1
|
Sankin A, Dave P, Cherrill LR, Boucher RH, Zeegers MP, Cheng KK, James ND, Agalliu I, Bryan RT. Low-grade Urothelial Carcinoma Recurs at a Tempo that Naturally Accelerates Over Time. Urology 2024:S0090-4295(24)00572-7. [PMID: 39029806 DOI: 10.1016/j.urology.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/04/2024] [Accepted: 07/09/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE To investigate the cadence of recurrence in patients with low grade intermediate-risk non-muscle invasive bladder cancer (LG IR-NMIBC) based on clinical determinants. We aim to describe patterns in rates of recurrence to better inform surveillance regimens for this chronic, burdensome, and costly disease. METHODS Using baseline and follow-up data from participants in the West Midlands' (United Kingdom, UK) Bladder Cancer Prognosis Programme (BCPP), we assessed overall recurrence rate and recurrence-free intervals throughout the follow-up period for IR-NMIBC participants. Recurrence-free intervals were calculated using the Kaplan-Meier method. RESULTS We identified 379 patients with G1/G2 pTa tumors classified as intermediate risk. Median age was 70 and 284/379 (75%) were male. The median follow-up time was 4.2 years (95% CI: 3.9-4.8). After 5 years of follow-up, 53% of patients had at least one recurrence. One-year recurrence-free survival (RFS) was 75% and 4-year RFS was 50%. The median time to or between 1st, 2nd, 3rd, 4th, and 5th sequential recurrences was 49, 19, 12, 14, and 10 months, respectively. CONCLUSION Over half of patients with IR-NMIBC are destined to recur. Our data suggest that a subset of patients experience acceleration of recurrence over time and that this acceleration may serve as a potential kinetic biomarker for these individuals that could inform surveillance intervals and future treatment strategies.
Collapse
Affiliation(s)
- Alex Sankin
- Department of Urology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY.
| | - Priya Dave
- Department of Urology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY
| | - Louise-Rae Cherrill
- Cancer Research United Kingdom Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England, UK
| | - Rebecca H Boucher
- Cancer Research United Kingdom Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England, UK
| | - Maurice P Zeegers
- Maastricht University, Schools of NUTRIM and CAPHRI, Department of Epidemiology, Maastricht, the Netherlands
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, England, UK
| | | | - Ilir Agalliu
- Department of Urology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Richard T Bryan
- Bladder Cancer Research Centre, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England, UK
| |
Collapse
|
2
|
An HW, Hou DY, Yang J, Wang ZQ, Wang MD, Zheng R, Zhang NY, Hu XJ, Wang ZJ, Wang L, Liu D, Hao JF, Xu W, Zhao Y, Wang H. A bispecific glycopeptide spatiotemporally regulates tumor microenvironment for inhibiting bladder cancer recurrence. SCIENCE ADVANCES 2023; 9:eabq8225. [PMID: 36857458 PMCID: PMC9977173 DOI: 10.1126/sciadv.abq8225] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Up to 75% of bladder cancer patients suffer from recurrence due to postoperative tumor implantation. However, clinically used Bacillus Calmette-Guerin (BCG) treatment failed to inhibit the recurrence. Here, we report a bispecific glycopeptide (bsGP) that simultaneously targets CD206 on tumor-associated macrophages (TAMs) and CXCR4 on tumor cells. bsGP repolarizes protumoral M2-like TAMs to antitumor M1-like that mediated cytotoxicity and T cell recruitment. Meanwhile, bsGP is cleaved by the MMP-2 enzyme to form nanostructure for the long-term inhibition of CXCR4 downstream signaling, resulting in reduced tumor metastasis and promoted T cell infiltration. In orthotopic bladder tumor models, bsGP reduced the postoperative recurrence rate to 22%. In parallel, the recurrence rates of 89 and 78% were treated by doxycycline and BCG used in clinic, respectively. Mechanistic studies reveal that bsGP reduces the matrix microenvironment barrier, increasing the spatially redirected CD8+ T cells to tumor cells. We envision that bis-targeting CD206 and CXCR4 may pave the way to inhibit tumor metastasis and recurrence.
Collapse
Affiliation(s)
- Hong-Wei An
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Da-Yong Hou
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing 100190, China
- Department of Urology, The Fourth Hospital of Harbin Medical University, Heilongjiang Key Laboratory of Scientific Research in Urology, Harbin 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin 150001, China
| | - Jia Yang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zi-Qi Wang
- Department of Urology, The Fourth Hospital of Harbin Medical University, Heilongjiang Key Laboratory of Scientific Research in Urology, Harbin 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin 150001, China
| | - Man-Di Wang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Rui Zheng
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Ni-Yuan Zhang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xing-Jie Hu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing 100190, China
| | - Zhi-Jia Wang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing 100190, China
- Department of Urology, The Fourth Hospital of Harbin Medical University, Heilongjiang Key Laboratory of Scientific Research in Urology, Harbin 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin 150001, China
| | - Lu Wang
- Department of Urology, The Fourth Hospital of Harbin Medical University, Heilongjiang Key Laboratory of Scientific Research in Urology, Harbin 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin 150001, China
| | - Di Liu
- Core Facility for Protein Research, Institute of Boiphysics, Chinese Academy of Science, Beijing, China
| | - Jun-Feng Hao
- Core Facility for Protein Research, Institute of Boiphysics, Chinese Academy of Science, Beijing, China
| | - Wanhai Xu
- Department of Urology, The Fourth Hospital of Harbin Medical University, Heilongjiang Key Laboratory of Scientific Research in Urology, Harbin 150001, China
- NHC Key Laboratory of Molecular Probes and Targeted Diagnosis and Therapy, Harbin Medical University, Harbin 150001, China
| | - Yuliang Zhao
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
- Core Facility for Protein Research, Institute of Boiphysics, Chinese Academy of Science, Beijing, China
| | - Hao Wang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology (NCNST), Beijing 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| |
Collapse
|
3
|
Roslan A, Sulaiman N, Mohd Ghani KA, Nurdin A. Cancer-Associated Membrane Protein as Targeted Therapy for Bladder Cancer. Pharmaceutics 2022; 14:pharmaceutics14102218. [PMID: 36297654 PMCID: PMC9607037 DOI: 10.3390/pharmaceutics14102218] [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: 08/15/2022] [Revised: 09/23/2022] [Accepted: 10/11/2022] [Indexed: 12/24/2022] Open
Abstract
Bladder cancer (BC) recurrence is one of the primary clinical problems encountered by patients following chemotherapy. However, the mechanisms underlying their resistance to chemotherapy remain unclear. Alteration in the pattern of membrane proteins (MPs) is thought to be associated with this recurrence outcome, often leading to cell dysfunction. Since MPs are found throughout the cell membrane, they have become the focus of attention for cancer diagnosis and treatment. Identifying specific and sensitive biomarkers for BC, therefore, requires a major collaborative effort. This review describes studies on membrane proteins as potential biomarkers to facilitate personalised medicine. It aims to introduce and discuss the types and significant functions of membrane proteins as potential biomarkers for future medicine. Other types of biomarkers such as DNA-, RNA- or metabolite-based biomarkers are not included in this review, but the focus is mainly on cell membrane surface protein-based biomarkers.
Collapse
Affiliation(s)
- Adlina Roslan
- Laboratory of UPM-MAKNA Cancer Research (CANRES), Institute of Bioscience, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Nurshahira Sulaiman
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Khairul Asri Mohd Ghani
- Department of Urology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Armania Nurdin
- Laboratory of UPM-MAKNA Cancer Research (CANRES), Institute of Bioscience, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Correspondence: ; Tel.: +603-8609-2971
| |
Collapse
|
4
|
Huang H, Zhang W. Bufalin induced apoptosis of bladder carcinoma cells through the inactivation of Na+K+-ATPase. Oncol Lett 2018; 16:3826-3832. [PMID: 30127995 PMCID: PMC6096233 DOI: 10.3892/ol.2018.9142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/20/2018] [Indexed: 12/30/2022] Open
Abstract
Bufalin has been demonstrated to possess a wide range of pharmacological effects. Among these is its antitumour effect, which has been confirmed in multiple organs or tissues and provoked many concerns. However, its cytostatic effect and underlying mechanism in bladder cancer has not thoroughly been elucidated. This study aimed to investigate the hypothesis that Bufalin induces cell apoptosis and inhibits cell growth in bladder cancer through the inactivation of Na+/K+-ATPase (NKA). In the current study, it was demonstrated that Bufalin remarkably inhibited cell viability and induced cell apoptosis in bladder cancer cell line T24. Subsequently, we found that the expression of NKA was significantly supressed in Bufalin-treated cells and the NKA-α3 isoform was most sensitive to Bufalin among all α subunits of NKA. By transfection with NKA-α3 overexpressing plasmids, the expression of the NKA-α3 subunit was upregulated and NKA-α3 overexpression was found to markedly attenuated Bufalin-induced cell apoptosis in T24 cells, suggesting NKA-α3 played a critical role in Bufalin-induced cell apoptosis. Taken together, the present study confirmed that Bufalin promotes tumour apoptosis and inhibits tumour growth in bladder cancer in vitro, and this antitumour effect may be ascribed to the inactivation of NKA.
Collapse
Affiliation(s)
- Houbao Huang
- Department of Urology, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.,Department of Urology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Wei Zhang
- Department of Urology, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| |
Collapse
|
5
|
Koyuncuer A. Histopathologic Evolution of Urothelial Carcinoma Recurrence in Transurethral Resection of the Urinary Bladder:35 Consecutive Cases And Literature Review. Asian Pac J Cancer Prev 2017; 18:459-463. [PMID: 28345830 PMCID: PMC5454743 DOI: 10.22034/apjcp.2017.18.2.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Urothelial carcinoma (UC) is the malignancy most frequently encountered in the urinary bladder. The primary aim of this study was to make a reappraisal of histopathologic features, recurrence and progression. Materials and Methods: The records of cases consecutively diagnosed with UC in the state hospital pathology laboratory were collected. Cases were classified according to age, gender, histologic grade, pathologic staging [primary Tumor (pT)],tumor configuration, primary or recurrent status, and progression. Results: A total of 35 (29 male and 6 female) cases were examined. The mean age was 68.9 years with a male-to-female incidence ratio of 4.8:1. Low-grade UCs accounted for 20 (57.1%) and high-grade for 15 (42.9%). A papillary pattern was observed in 80% of the UCs, classified into the following pathological stages: 11 (31.4%) pTa, 22 (62.9%) pT1, and 2 (5.9%) pT2 cases. Eleven patients progressed to a higher stage (pT1 to pT2), and three cases from low to higher grade. We analyzed results for 26 (74.3%) cases aged 65 years or older. Conclusions: UCs have a great tendency for recurrence but potentially may be amenable to effective local or systemic treatments.
Collapse
Affiliation(s)
- Ali Koyuncuer
- Department of Pathology, Antakya State Hospital, Hatay, Turkey.
| |
Collapse
|
6
|
Koyuncuer A. Histopathological evaluation of urothelial carcinomas in transurethral resection urinary bladder tumor specimens: eight years of single center experience. Asian Pac J Cancer Prev 2015; 16:2871-7. [PMID: 25854375 DOI: 10.7314/apjcp.2015.16.7.2871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urothelial carcinoma (UC) is a malignant neoplasm that most commonly occurs in the urinary bladder. The primary aim of this study was to evaluate the clinicopathologic features, recurrence and progression in patients with bladder urothelial cancer. MATERIALS AND METHODS The medical records of patients diagnosed with UC in the state pathology laboratory between January 2006 and July 2014 were retrospectively included. Carcinomas were categorized according to age, gender, histologic grade, tumor configuration, pathologic staging, recurrence status, and progression. RESULTS A total of 125 (113 men, 12 women) patients were examined. The mean age was 65.9 years and the male-to-female urothelial cancer incidence ratio was 9.4:1. Low-grade UCs were observed in 85 (68%) and high-grade in 40 (32%). A papillary tumor pattern was observed in 67.2% of the UCs. Cases were classified with the following pathological grades: 34 (27.2%) cases of pTa, 70 (56%) of pT1, and 21 (16.8%) of pT2. Recurrence occurred in 27 (21.6%) patients. Ten progressed to a higher stage (pT1 to pT2), and three cases to higher grade (low to high). We also analyzed the results separately for 70 (56%) patients 65 years of age and older. CONCLUSIONS With early detection and diagnosis of precursor lesions in older patients, by methods such as standard urologic evaluation, urinary cytology, ultrasound scanning and contrast urography, and cystoscopy, in addition to coordinated efforts between pathologists and urologists, early diagnosis may reduce the morbidity and mortality of patients with urothelial carcinoma.
Collapse
Affiliation(s)
- Ali Koyuncuer
- Department of Pathology, State Hospital, Antakya, Hatay, Turkey E-mail :
| |
Collapse
|
7
|
Dancik GM, Owens CR, Iczkowski KA, Theodorescu D. A cell of origin gene signature indicates human bladder cancer has distinct cellular progenitors. Stem Cells 2015; 32:974-82. [PMID: 24357085 DOI: 10.1002/stem.1625] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 09/09/2013] [Accepted: 11/12/2013] [Indexed: 12/27/2022]
Abstract
There are two distinct forms of urothelial (bladder) cancer: muscle-invasive (MI) and nonmuscle invasive (NMI) disease. Since it is currently believed that bladder cancer arises by transformation of urothelial cells of the basal layer, bladder cancer stem cells (CSCs) have been isolated based on expression markers found in such cells. However, these CSCs have only been identified in MI tumors raising the intriguing hypothesis that NMI tumor progenitors do not arise from the basal compartment. To test this hypothesis, we carried out genome-wide expression profiling of laser capture microdissected basal and umbrella cells, the two most histologically distinct cell types in normal urothelium and developed a cell of origin (COO) gene signature that distinguishes these. The COO signature was a better predictor of stage and survival than other bladder, generic, or breast CSC signatures and bladder cell differentiation markers in multiple patient cohorts. To assess whether NMI and MI tumors arise from a distinct progenitor cell (DPC) or common progenitor cell, we developed a novel statistical framework that predicts COO score as a function of known genetic alterations (TP53, HRAS, KDM6A, and FGFR3) that drive either MI or NMI bladder cancer and compared this to the observed COO score of the tumor. Analysis of 874 patients in five cohorts established the DPC model as the best fit to the available data. This observation supports distinct progenitor cells in NMI and MI tumors and provides a paradigm shift in our understanding of bladder cancer biology that has significant diagnostic and therapeutic implications.
Collapse
Affiliation(s)
- Garrett M Dancik
- Mathematics and Computer Science Department, Eastern Connecticut State University, Willimantic, Connecticut, USA
| | | | | | | |
Collapse
|
8
|
Kobayashi H, Kikuchi E, Mikami S, Maeda T, Tanaka N, Miyajima A, Nakagawa K, Oya M. Long term follow-up in patients with initially diagnosed low grade Ta non-muscle invasive bladder tumors: tumor recurrence and worsening progression. BMC Urol 2014; 14:5. [PMID: 24400640 PMCID: PMC3913327 DOI: 10.1186/1471-2490-14-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 01/06/2014] [Indexed: 11/12/2022] Open
Abstract
Background We evaluated the clinical outcome of low grade Ta bladder cancer followed-up for a long period using the 2004 WHO grading system. Methods We retrospectively reviewed 190 patients with primary, low grade Ta bladder cancer. We defined worsening progression (WP) as confirmed high grade Ta, all T1 or Tis/concomitant CIS of bladder recurrence, upper urinary tract recurrence (UTR), or progression to equal to or more than T2. The associations between clinicopathological factors and tumor recurrence as well as WP pattern were analyzed. We also evaluated the late recurrence of 76 patients who were tumor-free for more than 5 years. Results Tumor recurrence and WP occurred in 82 (43.2%) and 21 (11.1%) patients during follow-up (median follow-up: 101.5 months), respectively. WP to high grade Ta, all T1 or Tis/concomitant CIS was seen in 17 patients, and UTR and progression to equal to or more than T2 were seen in 2 and 2 patients, respectively. Multivariate analyses demonstrated that multiple tumor (p < 0.001, HR: 2.97) and absence of intravesical instillation (IVI) (p < 0.001, HR: 2.88) were significant risk factors for tumor recurrence while multiple tumor was the only risk factor for WP (p = 0.001, HR: 5.26). After a 5-year tumor-free period, 9 patients experienced late recurrence in years 5 and 10 and were diagnosed at a follow-up cystoscopy, however, only 2 patients recurred beyond 10 years and were found by gross hematuria. There were no significant risk factors of late recurrence. Conclusions Multiple tumor was a risk factor for both tumor recurrence and WP while IVI did not affect the occurrence of WP. Our results suggest that routine follow-up of patients with low grade Ta bladder cancer is needed up to 10 years from the initial diagnosis.
Collapse
Affiliation(s)
| | - Eiji Kikuchi
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | | | | | | | | | | | | |
Collapse
|
9
|
Wong KA, Zisengwe G, Athanasiou T, O'Brien T, Thomas K. Outpatient laser ablation of non-muscle-invasive bladder cancer: is it safe, tolerable and cost-effective? BJU Int 2013; 112:561-7. [DOI: 10.1111/bju.12216] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kathie A. Wong
- The Urology Centre; Guys and St. Thomas' NHS Foundation Trust
| | - Grace Zisengwe
- The Urology Centre; Guys and St. Thomas' NHS Foundation Trust
| | - Thanos Athanasiou
- Surgical Epidemiology Unit, Department of Surgery and Cancer; Imperial College London; London UK
| | - Tim O'Brien
- The Urology Centre; Guys and St. Thomas' NHS Foundation Trust
| | - Kay Thomas
- The Urology Centre; Guys and St. Thomas' NHS Foundation Trust
| |
Collapse
|
10
|
Lang F, Linlin M, Ye T, Yuhai Z. Alterations of dendritic cell subsets and TH1/TH2 cytokines in the peripheral circulation of patients with superficial transitional cell carcinoma of the bladder. J Clin Lab Anal 2013; 26:365-71. [PMID: 23001982 DOI: 10.1002/jcla.21532] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dendritic cells (DCs) and cytokines play an important role in the tumor growth and recurrence. METHODS Sixty-six patients with superficial transitional cell carcinoma of the bladder (STCCB) and 38 healthy controls were studied to investigate the percentages of DC subsets, monocyte-derived DC (MoDC) function, and alterations of Th1 and Th2 cytokines. MoDCs were generated and three-color flow cytometry was used for determining the phenotype of MoDCs and DC subsets. The ability to stimulate autologous T cells was tested in mixed leukocyte reaction (MLR). The levels of various cytokines were measured using commercially available sandwich enzyme linked immunosorbent assay (ELISA) kit. RESULTS The myeloid DC (mDC) counts, MoDC surface molecular expression, and stimulatory capacity to T cells were impaired in STCCB patients than in controls. The percentage of mDC and the expression of CD80, CD83, and CD86 were lower in patients showing recurrence. The serum levels of IL-2 and IFN-γ were found to be significantly lower while IL-4, IL-6, and IL-10 were significantly higher in STCCB patients than in controls. IL-6 was found to be significantly higher in recurrent patients. CONCLUSION The impairment of mDC counts and MoDC function with imbalance of Th1/Th2 cytokines was closely associated with proliferation and recurrence of STCCB.
Collapse
Affiliation(s)
- Feng Lang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | | | | | | |
Collapse
|
11
|
Liu W, Cao Y, Fernández MI, Niu H, Xiu Y. Additive antitumoral effect of interleukin-12 gene therapy and chemotherapy in the treatment of urothelial bladder cancer in vitro and in vivo. Int Urol Nephrol 2010; 43:721-7. [PMID: 21072592 DOI: 10.1007/s11255-010-9866-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Accepted: 10/18/2010] [Indexed: 02/03/2023]
Abstract
BACKGROUND We evaluated antitumoral effect of combined chemotherapy and interleukin-12 (IL-12) gene therapy in in vitro and in vivo experimental urothelial bladder cancer (UBC) model. MATERIALS AND METHODS EJ UBC cells were transfected with recombinant IL-12 genes using a liposomal transfection agent. Pirarubicin (THP) was added to the experimental samples at a final concentration of 20 mg/l. Four groups were assigned in vitro: untreated cells, transfected cells, untransfected cells plus THP and transfected cells plus THP. Death rates (DR) and cellular micromorphologic changes were evaluated. Bladder tumor model was established by subcutaneous injection of EJ cells to the nude mice. Four groups were assigned in vivo: control group; THP group; IL-12 gene group and IL-12 gene plus THP group. After injection of combined THP and IL-12 gene therapy, tumor size and IL-12 levels were evaluated. RESULTS In vitro study: DR in the THP + IL-12 gene therapy group (58.2 ± 15.8%) was significantly higher than transfected group (12.2 ± 5.6%; P = 0.01) and untransfected cells plus THP group (33.4 ± 7.8; P = 0.046). A higher amount of apoptotic changes and necrosis on transmission electron microscope analysis were observed in transfected cells plus THP group. In vivo study: A significant tumor attenuation was found in IL-12 gene in combination with THP group when compared with any other groups that were treated without Il-12 or THP (P < 0.05). IL-12 levels in serum were significant high in IL-12 gene groups (P < 0.01). CONCLUSION The combination of THP chemotherapy and IL-12 gene therapy showed an additive antitumoral effect on bladder cancer cells in vitro and in vivo. Further investigation should be focused on high-level transgene protocols in vivo.
Collapse
Affiliation(s)
- Wanpeng Liu
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Str, Nangang District, 150001 Harbin, Heilongjiang, People's Republic of China
| | | | | | | | | |
Collapse
|
12
|
Puppo P, Conti G, Francesca F, Mandressi A, Naselli A. New Italian guidelines on bladder cancer, based on the World Health Organization 2004 classification. BJU Int 2010; 106:168-79. [PMID: 20346041 DOI: 10.1111/j.1464-410x.2010.09324.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To provide evidence-based recommendations on bladder cancer management METHODS A multidisciplinary guideline panel composed of urologists, medical oncologists, radiotherapists, general practitioners, radiologists, epidemiologists and methodologists conducted a structured review of previous reports, searching the Medline database from 1 January 2004 to 31 December 2008. The milestone papers published before January 2004 were accepted for analysis. The level of evidence and the grade of the recommendations were established using the GRADE system. RESULTS In all, 15 806 references were identified, 1940 retrieved, 1712 eliminated (specifying the reason for their elimination) and 971 included in the analysis, as well as 241 milestone reports. A consensus conference held to discuss the discrepancies between the scientific evidence and the clinical practice was then attended by 122 delegates of various specialities. CONCLUSION Recommendations on bladder cancer management are provided.
Collapse
|
13
|
Low VJ, Wang D, Abel PD. Survival of patients with bladder cancer from a UK hospital: a 10-year follow-up study. BJU Int 2010; 105:1667-71. [DOI: 10.1111/j.1464-410x.2009.09071.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
14
|
Kikuchi E, Fujimoto H, Mizutani Y, Okajima E, Koga H, Hinotsu S, Shinohara N, Oya M, Miki T. Clinical outcome of tumor recurrence for Ta, T1 non-muscle invasive bladder cancer from the data on registered bladder cancer patients in Japan: 1999-2001 report from the Japanese Urological Association. Int J Urol 2009; 16:279-86. [DOI: 10.1111/j.1442-2042.2008.02235.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Pu XY, Wang HP, Wu YL, Wang XH. Use of bipolar energy for transurethral resection of superficial bladder tumors: long-term results. J Endourol 2008; 22:545-9. [PMID: 18257673 DOI: 10.1089/end.2007.0467] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To evaluate the long-term efficacy and safety of transurethral resection of bladder tumor (TURBT) with bipolar plasmakinetic energy. PATIENTS AND METHODS We reviewed the records of 121 patients with superficial transitional cell carcinoma of the bladder treated at our institute. Bipolar TURBT with plasmakinetic energy was performed for diagnostic and therapeutic purposes in all patients. Resected tissue was examined by a pathologist who recorded the number of tumors, tumor size, tumor shape, location, grade, invasion of the muscularis propria, and presence of muscular invasion. The operating time, length of hospital stay, blood loss, and intraoperative and postoperative complications were recorded by a urologist. Follow-up was 3 to 5.5 years after operation. RESULTS The median age of the patients was 61 years; 41 patients had multiple tumors and 80 had single tumors. The mean tumor size was 1.9 cm in diameter. The tumor was located in the lateral wall of the bladder in 67 patients. The mean operative time was (25 +/- 16) minutes and the mean postoperative hospitalization period was 3 days. Three (2.5%) patients had hematuria requiring blood transfusion and 2 (1.7%) patients had bladder perforation. Adductor contraction was noted in 6 patients (4.9%), and urethral strictures occurred in 5 patients (4.1%). CONCLUSION Transurethral resection of bladder tumors with bipolar plasmakinetic energy is safe and effective in the treatment of superficial bladder tumors.
Collapse
Affiliation(s)
- Xiao-Yong Pu
- Department of Urology, Guangdong Provincial People's Hospital, Guangdong, Guangzhou, China
| | | | | | | |
Collapse
|
16
|
Jurczok A, Fornara P, Söling A. Bioluminescence imaging to monitor bladder cancer cell adhesion in vivo: a new approach to optimize a syngeneic, orthotopic, murine bladder cancer model. BJU Int 2007; 101:120-4. [PMID: 17888045 DOI: 10.1111/j.1464-410x.2007.07193.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To improve the orthotopic murine bladder cancer model by using bioluminescent (BL) MB49 tumour cells for noninvasive in vivo monitoring of tumour growth and to examine the efficacy of integrin receptor-blocking oligopeptides on preventing tumour cell adhesion in this improved bladder cancer model. MATERIALS AND METHODS The capacity of oligopeptide combinations to interfere with tumour cell adhesion was assessed in vivo in a syngeneic, orthotopic, murine bladder cancer model. Tumour outgrowth was monitored noninvasively by bioluminescence imaging (BLI) after administration of luciferase-expressing MB49(LUC) bladder cancer cells. The presence of tumour cells was verified histologically and immunohistochemically on paraffin wax-embedded sections of excised bladders. RESULTS Anti-adhesive oligopeptides effectively inhibited tumour outgrowth. BLI detected tumour cells at an early stage when there were no clinical signs of cancer in any of the mice. The technique has high sensitivity in detecting tumour cell implantation, but is less reliable in assessing tumour volume in advanced-stage disease due to light attenuation in large tumours. CONCLUSIONS Peptides targeting adhesion molecules prevent attachment of bladder cancer cells to the injured bladder wall. BLI is a sensitive method for detecting luminescent bladder cancer cells in an orthotopic mouse model.
Collapse
Affiliation(s)
- Andreas Jurczok
- Department of Urology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | | | | |
Collapse
|