric and Colorectal Surgical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China
| | - Li Huang
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Xiong
- Department of Gastrointestinal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Gastric and Colorectal Surgical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China
| | - Qingming Xiang
- Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan, China.,Hubei Cancer Clinical Study Center, Wuhan, China.,Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan, China
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