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Maas M, Hilsendecker A, Pertoll A, Stühler V, Walz S, Rausch S, Stenzl A, Tsaur I, Hennenlotter J, Aufderklamm S. PD-L1 Expression in High-Risk Non-Muscle-Invasive Bladder Cancer Is Influenced by Intravesical Bacillus Calmette-Guérin (BCG) Therapy. Cancers (Basel) 2024; 16:1356. [PMID: 38611034 PMCID: PMC11011000 DOI: 10.3390/cancers16071356] [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: 02/13/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
In the expanding landscape of immune checkpoint inhibitors (CPI) in high-risk (HR) non-muscle-invasive bladder cancer (NMIBC), the role of programmed death ligand 1 (PD-L1) as prognostic and predictive is increasingly significant. However, data evaluating its variability and susceptibility to Bacillus Calmette-Guérin (BCG) therapy in HR NMIBC patients is scarce. This retrospective study analyzed 126 HR NMIBC tissue samples from 63 patients (38× BCG-treated, 25× BCG-naïve) at two time points to assess PD-L1 expression using the 'combined positivity score' (CPS) with the 22C3 DAKO antibody method and correlated it with clinicopathological parameters. A CPS > 10 defined PD-L1 positivity. The impact of initial PD-L1 status and its change over time on time-to-recurrence, progression-free survival, and overall survival (TTR, PFS, OS) was analyzed using Kaplan-Meier and Cox proportional hazard models. BCG treatment significantly increased PD-L1 expression (5.31 vs. 0.22, p = 0.0423), with PD-L1 positive cases rising post-treatment in the BCG group and remaining unchanged in BCG-naïve patients. Multivariate analysis including T-stage, CIS, grading, tumor size, multifocality, age, and sex revealed a significant correlation between PD-L1 status change to positivity and improved TTR (p = 0.03). Our findings demonstrate a potential modulation of the PD-L1 status by an intravesical BCG therapy. However, its prognostic value appears limited.
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Affiliation(s)
- Moritz Maas
- Department of Urology, University Hospital Tübingen, Eberhard Karls University, 72076 Tuebingen, Germany; (A.H.); (A.P.); (V.S.); (S.W.); (S.R.); (A.S.); (I.T.); (J.H.); (S.A.)
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Andreas Hilsendecker
- Department of Urology, University Hospital Tübingen, Eberhard Karls University, 72076 Tuebingen, Germany; (A.H.); (A.P.); (V.S.); (S.W.); (S.R.); (A.S.); (I.T.); (J.H.); (S.A.)
| | - Alexandra Pertoll
- Department of Urology, University Hospital Tübingen, Eberhard Karls University, 72076 Tuebingen, Germany; (A.H.); (A.P.); (V.S.); (S.W.); (S.R.); (A.S.); (I.T.); (J.H.); (S.A.)
| | - Viktoria Stühler
- Department of Urology, University Hospital Tübingen, Eberhard Karls University, 72076 Tuebingen, Germany; (A.H.); (A.P.); (V.S.); (S.W.); (S.R.); (A.S.); (I.T.); (J.H.); (S.A.)
| | - Simon Walz
- Department of Urology, University Hospital Tübingen, Eberhard Karls University, 72076 Tuebingen, Germany; (A.H.); (A.P.); (V.S.); (S.W.); (S.R.); (A.S.); (I.T.); (J.H.); (S.A.)
| | - Steffen Rausch
- Department of Urology, University Hospital Tübingen, Eberhard Karls University, 72076 Tuebingen, Germany; (A.H.); (A.P.); (V.S.); (S.W.); (S.R.); (A.S.); (I.T.); (J.H.); (S.A.)
| | - Arnulf Stenzl
- Department of Urology, University Hospital Tübingen, Eberhard Karls University, 72076 Tuebingen, Germany; (A.H.); (A.P.); (V.S.); (S.W.); (S.R.); (A.S.); (I.T.); (J.H.); (S.A.)
| | - Igor Tsaur
- Department of Urology, University Hospital Tübingen, Eberhard Karls University, 72076 Tuebingen, Germany; (A.H.); (A.P.); (V.S.); (S.W.); (S.R.); (A.S.); (I.T.); (J.H.); (S.A.)
| | - Jörg Hennenlotter
- Department of Urology, University Hospital Tübingen, Eberhard Karls University, 72076 Tuebingen, Germany; (A.H.); (A.P.); (V.S.); (S.W.); (S.R.); (A.S.); (I.T.); (J.H.); (S.A.)
| | - Stefan Aufderklamm
- Department of Urology, University Hospital Tübingen, Eberhard Karls University, 72076 Tuebingen, Germany; (A.H.); (A.P.); (V.S.); (S.W.); (S.R.); (A.S.); (I.T.); (J.H.); (S.A.)
- Department of Urology, General Hospital of Bregenz, 6900 Bregenz, Austria
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Alonso JCC, de Souza BR, Reis IB, de Arruda Camargo GC, de Oliveira G, de Barros Frazão Salmazo MI, Gonçalves JM, de Castro Roston JR, Caria PHF, da Silva Santos A, de Freitas LLL, Billis A, Durán N, Fávaro WJ. OncoTherad ® (MRB-CFI-1) Nanoimmunotherapy: A Promising Strategy to Treat Bacillus Calmette-Guérin-Unresponsive Non-Muscle-Invasive Bladder Cancer: Crosstalk among T-Cell CX3CR1, Immune Checkpoints, and the Toll-Like Receptor 4 Signaling Pathway. Int J Mol Sci 2023; 24:17535. [PMID: 38139364 PMCID: PMC10743608 DOI: 10.3390/ijms242417535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/09/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
This study assessed the safety and efficacy of OncoTherad® (MRB-CFI-1) nanoimmunotherapy for non-muscle invasive bladder cancer (NMIBC) patients unresponsive to Bacillus Calmette-Guérin (BCG) and explored its mechanisms of action in a bladder cancer microenvironment. A single-arm phase I/II study was conducted with 44 patients with NMIBC who were unresponsive to BCG treatment. Primary outcomes were pathological complete response (pCR) and relapse-free survival (RFS). Secondary outcomes comprised response duration and therapy safety. Patients' mean age was 65 years; 59.1% of them were refractory, 31.8% relapsed, and 9.1% were intolerant to BCG. Moreover, the pCR rate after 24 months reached 72.7% (95% CI), whereas the mean RFS reached 21.4 months. Mean response duration in the pCR group was 14.3 months. No patient developed muscle-invasive or metastatic disease during treatment. Treatment-related adverse events occurred in 77.3% of patients, mostly grade 1-2 events. OncoTherad® activated the innate immune system through toll-like receptor 4, leading to increased interferon signaling. This activation played a crucial role in activating CX3CR1+ CD8 T cells, decreasing immune checkpoint molecules, and reversing immunosuppression in the bladder microenvironment. OncoTherad® has proved to be a safe and effective therapeutic option for patients with BCG-unresponsive NMIBC, besides showing likely advantages in tumor relapse prevention processes.
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Affiliation(s)
- João Carlos Cardoso Alonso
- Laboratory of Urogenital Carcinogenesis and Immunotherapy (LCURGIN), Universidade Estadual de Campinas (UNICAMP), Campinas 13083-865, São Paulo, Brazil; (G.C.d.A.C.); (G.d.O.); (M.I.d.B.F.S.); (J.M.G.); (J.R.d.C.R.); (P.H.F.C.); (A.d.S.S.); (N.D.)
- Paulínia Municipal Hospital, Paulínia 13140-000, São Paulo, Brazil
| | - Bianca Ribeiro de Souza
- Obstetrics & Gynecology Department, Ovarian Cancer Research Group University of British Columbia, Vancouver, BC V6Z 2K8, Canada;
| | - Ianny Brum Reis
- Diagnosis and Surgery Department, Dentistry School, São Paulo State University (UNESP), Araraquara 14801-903, São Paulo, Brazil;
| | - Gabriela Cardoso de Arruda Camargo
- Laboratory of Urogenital Carcinogenesis and Immunotherapy (LCURGIN), Universidade Estadual de Campinas (UNICAMP), Campinas 13083-865, São Paulo, Brazil; (G.C.d.A.C.); (G.d.O.); (M.I.d.B.F.S.); (J.M.G.); (J.R.d.C.R.); (P.H.F.C.); (A.d.S.S.); (N.D.)
| | - Gabriela de Oliveira
- Laboratory of Urogenital Carcinogenesis and Immunotherapy (LCURGIN), Universidade Estadual de Campinas (UNICAMP), Campinas 13083-865, São Paulo, Brazil; (G.C.d.A.C.); (G.d.O.); (M.I.d.B.F.S.); (J.M.G.); (J.R.d.C.R.); (P.H.F.C.); (A.d.S.S.); (N.D.)
| | - Maria Izabel de Barros Frazão Salmazo
- Laboratory of Urogenital Carcinogenesis and Immunotherapy (LCURGIN), Universidade Estadual de Campinas (UNICAMP), Campinas 13083-865, São Paulo, Brazil; (G.C.d.A.C.); (G.d.O.); (M.I.d.B.F.S.); (J.M.G.); (J.R.d.C.R.); (P.H.F.C.); (A.d.S.S.); (N.D.)
| | - Juliana Mattoso Gonçalves
- Laboratory of Urogenital Carcinogenesis and Immunotherapy (LCURGIN), Universidade Estadual de Campinas (UNICAMP), Campinas 13083-865, São Paulo, Brazil; (G.C.d.A.C.); (G.d.O.); (M.I.d.B.F.S.); (J.M.G.); (J.R.d.C.R.); (P.H.F.C.); (A.d.S.S.); (N.D.)
| | - José Ronaldo de Castro Roston
- Laboratory of Urogenital Carcinogenesis and Immunotherapy (LCURGIN), Universidade Estadual de Campinas (UNICAMP), Campinas 13083-865, São Paulo, Brazil; (G.C.d.A.C.); (G.d.O.); (M.I.d.B.F.S.); (J.M.G.); (J.R.d.C.R.); (P.H.F.C.); (A.d.S.S.); (N.D.)
| | - Paulo Henrique Ferreira Caria
- Laboratory of Urogenital Carcinogenesis and Immunotherapy (LCURGIN), Universidade Estadual de Campinas (UNICAMP), Campinas 13083-865, São Paulo, Brazil; (G.C.d.A.C.); (G.d.O.); (M.I.d.B.F.S.); (J.M.G.); (J.R.d.C.R.); (P.H.F.C.); (A.d.S.S.); (N.D.)
| | - André da Silva Santos
- Laboratory of Urogenital Carcinogenesis and Immunotherapy (LCURGIN), Universidade Estadual de Campinas (UNICAMP), Campinas 13083-865, São Paulo, Brazil; (G.C.d.A.C.); (G.d.O.); (M.I.d.B.F.S.); (J.M.G.); (J.R.d.C.R.); (P.H.F.C.); (A.d.S.S.); (N.D.)
| | - Leandro Luiz Lopes de Freitas
- Pathology Department, Medical School, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-888, São Paulo, Brazil; (L.L.L.d.F.); (A.B.)
| | - Athanase Billis
- Pathology Department, Medical School, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-888, São Paulo, Brazil; (L.L.L.d.F.); (A.B.)
| | - Nelson Durán
- Laboratory of Urogenital Carcinogenesis and Immunotherapy (LCURGIN), Universidade Estadual de Campinas (UNICAMP), Campinas 13083-865, São Paulo, Brazil; (G.C.d.A.C.); (G.d.O.); (M.I.d.B.F.S.); (J.M.G.); (J.R.d.C.R.); (P.H.F.C.); (A.d.S.S.); (N.D.)
| | - Wagner José Fávaro
- Laboratory of Urogenital Carcinogenesis and Immunotherapy (LCURGIN), Universidade Estadual de Campinas (UNICAMP), Campinas 13083-865, São Paulo, Brazil; (G.C.d.A.C.); (G.d.O.); (M.I.d.B.F.S.); (J.M.G.); (J.R.d.C.R.); (P.H.F.C.); (A.d.S.S.); (N.D.)
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Celada Luis G, Albers Acosta E, de la Fuente H, Velasco Balanza C, Arroyo Correas M, Romero-Laorden N, Alfranca A, Olivier Gómez C. A Comprehensive Analysis of Immune Response in Patients with Non-Muscle-Invasive Bladder Cancer. Cancers (Basel) 2023; 15:cancers15051364. [PMID: 36900156 PMCID: PMC10000243 DOI: 10.3390/cancers15051364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Bladder carcinoma has elevated morbimortality due to its high recurrence and progression in localized disease. A better understanding of the role of the tumor microenvironment in carcinogenesis and response to treatment is needed. METHODS Peripheral blood and samples of urothelial bladder cancer and adjacent healthy urothelial tissue were collected from 41 patients and stratified in low- and high-grade urothelial bladder cancer, excluding muscular infiltration or carcinoma in situ. Mononuclear cells were isolated and labeled for flow cytometry analysis with antibodies aimed at identifying specific subpopulations within T lymphocytes, myeloid cells and NK cells. RESULTS In peripheral blood and tumor samples, we detected different percentages of CD4+ and CD8+ lymphocytes, monocyte and myeloid-derived suppressor cells, as well as differential expression of activation- and exhaustion-related markers. Conversely, only a significant increase in bladder total monocytes was found when comparing bladder and tumor samples. Interestingly, we identified specific markers differentially expressed in the peripheral blood of patients with different outcomes. CONCLUSION The analysis of host immune response in patients with NMIBC may help to identify specific markers that allow optimizing therapy and patient follow-up. Further investigation is needed to establish a strong predictive model.
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Affiliation(s)
| | | | | | | | | | - Nuria Romero-Laorden
- Department of Medical Oncology, Hospital Universitario La Princesa, 28006 Madrid, Spain
| | - Arantzazu Alfranca
- Department of Immunology, Hospital Universitario de la Princesa, 28006 Madrid, Spain
- Correspondence: ; Tel.: +34-91-520-23-07
| | - Carlos Olivier Gómez
- Department of Urology, Hospital Universitario de La Princesa, 28006 Madrid, Spain
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Accurate Characterization of Bladder Cancer Cells with Intraoperative Flow Cytometry. Cancers (Basel) 2022; 14:cancers14215440. [PMID: 36358858 PMCID: PMC9656620 DOI: 10.3390/cancers14215440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Simple Summary Bladder cancer is a malignancy that predominantly affects male patients. Surgical treatment is the first option for clinical management and cancer cell characterization is critical for tumor margin detection and complete tumor removal. We developed a specialized intraoperative flow cytometry (iFC) methodology for bladder cancer cell detection. Our study, including 52 individuals, reveals that iFC is highly specific, sensitive and accurate in detecting cancer cells, based on the quantification of cell proliferation and the presence of tumor aneuploidy. The results of this study advocate further research on the utility of iFC as a next-generation malignancy evaluation technique during transurethral resections. Abstract Bladder cancer represents a major health issue. Transurethral resection is the first line treatment and an accurate assessment of tumor margins might warrant complete tumor removal. Genomic instability and proliferative potential are common hallmarks of cancer cells. We have previously demonstrated the utility of intraoperative flow cytometry (iFC), a next-generation margin evaluation methodology for assessment of DNA content, in the detection of several types of malignancy. In the current study we investigated the possible value of iFC in the characterization of bladder cancer during surgery. Samples from a population of 52 people with urothelial cancer were included in the study. The total time for iFC evaluation is 3–5 min per sample and included a two-step analysis, including DNA-index and Tumor-index calculation. First, DNA-index calculation revealed 24 hyperploid and one hypoploid tumor. Second, cell cycle analysis and Tumor-index calculation revealed that tumor samples are distinguished from normal cells based on their significantly higher proliferative potential. The standard for iFC evaluation was pathology assessment and revealed that our protocol exhibits an accuracy of 98% in defining the presence of cancer cells in a given sample. Our results support the further assessment of iFC value towards its use as a novel malignancy evaluation tool in transurethral resections.
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Pramod S, Tampubolon KG, Safriadi F, Fitriana M, Hernowo B. Correlations of tumor depth and width with lymphovascular invasion in non-muscle invasive bladder cancer. UROLOGICAL SCIENCE 2022. [DOI: 10.4103/uros.uros_112_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Suh J, Jung JH, Kwak C, Kim HH, Ku JH. Stratifying risk for multiple, recurrent, and large (≥3 cm) Ta, G1/G2 tumors in non-muscle-invasive bladder cancer. Investig Clin Urol 2021; 62:408-415. [PMID: 34190435 PMCID: PMC8246012 DOI: 10.4111/icu.20210017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/10/2021] [Accepted: 03/21/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose The current stratification of risk groups regarding recurrence and progression of non-muscle-invasive bladder cancer (NMIBC) is problematic. We aimed to assess the long-term outcome and risk of multiple, recurrent, and large (≥3 cm) Ta, G1/G2 tumors after transurethral resection of the bladder tumor (TURBT). Materials and Methods We categorized 1,621 patients with NMIBC who underwent TURBT into four risk groups according to the European Association of Urology (EAU) guidelines as follows: low-risk, intermediate-risk, high-risk, and study group. The overall, cancer-specific, disease recurrence-free, and disease progression-free survival rates were estimated by using the Kaplan–Meier method. Then, the impact of risk group was assessed by using a multivariable Cox regression model. Results The study group comprised 52 patients (3.2%) within a mean follow-up of 64.8 months. The disease recurred and progressed in 41 (78.8%) and 7 (13.5%) patients, respectively. Among the four groups, the study group showed the highest risk for 10-year recurrence after TURBT. The disease progression risk in the study group was between that of the intermediate- and high-risk groups. Cancer-specific and all-cause deaths occurred in one and four patients in the study group, respectively. The study group had a higher risk for disease recurrence than did the high-risk group; however, it did not have a higher risk for disease progression than in the high-risk group. Conclusions Multiple, recurrent, and large (≥3 cm) Ta, G1/G2 tumors carry a higher risk for disease recurrence, but not progression, than in the EAU high-risk group of NMIBC.
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Affiliation(s)
- Jungyo Suh
- Department of Urology, Asan Medical Center, Seoul, Korea
| | | | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul, Korea.,Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeon Hoe Kim
- Department of Urology, Seoul National University Hospital, Seoul, Korea.,Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University Hospital, Seoul, Korea.,Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
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Azuma T, Sato Y, Ohno T, Azuma M, Kume H. Serum soluble B7-H3 is a prognostic marker for patients with non-muscle-invasive bladder cancer. PLoS One 2020; 15:e0243379. [PMID: 33306717 PMCID: PMC7732087 DOI: 10.1371/journal.pone.0243379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/19/2020] [Indexed: 02/07/2023] Open
Abstract
Background B7-H3 is a member of the B7 family of immune-regulatory ligands and is a costimulatory molecule promoting the T cell response in vitro. We herein investigated the clinical utility of serum soluble B7-H3 (sB7-H3) in patients with non-muscle invasive bladder cancer (NMIBC). Methods We analyzed 555 patients in whom NMIBC was diagnosed at Tokyo Metropolitan Tama Medical Center between 2008 and 2013. We measured the serum sB7-H3 (sB7-H3) level using the enzyme-linked immunosorbent assay (ELISA) and evaluated the utility of sB7-H3 as a prognostic biomarker for NMIBC. We used the Cox proportional hazards regression model to assess recurrence-free survival (RFS) and progression-free survival (PFS) with the sB7-H3 level. Results We detected high levels of sB7-H3 in the sera of 47% of patients with NMIBC versus only 8% in healthy donors. The increase of sB7-H3 was significantly associated with poor RFS and PFS. Multivariate analysis showed that elevated sB7-H3 was an independent prognostic factor of RFS and PFS. According to the European Organization for Research and Treatment of Cancer (EORTC), in intermediate-low and intermediate-high risk groups, the presence of sB7-H3 significantly determined the rate of recurrence and progression. Conclusions Our data suggested that evaluating serum sB7-H3 expression is a useful tool for predicting the prognosis of patients with NMIBC.
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Affiliation(s)
- Takeshi Azuma
- Department of Urology, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
- Department of Molecular Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Hongo, Tokyo, Japan
- Department of Urology, The University of Tokyo Graduate School of Medicine, Hongo, Tokyo, Japan
- * E-mail:
| | - Yujiro Sato
- Department of Urology, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Tatsukuni Ohno
- Oral Health Science Center, Tokyo Dental College, Chiyoda, Tokyo, Japan
| | - Miyuki Azuma
- Department of Molecular Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Hongo, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, The University of Tokyo Graduate School of Medicine, Hongo, Tokyo, Japan
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Loh XY, Sun QY, Ding LW, Mayakonda A, Venkatachalam N, Yeo MS, Silva TC, Xiao JF, Doan NB, Said JW, Ran XB, Zhou SQ, Dakle P, Shyamsunder P, Koh APF, Huang RYJ, Berman BP, Tan SY, Yang H, Lin DC, Koeffler HP. RNA-Binding Protein ZFP36L1 Suppresses Hypoxia and Cell-Cycle Signaling. Cancer Res 2019; 80:219-233. [PMID: 31551365 DOI: 10.1158/0008-5472.can-18-2796] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 06/28/2019] [Accepted: 09/16/2019] [Indexed: 11/16/2022]
Abstract
ZFP36L1 is a tandem zinc-finger RNA-binding protein that recognizes conserved adenylate-uridylate-rich elements (ARE) located in 3'untranslated regions (UTR) to mediate mRNA decay. We hypothesized that ZFP36L1 is a negative regulator of a posttranscriptional hub involved in mRNA half-life regulation of cancer-related transcripts. Analysis of in silico data revealed that ZFP36L1 was significantly mutated, epigenetically silenced, and downregulated in a variety of cancers. Forced expression of ZFP36L1 in cancer cells markedly reduced cell proliferation in vitro and in vivo, whereas silencing of ZFP36L1 enhanced tumor cell growth. To identify direct downstream targets of ZFP36L1, systematic screening using RNA pull-down of wild-type and mutant ZFP36L1 as well as whole transcriptome sequencing of bladder cancer cells {plus minus} tet-on ZFP36L1 was performed. A network of 1,410 genes was identified as potential direct targets of ZFP36L1. These targets included a number of key oncogenic transcripts such as HIF1A, CCND1, and E2F1. ZFP36L1 specifically bound to the 3'UTRs of these targets for mRNA degradation, thus suppressing their expression. Dual luciferase reporter assays and RNA electrophoretic mobility shift assays showed that wild-type, but not zinc-finger mutant ZFP36L1, bound to HIF1A 3'UTR and mediated HIF1A mRNA degradation, leading to reduced expression of HIF1A and its downstream targets. Collectively, our findings reveal an indispensable role of ZFP36L1 as a posttranscriptional safeguard against aberrant hypoxic signaling and abnormal cell-cycle progression. SIGNIFICANCE: RNA-binding protein ZFP36L1 functions as a tumor suppressor by regulating the mRNA stability of a number of mRNAs involved in hypoxia and cell-cycle signaling.
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Affiliation(s)
- Xin-Yi Loh
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Qiao-Yang Sun
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Ling-Wen Ding
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.
| | - Anand Mayakonda
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | | | - Mei-Shi Yeo
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Tiago C Silva
- Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Center for Bioinformatics and Functional Genomics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jin-Fen Xiao
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Ngan B Doan
- Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Jonathan W Said
- Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Xue-Bin Ran
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Si-Qin Zhou
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Pushkar Dakle
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Pavithra Shyamsunder
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Angele Pei-Fern Koh
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Ruby Yun-Ju Huang
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Benjamin P Berman
- Center for Bioinformatics and Functional Genomics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California.,Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Soo-Yong Tan
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Henry Yang
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - De-Chen Lin
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - H Phillip Koeffler
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California.,National University Cancer Institute of Singapore, National University Hospital, Singapore
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Yumioka T, Honda M, Nishikawa R, Teraoka S, Kimura Y, Iwamoto H, Morizane S, Hikita K, Takenaka A. Sarcopenia as a significant predictive factor of neutropenia and overall survival in urothelial carcinoma patients underwent gemcitabine and cisplatin or carboplatin. Int J Clin Oncol 2019; 25:158-164. [DOI: 10.1007/s10147-019-01544-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 09/03/2019] [Indexed: 10/26/2022]
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10
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Novel endoscopic visualization techniques for bladder cancer detection: a review of the contemporary literature. Curr Opin Urol 2019; 28:214-218. [PMID: 29045251 DOI: 10.1097/mou.0000000000000459] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE OF REVIEW To describe the principles of photodynamic diagnosis (PDD), narrow-band imaging (NBI) and Storz Professional Image Enhancement System (SPIES) techniques for the endoscopic management of nonmuscle-invasive bladder cancer (BCa) and to report their impact on clinical practice. RECENT FINDINGS PDD is associated with an increased sensitivity for detecting BCa specifically carcinoma in situ (CIS). Moreover, PDD has been shown to lower recurrence rate in comparison with white-light cystoscopy. The impact on progression-free survival is still unclear yet. NBI and, more recently, SPIES are two novel imaging techniques that do not require preoperative instillation of photosensitizing agents. NBI seems to be associated with lower recurrence rates. Nevertheless, further trials are necessary to confirm these results, in particular in high-risk lesions and CIS. Randomized clinical trials addressing the clinical impact of SPIES are ongoing. SUMMARY Novel endoscopic imaging techniques are useful diagnostic tools for evaluating BCa during cystoscopic diagnostic surveillance as well as during transurethral resection of the bladder. Although the standard of care remains white-light cystoscopy, these techniques provide higher sensitivity in detecting BCa especially CIS. The continued evidence also suggests that this increased detection leads to lower recurrence rates. The impact on progression and the cost-efficacy as well as selection remains to be refined.
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11
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Han Y, Zheng Q, Tian Y, Ji Z, Ye H. Identification of a nine-gene panel as a prognostic indicator for recurrence with muscle-invasive bladder cancer. J Surg Oncol 2019; 119:1145-1154. [PMID: 30887516 DOI: 10.1002/jso.25446] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/28/2019] [Accepted: 02/27/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Bladder cancer is one of the most common and highly recurrent cancers worldwide. Recurrence-associated genes may potentially predict cancer recurrence. We aimed to construct a recurrence-associated gene panel to improve the prognostic prediction of bladder cancer. METHODS Based on DNA sequencing and clinical data from the TCGA-BLCA project, we identified 10 potential driver genes significantly associated with recurrence of bladder cancer. We performed multivariable logistic regression analysis to construct an optimized recurrence prediction model with nine recurrence-associated genes (EME1, AKAP9, ZNF91, PARD3, STAG2, ZFP36L2, METTL3, POLR3B, and MUC7) and clinical information as the independent variables. RESULTS The area under the receiver operating characteristic (ROC) curve was 0.80 in this model, much higher than that of the baseline model (AUC = 0.73) and the same trend was also validated in its subset. Decision curve analysis also revealed that there is a significant net benefit gained by adding nine genes mutation to the baseline model. Furthermore, Kaplan-Meier survival analysis showed that eight out of the nine genes (excluding MUC7) had good effects on the overall prognosis of patients. CONCLUSIONS This nine-gene panel will most likely be a useful tool for prognostic evaluation and will facilitate the personalized management of patients with bladder cancer.
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Affiliation(s)
- Yuying Han
- Department of Medical Genetics and Developmental Biology, School of Basic Medical Sciences, Beijing Key Laboratory of Neural Regeneration and Repair, Capital Medical University, Beijing, China
| | - Qiyu Zheng
- Department of Medical Genetics and Developmental Biology, School of Basic Medical Sciences, Beijing Key Laboratory of Neural Regeneration and Repair, Capital Medical University, Beijing, China
| | - Ye Tian
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhengguo Ji
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Haihong Ye
- Department of Medical Genetics and Developmental Biology, School of Basic Medical Sciences, Beijing Key Laboratory of Neural Regeneration and Repair, Capital Medical University, Beijing, China
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12
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Does restaging transurethral resection of bladder tumour influence outcomes in patients treated with BCG immunotherapy? 491 cases in 20 years' experience. Wideochir Inne Tech Maloinwazyjne 2018; 14:284-296. [PMID: 31118996 PMCID: PMC6528127 DOI: 10.5114/wiitm.2018.79993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 10/24/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction Bladder cancer is one of the most common malignancies worldwide. Aim To analyse the influence of restaging transurethral resection of bladder tumour (reTURB) on outcomes in patients treated with BCG immunotherapy. Material and methods We analysed a database of 491 patients who were treated in a Bacillus Calmette-Guérin (BCG) outpatient department between 1998 and 2016. A minimum of 12 months of follow-up was required. The study included 235 patients with a history of the reTURB procedure and 256 patients without reTURB. The patients were analysed in terms of recurrence-free (RFS), progression-free (PFS), cancer-specific and overall survival. Results The RFS was significantly higher in the reTURB group for both general and subgroup analysis (T1HG, TaHG). The PFS was significantly higher in the reTURB group for both general and subgroup analysis (TaHG). In patients without lamina muscularis in the specimen there was a greater improvement in RFS due to the reTURB procedure than for other patients. ReTURB performed in T1 tumours with massive lamina propria infiltration had a positive influence on RFS. In patients with reTURB the presence of focal invasion was related to lower risk of progression. Both overall and cancer-specific survival were significantly improved by the reTURB procedure in T1HG and HG tumours. Conclusions This study highlights the importance of reTURB. It was found that the patients with TaHG tumours benefited the most in terms of RFS, PFS and cancer-specific survival. It was also demonstrated that massive lamina propria infiltration in T1 tumours is associated with the worst outcomes.
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13
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Lee YH, Lai CW, Cheng YC. Fluid Shear Stress Induces Cell Cycle Arrest in Human Urinary Bladder Transitional Cell Carcinoma Through Bone Morphogenetic Protein Receptor-Smad1/5 Pathway. Cell Mol Bioeng 2018; 11:185-195. [PMID: 31719885 DOI: 10.1007/s12195-018-0523-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/13/2018] [Indexed: 10/17/2022] Open
Abstract
Introduction Mechanical force generated from the interstitial fluid flow inside and surrounding tissue has been known to play a significant role in cancer pathophysiology. In this study, we aimed to investigate the role of laminar shear stress (LSS) in modulating the cell cycle of human bladder transitional carcinoma (BFTC-905) cells which are frequently stimulated by not only the interstitial fluid flow, but also the urine flow transported from kidney to bladder in the urinary tract. Methods The BFTC-905 cells were subjected to 0-12 dynes cm-2 LSS for 1, 4, 8, or 12 h, respectively, followed by cellular and molecular assays for investigations of cell cycle regulation protein expressions, cell growth rates, and the potential mechanism. Results The results showed that the LSS with ≥ 8 dynes cm-2 for ≥ 8 h significantly increased protein expressions of cyclin B1, Wee1, p21, and p-CDK1(Tyr15) (p < 0.05 for each), but conversely decreased protein expressions of cyclin A2, D1, E1, and CDK-1, -2, -4, and -6 (p < 0.05 for each) in the BFTC-905 cells, indicating that a G2/M cell cycle arrest was obtained after shearing stimulation. Furthermore, our data demonstrated that the LSS-induced G2/M arrest and the corresponding changes in cell cycle regulatory protein expressions were modulated by bone morphogenetic protein (BMP) receptor-Smad1/5 signaling pathway. Conclusions Our findings provided evidences for the effect of mechanical microenvironment on urothelial cancer pathobiology and generated insights into mechanism of LSS-regulated bladder tumor cell cycle.
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Affiliation(s)
- Yu-Hsiang Lee
- Department of Biomedical Sciences and Engineering, National Central University, No. 300, Jhongda Rd., Taoyuan City, 32001 Taiwan, ROC.,Department of Chemical and Materials Engineering, National Central University, Taoyuan City, Taiwan, ROC
| | - Chia-Wei Lai
- Department of Biomedical Sciences and Engineering, National Central University, No. 300, Jhongda Rd., Taoyuan City, 32001 Taiwan, ROC
| | - Yu-Che Cheng
- Department of Biomedical Sciences and Engineering, National Central University, No. 300, Jhongda Rd., Taoyuan City, 32001 Taiwan, ROC.,Proteomics Laboratory, Cathay Medical Research Institute, Cathay General Hospital, No.32, Ln.160, Jiancheng Rd., New Taipei City, 22174 Taiwan, ROC.,School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC
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14
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Increased expression of ZEB1-AS1 correlates with higher histopathological grade and promotes tumorigenesis in bladder cancer. Oncotarget 2018; 8:24202-24212. [PMID: 28445936 PMCID: PMC5421840 DOI: 10.18632/oncotarget.15527] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 01/04/2017] [Indexed: 11/30/2022] Open
Abstract
Bladder cancer is one of the most common urinary cancers worldwide. Emerging studies indicated that long non-coding RNAs (lncRNAs) play crucial roles in cancer biology. In this study, we found that a novel lncRNA Zinc finger E-box-binding homeebox1 (ZEB1) antisense RNA (ZEB1-AS1) was overexpressed in bladder cancer tissues compared to paired noncancerous tissues. Moreover, the expression of ZEB1-AS1 was positive correlated with higher histological grade and TNM stage in bladder cancer. Furthermore, Loss-of-function experiments showed that down-regulation of ZEB1-AS1 not only can suppress cell growth but also can inhibit migration and induce apoptosis in bladder cancer cell lines 5637 and SW780. In conclusion, these findings indicated that ZEB1-AS1 plays regulatory roles in bladder cancer and it may become a novel molecular biomarker of prognosis and therapy in bladder cancer.
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15
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Seo HK, Kwon WA, Kim SH. Neoadjuvant Chemotherapy for Muscle-Invasive Bladder Cancer. Bladder Cancer 2018. [DOI: 10.1016/b978-0-12-809939-1.00022-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Almeida GL, Busato WFS, Ribas CM, Ribas JM, De Cobelli O. External validation of EORTC risk scores to predict recurrence after transurethral resection of brazilian patients with non -muscle invasive bladder cancer stages Ta and T1. Int Braz J Urol 2017; 42:932-941. [PMID: 27509372 PMCID: PMC5066889 DOI: 10.1590/s1677-5538.ibju.2015.0169] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 10/26/2015] [Indexed: 11/22/2022] Open
Abstract
Validate the EORTC risk tables in Brazilian patients with NMIBC. METHODS 205 patients were analyzed. The 6 parameters analyzed were: histologic grading, pathologic stage, size and number of tumors, previous recurrence rate and concomitant CIS. The time for first recurrence (TFR), risk score and probability of re¬currence were calculated and compared to the probabilities obtained from EORTC risk tables. C-index was calculated and accuracy of EORTC tables was analyzed. RESULTS pTa was presented in 91 (44.4%) patients and pT1 in 114 (55.6%). Ninety-seven (47.3%) patients had solitary tumor, and 108 (52.7%) multiple tumors. One hundred and three (50.2%) patients had tumors smaller than 3 cm and 102 (40.8%) had bigger than 3 cm. Concomitant CIS was observed in 21 (10.2%) patients. Low grade was presented in 95 (46.3%) patients, and high grade in 110 (53.7%). Intravesical therapy was utilized in 105 (56.1%) patients. Recurrence was observed in 117 (57.1%) patients and the mean TFR was 14,2 ± 7,3 months. C-index was 0,72 for 1 year and 0,7 for 5 years. The re¬currence risk was 28,8% in 1 year and 57,1% in 5 years, independently of the scoring risk. In our population, the EORTC risk tables overestimated the risk of recurrence in 1 year and underestimated in 5 years. CONCLUSION The validation of the EORTC risk tables in Brazilian patients with NMIBC was satisfactory and should be stimulated to predict recurrence, although these may overestimated the risk of recurrence in 1 year and underestimated in 5 years.
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Affiliation(s)
- Gilberto L Almeida
- Universidade do Vale do Itajaí, SC, Brasil/Instituto Catarinense de Urologia (INCAU), Itajaí, Brasil.,Faculdade Evangélica do Paraná (FEPAR)/Instituto de Pesquisas Médicas (IPEM), Curitiba, Brasil
| | - Wilson F S Busato
- Universidade do Vale do Itajaí, SC, Brasil/Instituto Catarinense de Urologia (INCAU), Itajaí, Brasil
| | - Carmen Marcondes Ribas
- Faculdade Evangélica do Paraná (FEPAR)/Instituto de Pesquisas Médicas (IPEM), Curitiba, Brasil
| | | | - Ottavio De Cobelli
- Università degli Studi di Milano, Milano, Italia.,Dipartimento di Urologia, Istituto Europeo di Oncologia (IEO), Milano, Italia
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Arslankoz S, Kulaç İ, Ertoy Baydar D. The Influence of Inverted Growth Pattern on Recurrence for Patients with Non-Invasive Low Grade Papillary Urothelial Carcinoma of Bladder. Balkan Med J 2017; 34:464-468. [PMID: 28443589 PMCID: PMC5635635 DOI: 10.4274/balkanmedj.2017.0081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
AIMS To evaluate the impact of a histologically inverted pattern on recurrence in patients with newly diagnosed non-invasive, low-grade papillary urothelial carcinoma of the urinary bladder. METHODS A total of 81 patients with primary bladder non-invasive, low-grade papillary urothelial carcinoma diagnosed in a single tertiary-care centre who had at least 1-year follow-up after an initial resection were included. All slides from each case were reviewed to determine the growth pattern (exophytic versus endophytic, i.e. inverted) and other histological parameters. Clinical data were retrieved from hospital records. RESULTS Disease recurrence occurred in 41 (50.6%) patients. Cases with an inverted pattern showed a lower recurrence rate than those with pure exophytic tumours (37.5% versus 52.1%), a longer time to first recurrence (mean 34 versus 21.5 months) and fewer recurrence episodes (p=0.482, 0.564 and 0.051, respectively). All recurring inverted cases recurred only once during follow-up. No tumour with >80% inverted architecture recurred. CONCLUSION Our results suggest that non-invasive, low-grade papillary urothelial carcinoma of the bladder tends to have a better outcome in terms of disease recurrence if it shows an inverted growth pattern. To indicate the presence and percentage of the inverted pattern in low-grade urothelial carcinomas in the pathology report might be considered as an adjunct to help long-term patient management.
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Affiliation(s)
- Sehbal Arslankoz
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
| | - İbrahim Kulaç
- Clinic of Pathology, Mardin State Hospital, Mardin, Turkey
| | - Dilek Ertoy Baydar
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
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18
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Caione P, Patruno G, Pagliarulo V, Bulotta AL, Salerno A, Diomedi Camassei F, Lastilla G, Gerocarni Nappo S. Nonmuscular Invasive Urothelial Carcinoma of the Bladder in Pediatric and Young Adult Patients: Age-related Outcomes. Urology 2017; 99:215-220. [DOI: 10.1016/j.urology.2016.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 07/05/2016] [Accepted: 07/11/2016] [Indexed: 11/26/2022]
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19
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Jermyn M, Desroches J, Aubertin K, St-Arnaud K, Madore WJ, De Montigny E, Guiot MC, Trudel D, Wilson BC, Petrecca K, Leblond F. A review of Raman spectroscopy advances with an emphasis on clinical translation challenges in oncology. Phys Med Biol 2016; 61:R370-R400. [DOI: 10.1088/0031-9155/61/23/r370] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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20
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Predictive Markers for the Recurrence of Nonmuscle Invasive Bladder Cancer Treated with Intravesical Therapy. DISEASE MARKERS 2015; 2015:857416. [PMID: 26681820 PMCID: PMC4670878 DOI: 10.1155/2015/857416] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 11/10/2015] [Indexed: 12/24/2022]
Abstract
High recurrence rate is one representative characteristic of bladder cancer. Intravesical therapy after transurethral resection is often performed in patients with nonmuscle invasive bladder cancer (NMIBC) to prevent recurrence. Bacillus Calmette-Guérin (BCG) and several anticancer/antibiotic agents, such as mitomycin C and epirubicin, are commonly used for this therapy. BCG treatment demonstrates strong anticancer effects. However, it is also characterized by a high frequency of adverse events. On the other hand, although intravesical therapies using other anticancer and antibiotic agents are relatively safe, their anticancer effects are lower than those obtained using BCG. Thus, the appropriate selection of agents for intravesical therapy is important to improve treatment outcomes and maintain the quality of life of patients with NMIBC. In this review, we discuss the predictive value of various histological and molecular markers for recurrence after intravesical therapy in patients with NMIBC.
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21
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Sha N, Xie L, Chen T, Xing C, Liu X, Zhang Y, Shen Z, Xu H, Wu Z, Hu H, Wu C. Impact of lymphovascular invasion on recurrence and progression rates in patients with pT1 urothelial carcinoma of bladder after transurethral resection. Onco Targets Ther 2015; 8:3401-6. [PMID: 26604797 PMCID: PMC4655960 DOI: 10.2147/ott.s95609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the clinical significance of lymphovascular invasion (LVI) on recurrence and progression rates in patients with pT1 urothelial carcinoma of bladder after transurethral resection. Methods This retrospective study was performed with 155 patients with newly diagnosed pT1 urothelial carcinoma of bladder who were treated with transurethral resection of bladder tumor at our institution from January 2006 to January 2010. The presence or absence of LVI was examined by pathologists. Chi-square test was performed to identify the correlations between LVI and other clinical and pathological features. Kaplan–Meier method was used to estimate the recurrence-free survival (RFS) and progression-free survival curves and difference was determined by the log-rank test. Univariate and multivariate analyses were performed to determine the predictive factors through a Cox proportional hazards analysis model. Results LVI was detected in a total of 34 patients (21.9%). While LVI was associated with high-grade tumors (P<0.001) and intravesical therapy (P=0.009). Correlations with age (P=0.227), sex (P=0.376), tumor size (P=0.969), tumor multiplicity (P=0.196), carcinoma in situ (P=0.321), and smoking (P=0.438) were not statistically significant. There was a statistically significant tendency toward higher recurrence rate and shorter RFS time in LVI-positive patients. However, no statistically significant differences were observed in progression rate between the two groups. Moreover, multivariate Cox proportional hazards analysis revealed that LVI, tumor size, and smoking were independent prognostic predictors of recurrence. The hazard ratios (95% confidence interval) were 2.042 (1.113–3.746, P=0.021), 1.817 (1.014–3.256, P=0.045), and 2.079 (1.172–3.687, P=0.012), respectively. Conclusion The presence of LVI in transurethral resection of bladder tumor specimens is significantly associated with higher recurrence rate and shorter RFS time in patients with newly diagnosed T1 urothelial carcinoma of the bladder. It is an independent prognostic predictor for disease recurrence. Thus, patients with LVI should be followed up closely.
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Affiliation(s)
- Nan Sha
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Linguo Xie
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Tao Chen
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Chen Xing
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Xiaoteng Liu
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Yu Zhang
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Zhonghua Shen
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Hao Xu
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Zhouliang Wu
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Hailong Hu
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Changli Wu
- Department of Urology, Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
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Abstract
OBJECTIVES We retrospectively evaluated characteristics of T1 high-grade bladder cancer in patients in our hospitals. PATIENTS AND METHODS Data was reviewed from 134 patients who were diagnosed with T1 high-grade bladder cancer and who underwent transurethral resection (TUR) in our hospitals between January 2006 and December 2012. The clinical course for each patient, the recurrence and progression rates, and the risk factors for recurrence and progression were evaluated. RESULTS The median follow-up was 31.5 months. A second TUR was performed in 55 patients (41.0%), and showed 32 cases of residual tumor (58.2%) and 4 cases of upstaging (7.3%). The recurrence rate was 41.5%. The risk factors for recurrence were (1) no muscle obtained in initial TUR, (2) no BCG, and (3) no second TUR. The progression rate was 10.5%; no significant risk factors were identified for progression. Within the T1 high-grade bladder cancer cohort, a total of 31 patients underwent radical cystectomy (RC). When we graphed cancer-specific survival (CSS) curves stratified by pathological T stage at the time of RC, and then compared findings from the upstage group (greater than pT2) and the non-upstage group (less than pT2), the CSS rate was significantly higher in the non-upstage group (p = 0.0027). CONCLUSION No muscle in initial TUR, no BCG, and no second TUR are factors associated with recurrence of T1 high-grade bladder cancer. Further investigation is needed for preventing recurrence and progression and for improving survival following radical cystectomy in T1 high-grade bladder cancer.
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23
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Kamat AM, Willis DL, Dickstein RJ, Anderson R, Nogueras-González G, Katz RL, Wu X, Barton Grossman H, Dinney CP. Novel fluorescence in situ hybridization-based definition of bacille Calmette-Guérin (BCG) failure for use in enhancing recruitment into clinical trials of intravesical therapies. BJU Int 2015; 117:754-60. [PMID: 26032953 DOI: 10.1111/bju.13186] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To present a molecular definition of bacille Calmette-Guérin (BCG) failure that incorporates fluorescence in situ hybridization (FISH) testing to predict BCG failure before it becomes clinically evident, which can be used to enhance trial designs for patients with non-muscle-invasive bladder cancer. PATIENTS AND METHODS We used data from 143 patients who were followed prospectively for 2 years during intravesical BCG therapy, during which time FISH assays were collected and correlated to clinical outcomes. RESULTS Of the 95 patients with no evidence of tumour at 3-month cystoscopy, 23 developed tumour recurrence and 17 developed disease progression by 2 years. Patients with a positive FISH test at both 6 weeks and 3 months were more likely to develop tumour recurrence (17/37 patients [46%] and 16/28 patients [57%], respectively) than patients with a negative FISH test (6/58 patients [10%] and 3/39 patients [8%], respectively; both P < 0.001). Using hazard ratios for recurrence with positive 6-week and 3-month FISH results, we constructed clinical trial scenarios whereby patients with a negative 3-month cystoscopy and positive FISH result could be considered to have 'molecular BCG failure' and could be enrolled in prospective, randomized clinical trials comparing BCG therapy (control) with an experimental intravesical therapy. CONCLUSIONS Patients with positive early FISH and negative 3-month cystoscopy results can be considered to have molecular BCG failure based on their high rates of recurrence and progression. This definition is intended for use in designing clinical trials, thus potentially allowing continued use of BCG as an ethical comparator arm.
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Affiliation(s)
- Ashish M Kamat
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Daniel L Willis
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rian J Dickstein
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rooselvelt Anderson
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Ruth L Katz
- Department of Cytopathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xifeng Wu
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - H Barton Grossman
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Colin P Dinney
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Satake N, Ohno Y, Nakashima J, Ohori M, Tachibana M. Prognostic value of preoperative pyuria in patients with non-muscle-invasive bladder cancer. Int J Urol 2015; 22:645-9. [PMID: 25912166 DOI: 10.1111/iju.12788] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 02/21/2015] [Accepted: 03/15/2015] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To investigate the prognostic value of preoperative pyuria in patients with non-muscle-invasive bladder cancer. METHODS We retrospectively reviewed data from 237 patients diagnosed with non-muscle-invasive bladder cancer. Pyuria was defined as urine containing ≥5 white blood cells per high power field. The association between clinicopathological factors and recurrence was assessed by Cox univariate and multivariate analyses. RESULTS Preoperative pyuria was found in 116 (49.0%) patients. Pyuria was significantly associated with advanced age, positive cytology, multiple tumors, large tumor size, non-papillary tumors, T1 tumors and high-grade tumors. In univariate analysis of the entire patient population, pyuria, positive urine cytology, multiple tumors, pT1 tumors and no bacillus Calmette-Guérin were significantly associated with recurrence. Multivariate analysis showed that pyuria was an independent predictor of recurrence (hazard ratio 3.332, 95% confidence interval 2.052-5.410; P < 0.001), along with positive urine cytology, multiple tumors and no bacillus Calmette-Guérin therapy. Subanalysis of the patients who underwent bacillus Calmette-Guérin therapy also showed that pyuria was an independent predictor of recurrence (hazard ratio 2.062, 95% confidence interval 1.085-3.918, P = 0.027). The 2-year recurrence-free survival rate for patients with pyuria was significantly lower than for patients without pyuria (65.5% vs 80.7%; P = 0.027). CONCLUSIONS Preoperative pyuria seems to be significantly associated with recurrence in patients with non-muscle-invasive bladder cancer, and it might be a useful predictor for recurrence after bacillus Calmette-Guérin therapy.
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Affiliation(s)
- Naoya Satake
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Jun Nakashima
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Human epidermal growth factor receptor 2: a significant indicator for predicting progression in non-muscle-invasive bladder cancer especially in high-risk groups. World J Urol 2015; 33:1951-7. [DOI: 10.1007/s00345-015-1557-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 04/07/2015] [Indexed: 10/23/2022] Open
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Liu S, Hou J, Zhang H, Wu Y, Hu M, Zhang L, Xu J, Na R, Jiang H, Ding Q. The evaluation of the risk factors for non-muscle invasive bladder cancer (NMIBC) recurrence after transurethral resection (TURBt) in Chinese population. PLoS One 2015; 10:e0123617. [PMID: 25849552 PMCID: PMC4388336 DOI: 10.1371/journal.pone.0123617] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 02/23/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The risk factors of bladder cancer recurrence after transurethral resection of bladder tumor (TURBt) were poorly understood, especially in Chinese population. This study evaluated the potential risk factors of recurrence based on a Chinese population. MATERIALS AND METHODS A total of 698 patients that received TURBt procedure in our institute from 2000 to 2012 were recruited in this study. Clinical information was collected. The patients were followed up according to the schedule recommended by Chinese guideline. RESULTS A total of 583 males (83.5%) and 115 females (16.5%) were enrolled in our study. The median follow-up duration was 51.5 months. Gender, chief complain, tumor size, number of lesions, histological grade and chemotherapeutic agents were found significantly associated with patients' short-term recurrence (less than 1 year) (All p<0.05). In the multivariate analysis, tumor size, number of lesions, histological grade and chemotherapeutic agents were significantly related to patients' short-term recurrence (less than 1 year) (All p<0.05). A multivariate model based on tumor size, number of lesions, histological grade and chemotherapeutic agents had an AUC of 0.697, which significantly improved the prediction utility for bladder cancer short-term recurrence (less than 1 year) than any single factor In the multivariate Cox regression, tumor size greater than 3 cm, multifocal lesions, worsen histological grade and non-urothelial carcinoma was related to time to recurrence (TR). CONCLUSION Patients with larger tumor size, multifocal number of lesions, higher tumor grade and who received chemotherapeutic agents other than Epirubicin and Pirarubicin might have higher risks of recurrence less than 1 year. Tumor size, number of lesions, pathology and histological grade might be associated with TR. As Bacille Calmette-Guerin (BCG) is currently not approved for bladder cancer in China, Epirubicin and Pirarubicin might be considered prior to other chemotherapy medications when providing post-operative instillation of chemotherapy.
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Affiliation(s)
- Shenghua Liu
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Junyao Hou
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hu Zhang
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yishuo Wu
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Mengbo Hu
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Limin Zhang
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianfeng Xu
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
- State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China
- Center for Cancer Genomics, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Rong Na
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
- * E-mail: (HWJ); (RN)
| | - Haowen Jiang
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
- * E-mail: (HWJ); (RN)
| | - Qiang Ding
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
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Miyata Y, Asai A, Mitsunari K, Matsuo T, Ohba K, Mochizuki Y, Sakai H. Met in urological cancers. Cancers (Basel) 2014; 6:2387-403. [PMID: 25521854 PMCID: PMC4276973 DOI: 10.3390/cancers6042387] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 12/03/2014] [Accepted: 12/04/2014] [Indexed: 12/18/2022] Open
Abstract
Met is a tyrosine kinase receptor that is considered to be a proto-oncogene. The hepatocyte growth factor (HGF)-Met signaling system plays an important role in tumor growth, invasion, and metastasis in many types of malignancies. Furthermore, Met expression has been reported to be a useful predictive biomarker for disease progression and patient survival in these malignancies. Many studies have focused on the clinical significance and prognostic role of Met in urological cancers, including prostate cancer (PCa), renal cell carcinoma (RCC), and urothelial cancer. Several preclinical studies and clinical trials are in progress. In this review, the current understanding of the pathological role of Met in cancer cell lines, its clinical significance in cancer tissues, and its predictive value in patients with urological cancers are summarized. In particular, Met-related malignant behavior in castration-resistant PCa and the different pathological roles Met plays in papillary RCC and other histological types of RCC are the subjects of focus. In addition, the pathological significance of phosphorylated Met in these cancers is shown. In recent years, Met has been recognized as a potential therapeutic target in various types of cancer; therapeutic strategies used by Met-targeted agents in urological cancers are summarized in this review.
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Affiliation(s)
- Yasuyoshi Miyata
- Department of Urology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
| | - Akihiro Asai
- Department of Urology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
| | - Kensuke Mitsunari
- Department of Urology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
| | - Tomohiro Matsuo
- Department of Urology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
| | - Kojiro Ohba
- Department of Urology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
| | - Yasushi Mochizuki
- Department of Urology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
| | - Hideki Sakai
- Department of Urology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
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Gou Y, Ding W, Xu K, Wang H, Chen Z, Tan J, Xia G, Ding Q. Snail is an independent prognostic indicator for predicting recurrence and progression in non-muscle-invasive bladder cancer. Int Urol Nephrol 2014; 47:289-93. [PMID: 25388353 DOI: 10.1007/s11255-014-0874-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 10/29/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Snail, an inducer of the epithelial-to-mesenchymal transition, increases motility and invasiveness of cancer cells by repressing E-cadherin expression. We investigate the relationship between Snail expression and clinicopathological parameters and evaluate its prognostic significance in patients with non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS A total of 332 patients treated with transurethral resection of the bladder tumor between October 2002 and July 2010 were histopathologically confirmed to be NMIBC. Tumor recurrence and progression were followed up in all patients. Immunohistochemical staining of 332 slices was performed. The expression of Snail was evaluated by ICH and graded for intensity and area of staining. We correlated Snail scores with clinical and pathological variables, and association of Snail staining with tumor recurrence and progression was evaluated by univariate, multivariate analysis and Kaplan-Meier survival curves. RESULTS Of 332 patients with NMIBC, there was Snail positivity in 104 tumors (31.3 %), and Snail expression correlated with age, multifocality, carcinoma in situ, tumor stage and tumor grade (each p < 0.05, respectively). A multivariate Cox regression model revealed that Snail expression was an independent predictor of tumor recurrence [hazard ratio (HR) 1.95, p = 0.001] and progression (HR 2.34, p = 0.014) in patients with NMIBC. Kaplan-Meier estimates showed that Snail expression was significantly associated with recurrence and progression (log-rank test, p < 0.0001, respectively). CONCLUSIONS Analysis of Snail expression in 332 NMIBC tissue specimens revealed its potential usefulness as a biomarker to predict the NMIBC prognosis.
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Affiliation(s)
- Yuancheng Gou
- Department of Urology, Huashan Hospital Affiliated to Fudan University, No.12 Middle Urumqi Road, Shanghai, 200040, China
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Ding W, Gou Y, Sun C, Xia G, Wang H, Chen Z, Tan J, Xu K, Qiang D. Ki-67 is an independent indicator in non-muscle invasive bladder cancer (NMIBC); combination of EORTC risk scores and Ki-67 expression could improve the risk stratification of NMIBC. Urol Oncol 2014; 32:42.e13-9. [PMID: 24360660 DOI: 10.1016/j.urolonc.2013.05.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 05/05/2013] [Accepted: 05/09/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To prove the predicting role of Ki-67 expression and to demonstrate that the combination of European Organization for Research and Treatment of Cancer (EORTC) risk scores and Ki-67 staining status could improve the risk stratification in a large series of patients with non-muscle invasive bladder cancer (NMIBC). MATERIAL AND METHODS From October 2002 to July 2010, in our cohort, 332 patients who were treated with transurethral resection of the bladder tumor were diagnosed with NMIBC by histopathologic analysis. Two experienced uropathologists rereviewed the slides. The EORTC risk scores for recurrence and progression were determined. Ki-67 expression was evaluated using immunohistochemical studies and scored for intensity and area of staining. We correlated Ki-67 expression scores with clinical and pathologic variables. We evaluated the prognosis role of EORTC risk scores, Ki-67 staining, and their combination on tumor recurrence-free survival and progression-free survival (PFS) by univariate analysis, multivariate analysis, and Kaplan-Meier survival curves. RESULTS With a median follow-up of 47 (range, 2-124) months, 119 patients (35.8%) had tumor recurrence and 40 patients (12%) had tumor progression. Ki-67 positivity (Ki-67>25%) was reported in 108 tumors (32.5%), and it was significantly associated with high EORTC risk scores for both tumor recurrence and progression. In univariate analysis, multifocality, tumor size, tumor stage, tumor grade, and Ki-67 staining correlated with recurrence-free survival, whereas tumor size, tumor stage, tumor grade, concomitant CIS, and Ki-67 staining correlated with PFS. In multivariable analysis, Ki-67 expression was an independent risk factor for predicting tumor recurrence (hazard ratio, 2.14; P<0.0001) and progression (hazard ratio: 2.97, P = 0.004). Kaplan-Meier curves showed that combining EORTC risk scores and Ki-67 staining led to more accurate prediction for tumor recurrence and progression (log-rank test; P<0.0001). CONCLUSIONS Ki-67 positivity is prognostic for predicting tumor recurrence and progression. Combination of EORTC risk scores with Ki-67 expression could improve the risk stratification for both recurrence and progression in NMIBC.
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Affiliation(s)
- Weihong Ding
- Department of Urology, Fudan University, Shanghai, China
| | - Yuancheng Gou
- Department of Urology, Fudan University, Shanghai, China
| | - Chuanyu Sun
- Department of Urology, Fudan University, Shanghai, China
| | - Guowei Xia
- Department of Urology, Fudan University, Shanghai, China
| | - Hong Wang
- Department of Urology, Fudan University, Shanghai, China
| | - Zhongqing Chen
- Department of Urology, Fudan University, Shanghai, China
| | - Jun Tan
- Department of Urology, Fudan University, Shanghai, China
| | - Ke Xu
- Department of Urology, Fudan University, Shanghai, China.
| | - Ding Qiang
- Department of Urology, Fudan University, Shanghai, China
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Animal model of naturally occurring bladder cancer: characterization of four new canine transitional cell carcinoma cell lines. BMC Cancer 2014; 14:465. [PMID: 24964787 PMCID: PMC4082678 DOI: 10.1186/1471-2407-14-465] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 06/11/2014] [Indexed: 12/22/2022] Open
Abstract
Background Development and further characterization of animal models for human cancers is important for the improvement of cancer detection and therapy. Canine bladder cancer closely resembles human bladder cancer in many aspects. In this study, we isolated and characterized four primary transitional cell carcinoma (K9TCC) cell lines to be used for future in vitro validation of novel therapeutic agents for bladder cancer. Methods Four K9TCC cell lines were established from naturally-occurring canine bladder cancers obtained from four dogs. Cell proliferation rates of K9TCC cells in vitro were characterized by doubling time. The expression profile of cell-cycle proteins, cytokeratin, E-cadherin, COX-2, PDGFR, VEGFR, and EGFR were evaluated by immunocytochemistry (ICC) and Western blotting (WB) analysis and compared with established human bladder TCC cell lines, T24 and UMUC-3. All tested K9TCC cell lines were assessed for tumorigenic behavior using athymic mice in vivo. Results Four established K9TCC cell lines: K9TCC#1Lillie, K9TCC#2Dakota, K9TCC#4Molly, and K9TCC#5Lilly were confirmed to have an epithelial-cell origin by morphology analysis, cytokeratin, and E-cadherin expressions. The tested K9TCC cells expressed UPIa (a specific marker of the urothelial cells), COX-2, PDGFR, and EGFR; however they lacked the expression of VEGFR. All tested K9TCC cell lines confirmed a tumorigenic behavior in athymic mice with 100% tumor incidence. Conclusions The established K9TCC cell lines (K9TCC#1Lillie, K9TCC#2Dakota, K9TCC#4Molly, and K9TCC#5Lilly) can be further utilized to assist in development of new target-specific imaging and therapeutic agents for canine and human bladder cancer.
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Lodde M, Mian C, Mayr R, Comploj E, Trenti E, Melotti R, Campodonico F, Maffezzini M, Fritsche HM, Pycha A. Recurrence and progression in patients with non-muscle invasive bladder cancer: Prognostic models including multicolor fluorescencein situhybridization molecular grading. Int J Urol 2014; 21:968-72. [DOI: 10.1111/iju.12509] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 04/22/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Michele Lodde
- Department of Urology; General Hospital of Bolzano; Bolzano Italy
| | - Christine Mian
- Department of Pathology; General Hospital of Bolzano; Bolzano Italy
| | - Roman Mayr
- Department of Urology; General Hospital of Bolzano; Bolzano Italy
| | - Evi Comploj
- Department of Urology; General Hospital of Bolzano; Bolzano Italy
| | - Emanuela Trenti
- Department of Urology; General Hospital of Bolzano; Bolzano Italy
| | - Roberto Melotti
- Center for Biomedicine; European Academy of Bolzano; Bolzano Italy
| | | | | | | | - Armin Pycha
- Department of Urology; General Hospital of Bolzano; Bolzano Italy
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Kwon T, Jeong IG, You D, Hong B, Hong JH, Ahn H, Kim CS. Long-term oncologic outcomes after radical cystectomy for bladder cancer at a single institution. J Korean Med Sci 2014; 29:669-75. [PMID: 24851023 PMCID: PMC4024950 DOI: 10.3346/jkms.2014.29.5.669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 03/03/2014] [Indexed: 12/03/2022] Open
Abstract
The aim of this study was to evaluate our experience using radical cystectomy to treat patients with bladder cancer and to describe the associations between pathologic features and clinical outcomes. All 701 patients who underwent radical cystectomy for bladder cancer were evaluated. The patient population consisted of 623 men and 78 women. The overall 5 and 10 yr recurrence-free survival (RFS) rates were 61.8% and 57.7%, respectively, and the 5 and 10 yr cancer-specific survival (CSS) rates were 70.8% and 65.1%, respectively. Multivariate analysis showed that factors significantly predictive of RFS and CSS included extravesical extension (P = 0.001), lymph node metastasis (P = 0.001), and lymphovascular invasion (P < 0.001 and P = 0.007). The 5 and 10 yr RFS rates for patients with lymph node metastasis were 25.6% and 20.8%, respectively, and the 5 and 10 yr CSS rates were 38.6% and 30.9%, respectively. Adjuvant chemotherapy significantly improved RFS (P = 0.002) and CSS (P = 0.001) in patients with lymph node metastasis. Radical cystectomy provides good survival results in patients with invasive bladder cancer. Pathologic features significantly associated with prognosis include extravesical extension, node metastasis, and lymphovascular invasion. Adjuvant chemotherapy improves survival in patients with advanced stage disease.
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Affiliation(s)
- Taekmin Kwon
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - In Gab Jeong
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Dalsan You
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Bumsik Hong
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jun Hyuk Hong
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hanjong Ahn
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Choung-Soo Kim
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Ding W, Chen Z, Gou Y, Sun C, Xu K, Tan J, Tong S, Xia G, Ding Q. Are EORTC risk tables suitable for Chinese patients with non-muscle-invasive bladder cancer? Cancer Epidemiol 2014; 38:157-61. [DOI: 10.1016/j.canep.2014.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 01/27/2014] [Accepted: 02/05/2014] [Indexed: 01/22/2023]
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Kausch I, Doehn C, Jocham D. Recent improvements in the detection and treatment of nonmuscle-invasive bladder cancer. Expert Rev Anticancer Ther 2014; 6:1301-11. [PMID: 17020462 DOI: 10.1586/14737140.6.9.1301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In total, 70-80% of newly diagnosed bladder cancers are confined to the mucosa and staged as Ta, T1 or carcinoma in situ according to the 2002 tumor, lymph nodes and metastasis classification. The standard treatment for these nonmuscle-invasive bladder cancers is transurethral tumor resection with or without adjuvant intravesical chemotherapy or intravesical immunotherapy and subsequent follow-up. Diagnosis and follow-up of nonmuscle-invasive bladder cancer offers two main problems. First, approximately 10-20% of all tumors are not seen in standard cystoscopy. Additionally, frequently repeated follow-up cystoscopies are bothersome for the patient. As an adjunct to standard cystoscopy, fluorescence-guided cystoscopy has demonstrated significantly higher tumor detection rates and optimized patient treatment in recent Phase III studies. Second, routinely performed urine cytology is characterized by high specificity but low sensitivity. Today, several urine tests are available that may increase diagnostic accuracy and potentially prolong intervals of follow-up cystocopy. Owing to rather high recurrence rates after transurethral tumor resection in most tumors and high progression rates in poorly differentiated tumors, adjuvant intravesical chemotherapy or intravesical immunotherapy has gained widespread use in patients with nonmuscle-invasive bladder cancer. Only a few further immunomodulatory drugs, such as recombinant cytokines, have shown significant clinical effectiveness. Additional approaches, such as photodynamic therapy with different photosensitizers and thermotherapy in combination with intravesical chemotherapy, have been evaluated in Phase III studies.
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Affiliation(s)
- Ingo Kausch
- Department of Urology, University of Lubeck Medical School, Ratzeburger Allee 160, 23538 Lubeck, Germany.
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Ogata DC, Marcondes CAPR, Tuon FF, Busato WFS, Cavalli G, Czeczko LEA. Superficial papillary urothelial neoplasms of the bladder (PTA E PT1): correlation of expression of P53, KI-67 and CK20 with histologic grade, recurrence and tumor progression. Rev Col Bras Cir 2013; 39:394-400. [PMID: 23174791 DOI: 10.1590/s0100-69912012000500010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 07/05/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the immunohistochemical expressions of p53, ki67, CK20 in superficial papillary urothelial neoplasms of the bladder and correlate them with histological grade, tumor progression and recurrence. METHODS We selected samples of 43 patients with superficial transitional cell carcinoma of the bladder. They were divided into two groups, one called Recurrent (R), with 18 individuals, and other Non-Recurrent (NR), with 25. Multi-sampling blocks were prepared. The immunohistochemical technique employed was immunoperoxidase, and the antibodies were: p53: Novocastra (clone DO7) at a dilution of 1/100; Ki67: Spring (clone SP6) at a dilution of 1/100; and CK20: Dako (clone K20 .8) at a dilution of 1/50. RESULTS The expression of p53 was observed in 11 cases, six in the Recurrent group and five in the Non-Recurrent, all high-grade tumors (p = 0.0001). The histological progression occurred in six patients (p = 0.0076). Of the 18 Recurrent cases, six showed immunoreactivity for p53 and 12 were negative for this antibody (p = 0.1715). Ki67 was positive in 17 of the 18 cases from the Recurrent group (p = 0.0001) and, from 20 high-grade tumors, 18 showed reaction to this antibody (p = 0.0001). Of the 18 individuals who had recurrence, 13 showed anomalous expression for CK20 (p = 0.0166). In high-grade carcinomas, of the 20 cases, 16 showed anomalous expression for this antibody, while 18 of the 23 patients with low-grade tumors showed normal expression for CK20 (p = 0.0002). CONCLUSION The p53 showed good correlation with histological progression and histologic grade. Ki67 was strongly associated with recurrence and histological grade, and CK20 was also associated with these variables.
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Affiliation(s)
- Daniel Cury Ogata
- Medical Research Institute, Evangelical Faculty of Paraná / EvangelicalUniversity Hospital of Curitiba, Brazil.
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Utility of Quantitative MRI Metrics for Assessment of Stage and Grade of Urothelial Carcinoma of the Bladder: Preliminary Results. AJR Am J Roentgenol 2013; 201:1254-9. [DOI: 10.2214/ajr.12.10348] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Gladkova N, Kiseleva E, Streltsova O, Prodanets N, Snopova L, Karabut M, Gubarkova E, Zagaynova E. Combined use of fluorescence cystoscopy and cross-polarization OCT for diagnosis of bladder cancer and correlation with immunohistochemical markers. JOURNAL OF BIOPHOTONICS 2013; 6:687-98. [PMID: 23420564 DOI: 10.1002/jbio.201200105] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 10/10/2012] [Accepted: 10/11/2012] [Indexed: 05/15/2023]
Abstract
The combined use of fluorescence cystoscopy and cross-polarization optical coherence tomography (CP OCT) with quantitative estimation of the OCT signal was assessed in 92 bladder zones. It demonstrated the diagnostic accuracy in detecting superficial bladder cancer of 93.6%, sensitivity 96.4%, specificity 92.1%, positive predictive value 87% and negative predictive value 97.9%. Quantitative estimation of OCT signal standard deviation in cross-polarization (CP OCT SD index) makes the visual criteria of CP OCT image assessment more objective. The level of CP OCT SD index for diagnosing superficial bladder cancer, including cancer in situ, was 4.32 dB and lower. When tumor is located on a postoperative scar, CP OCT SD index may be higher than the threshold level of 4.32 dB due to strong scattering and depolarization in scar fibrous tissue. A high inverse correlation was found between CP OCT SD index and the level expressed by p63, Ki-67, p53, CD44v6 markers.
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Besaratinia A, Cockburn M, Tommasi S. Alterations of DNA methylome in human bladder cancer. Epigenetics 2013; 8:1013-22. [PMID: 23975266 DOI: 10.4161/epi.25927] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Bladder cancer is the fourth most common cancer in men in the United States, and its recurrence rate is highest among all malignancies. The unmet need for improved strategies for early detection, treatment, and monitoring of the progression of this disease continues to translate into high mortality and morbidity. The quest for advanced diagnostic, therapeutic, and prognostic approaches for bladder cancer is a high priority, which can be achieved by understanding the molecular mechanisms of the initiation and progression of this malignancy. Aberrant DNA methylation in single or multiple cancer-related genes/loci has been found in human bladder tumors and cancer cell lines, and urine sediments, and correlated with many clinicopathological features of this disease, including tumor relapse, muscle-invasiveness, and survival. The present review summarizes the published research on aberrant DNA methylation in connection with human bladder cancer. Representative studies are highlighted to set forth the current state of knowledge, gaps in the knowledgebase, and future directions in this prime epigenetic field of research. Identifying the potentially reversible and 'drugable' aberrant DNA methylation events that initiate and promote bladder cancer development can highlight biological markers for early diagnosis, effective therapy and accurate prognosis of this malignancy.
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Affiliation(s)
- Ahmad Besaratinia
- Department of Preventive Medicine; Keck School of Medicine of USC; University of Southern California; Los Angeles, CA USA
| | - Myles Cockburn
- Department of Preventive Medicine; Keck School of Medicine of USC; University of Southern California; Los Angeles, CA USA
| | - Stella Tommasi
- Department of Preventive Medicine; Keck School of Medicine of USC; University of Southern California; Los Angeles, CA USA
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Ayari C, LaRue H, Hovington H, Caron A, Bergeron A, Têtu B, Fradet V, Fradet Y. High level of mature tumor-infiltrating dendritic cells predicts progression to muscle invasion in bladder cancer. Hum Pathol 2013; 44:1630-7. [DOI: 10.1016/j.humpath.2013.01.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 01/14/2013] [Accepted: 01/16/2013] [Indexed: 12/31/2022]
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Azuma T, Nagase Y, Oshi M. Pyuria predicts poor prognosis in patients with non-muscle-invasive bladder cancer. Clin Genitourin Cancer 2013; 11:331-6. [PMID: 23664207 DOI: 10.1016/j.clgc.2013.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Revised: 12/31/2012] [Accepted: 04/02/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND To evaluate the significance of inflammation in non-muscle-invasive bladder cancer (NMIBC), we assessed the presence of pyuria at time of diagnosis. PATIENTS AND METHODS A cohort of 805 patients with newly diagnosed NMIBC between 1994 and 2007 at the Tokyo Metropolitan Tama Medical Center were enrolled in this retrospective study. Pyuria was defined as urine containing ≥ 10 white blood cells (WBCs) per high power field (HPF). RESULTS One hundred ninety-nine (24%) of the patients with NMIBC had pyuria. The 3-year recurrence-free survival rates of patients with and without pyuria were 10.9 vs. 45.0%, respectively. The 5-year progression-free survival rates of patients with and without pyuria were 72.3% and 95.7%, respectively. Multivariate Cox proportional hazards regression models indicated that pyuria was an independent predictor of disease recurrence and progression. After dividing the sample according to the European Organization for Research and Treatment of Cancer (EORTC) risk tables, we further classified patients into subgroups according to the presence of pyuria. The recurrence-free survival rates were higher in the pyuria-negative subgroups of the low, intermediate-low, intermediate-high, and high risk for recurrence groups. Similarly, the progression-free survival rates at 5 years were higher in the pyuria-negative subgroups of the low, intermediate-low, and intermediate-high risk for progression groups. CONCLUSION Patients with inflammatory NMIBC exhibited poor clinical outcomes.
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Affiliation(s)
- Takeshi Azuma
- Department of Urology, Tokyo Metropolitan Tama Medical Center, 2-9-2 Musashi-dai, Fuchu, Tokyo, Japan.
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Kandimalla R, van Tilborg AA, Zwarthoff EC. DNA methylation-based biomarkers in bladder cancer. Nat Rev Urol 2013; 10:327-35. [DOI: 10.1038/nrurol.2013.89] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Ali-El-Dein B, Sooriakumaran P, Trinh QD, Barakat TS, Nabeeh A, Ibrahiem EHI. Construction of predictive models for recurrence and progression in >1000 patients with non-muscle-invasive bladder cancer (NMIBC) from a single centre. BJU Int 2013; 111:E331-41. [DOI: 10.1111/bju.12026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Tamer S. Barakat
- Urology and Nephrology Centre; Mansoura University; Mansoura; Egypt
| | - Adel Nabeeh
- Urology and Nephrology Centre; Mansoura University; Mansoura; Egypt
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Jackson J, Barkan GA, Kapur U, Wojcik EM. Cytologic and cystoscopic predictors of recurrence and progression in patients with low-grade urothelial carcinoma. Cancer Cytopathol 2013; 121:398-402. [DOI: 10.1002/cncy.21272] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 11/20/2012] [Accepted: 11/20/2012] [Indexed: 11/12/2022]
Affiliation(s)
- Julie Jackson
- Department of Pathology; Loyola University Medical Center; Maywood Illinois
| | - Güliz A. Barkan
- Department of Pathology; Loyola University Medical Center; Maywood Illinois
| | - Umesh Kapur
- Department of Pathology; Loyola University Medical Center; Maywood Illinois
| | - Eva M. Wojcik
- Department of Pathology; Loyola University Medical Center; Maywood Illinois
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Houghton BB, Chalasani V, Hayne D, Grimison P, Brown CSB, Patel MI, Davis ID, Stockler MR. Intravesical chemotherapy plus bacille Calmette-Guérin in non-muscle invasive bladder cancer: a systematic review with meta-analysis. BJU Int 2012; 111:977-83. [DOI: 10.1111/j.1464-410x.2012.11390.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Baerin B. Houghton
- National Health and Medical Research Council Clinical Trials Centre; University of Sydney; Sydney NSW Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group Ltd; Sydney NSW Australia
| | - Venu Chalasani
- National Health and Medical Research Council Clinical Trials Centre; University of Sydney; Sydney NSW Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group Ltd; Sydney NSW Australia
- Northern Sydney Local Health District; Sydney NSW Australia
| | - Dickon Hayne
- School of Surgery; University of Western Australia; Perth WA Australia
| | | | - Christopher S. B. Brown
- National Health and Medical Research Council Clinical Trials Centre; University of Sydney; Sydney NSW Australia
| | - Manish I. Patel
- Urological Cancers Outcomes Centre; University of Sydney; Sydney NSW Australia
| | - Ian D. Davis
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group Ltd; Sydney NSW Australia
- Monash University; Melbourne Vic. Australia
| | - Martin R. Stockler
- National Health and Medical Research Council Clinical Trials Centre; University of Sydney; Sydney NSW Australia
- Sydney Cancer Centre; Sydney NSW Australia
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Abstract
The determination of prognosis in bladder cancer is currently based on staging methods that rely primarily on the pathological stage of a tumor with limited objective correlates. The development and progression of bladder cancer involve alterations in several cellular pathways. Dysregulation in markers associated with cell-cycle regulation has been the most extensively examined molecular aberration in this cancer. Individual alterations of these markers have been associated with disease outcome, with several observations suggesting that their prognostic potential is independent of pathological stage. While many individual molecules in the cell growth receptor signaling, p53, and retinoblastoma (Rb) pathways have been identified, there is a general lack of consensus on which markers can be adopted in the clinical setting. More recent studies have suggested that the combination of markers as concise panels may be more beneficial in determining the degree of aggressiveness of a given tumor and its impending outcome than individual markers alone. This review will discuss alterations in molecules within pathways controlling cell-cycle regulation in the context of bladder cancer, and their impact on patient outcome when examined individually and in combination.
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Affiliation(s)
- Anirban P Mitra
- Department of Pathology and Center for Personalized Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
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Olsson H, Hultman P, Monsef N, Rosell J, Jahnson S. Immunohistochemical evaluation of cell cycle regulators: impact on predicting prognosis in stage t1 urinary bladder cancer. ISRN UROLOGY 2012; 2012:379081. [PMID: 23304558 PMCID: PMC3523551 DOI: 10.5402/2012/379081] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 10/17/2012] [Indexed: 12/20/2022]
Abstract
Background and Objective. The cell cycle is regulated by proteins at different checkpoints, and dysregulation of this cycle plays a role in carcinogenesis. Matrix metalloproteinases (MMPs) are enzymes that degrade collagen and promote tumour infiltration. The aim of this study was to evaluate the expression of various cell cycle regulators and MMPs and to correlate such expression with progression and recurrence in patients with stage T1 urothelial carcinoma of the bladder (UCB). Patients and Methods. This population-based cohort study comprised 201 well-characterized patients with primary stage T1 urothelial carcinoma of the bladder. Immunohistochemistry was performed on formalin-fixed material to quantify expression of cell cycle regulators and two MMPs. Results. Normal expression of p53 and abnormal expression of MMP9 were associated with greater risk of tumour recurrence. Also, normal p16 expression was related to a lower risk of tumour progression. MMP2, p21, cyclin D1, and pRb showed no significant results that could estimate progression or recurrence. Conclusions. Normal p16 expression is associated with a lower risk of tumour progression, but immunohistochemistry on cell cycle regulators and MMPs has little value in predicting the prognosis in stage T1 UCB.
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Affiliation(s)
- Hans Olsson
- Molecular and Immunological Pathology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Department of Clinical Pathology and Clinical Genetics, County Council of Östergötland, 581 85 Linköping, Sweden
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Lyle SR, Hsieh CC, Fernandez CA, Shuber AP. Molecular grading of tumors of the upper urothelial tract using FGFR3 mutation status identifies patients with favorable prognosis. Res Rep Urol 2012; 4:65-9. [PMID: 24199183 PMCID: PMC3806446 DOI: 10.2147/rru.s37355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Mutations in FGFR3 have been shown to occur in tumors of the upper urothelial tract and may be indicative of a good prognosis. In bladder tumors, the combination of FGFR3 mutation status and Ki-67 level has been used to define a tumor’s molecular grade and predict survival. Pathological evaluation of upper urothelial tumors is currently the best predictor of prognosis, but suffers from variability in pathological assessments. This study investigated the association with prognosis of FGFR3 mutations alone and in combination with Ki-67 in this patient population. Methods Genomic DNA was isolated from tumor samples of 80 patients with upper urothelial cancer. The presence of mutation in FGFR3 was evaluated using real-time polymerase chain reaction. Ki-67 protein expression was determined by immunohistochemistry. Kaplan–Meier survival analysis evaluated the relationship of FGFR3 mutations and Ki-67 levels with survival. Results FGFR3 mutations were identified in 40% of tumors and were predominantly associated with noninvasive tumors. Overall survival was higher in patients with FGFR3 mutant tumors (P = 0.02) and in molecular grade 1 tumors as determined by FGFR3 and Ki-67 (P = 0.02). Conclusion In this study, we confirm the occurrence of FGFR3 mutations in tumors of the upper urothelial tract and its association with a good prognosis. Both FGFR3 and molecular grading are predictors of overall survival. Molecular grading can help to assess the prognosis of patients with upper urinary tract cancer and may represent a new tool for managing this population of patients.
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Sapre N, Bugeja P, Hayes E, Corcoran NM, Costello A, Anderson PD. Nurse-led flexible cystoscopy in Australia: initial experience and early results. BJU Int 2012. [DOI: 10.1111/j.1464-410x.2012.11472.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The 1973 WHO Classification is more suitable than the 2004 WHO Classification for predicting prognosis in non-muscle-invasive bladder cancer. PLoS One 2012; 7:e47199. [PMID: 23082147 PMCID: PMC3474808 DOI: 10.1371/journal.pone.0047199] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 09/10/2012] [Indexed: 12/04/2022] Open
Abstract
Background Predicting the recurrence and progression of Non-muscle-invasive bladder cancer(NMIBC) is critical for urologist. Histological grade provides significant prognostic information, especially for prediction of progression. Currently, the 1973 and the 2004 WHO classification co-exist. Which system is better for predicting rumor recurrence and progression still a matter for debate. Methodology/Principal Findings 348 patients diagnosed with Non-muscle invasive bladder cancer were enrolled in our retrospective study. Paraffin sections were assessed by an experienced urological pathologist according to both the 1973 and 2004 WHO classifications. Tumor recurrence and progression was followed-up in all patients. During follow-up, corresponding 5-year recurrence-free survival rates of G1, G2 and G3 were 82.1%, 55.9%, 32.1% and the 5-year progression-free survival rates were 95.9%, 84.4% and 43.3%, respectively. The 5-year recurrence-free survival rates of papillary urothelial neoplasm of low malignant potential (PUNLMP), low-grade papillary urothelial carcinoma(LGPUC) and high-grade papillary urothelial carcinoma (HGPUC) were 69.8%, 67.1% and 42.0% respectively and the 5-year progression-free survival rates were 100%, 90.9% and 54.8% respectively. In multivariate analysis, the 1973 WHO classification significantly associated with both tumor recurrence and progression(p = 0.010 and p = 0.022, respectively); the 2004 WHO classification correlated with tumor progression(p = 0.019), while was not proved to be a variable that can predict the risk of recurrence(p = 0.547). Kaplan-Meier plots showed that both the 1973 WHO and the 2004 WHO classifications were significantly associated with progression-free survival (p<0.0001, log-rank test). For prediction of recurrence, significant differences were observed between the tumor grades classified using the 1973 WHO grading system (p<0.0001, log-rank test), while a significant overlap was observed between PUNLMP and LG plots using the 2004 WHO grading system(p = 0.616, log-rank test). Conclusion/Significance Both the 1973 WHO and the 2004 WHO Classifications are effective in predicting tumor progression in Non-muscle invasive bladder cancer, while the 1973 WHO Classification is more suitable for predicting tumor recurrence.
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