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Viergever BJ, Raats DAE, Geurts V, Mullenders J, Jonges TN, van der Heijden MS, van Es JH, Kranenburg O, Meijer RP. Urine-derived bladder cancer organoids (urinoids) as a tool for cancer longitudinal response monitoring and therapy adaptation. Br J Cancer 2024; 130:369-379. [PMID: 38102228 PMCID: PMC10844626 DOI: 10.1038/s41416-023-02494-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 10/27/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Bladder cancer is one of the most common cancer types worldwide. Generally, research relies on invasive sampling strategies. METHODS Here, we generate bladder cancer organoids directly from urine (urinoids). In this project, we establish 12 urinoid lines from 22 patients with non-muscle and muscle-invasive bladder tumours, with an efficiency of 55%. RESULTS The histopathological features of the urinoids accurately resemble those of the original bladder tumours. Genetically, there is a high concordance of single nucleotide polymorphisms (92.56%) and insertions & deletions (91.54%) between urinoids and original tumours from patient 4. Furthermore, these urinoids show sensitivity to bladder cancer drugs, similar to their tissue-derived organoid counterparts. Genetic analysis of longitudinally generated tumoroids and urinoids from one patient receiving systemic immunotherapy, identify alterations that may guide the choice for second-line therapy. Successful treatment adaptation was subsequently demonstrated in the urinoid setting. CONCLUSION Therefore, urinoids can advance precision medicine in bladder cancer as a non-invasive platform for tumour pathogenesis, longitudinal drug-response monitoring, and therapy adaptation.
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Affiliation(s)
- Bastiaan J Viergever
- Laboratory Translational Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, 3584CX, Utrecht, The Netherlands
- Department of Oncological Urology, Division of Imaging and Oncology, University Medical Center Utrecht, 3584CX, Utrecht, The Netherlands
| | - Daniëlle A E Raats
- Laboratory Translational Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, 3584CX, Utrecht, The Netherlands
- Utrecht Platform for Organoid Technology, Utrecht University, 3584 CX, Utrecht, The Netherlands
| | - Veerle Geurts
- Oncode Institute, Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences (KNAW) and University Medical Center Utrecht, 3584 CT, Utrecht, The Netherlands
| | - Jasper Mullenders
- Oncode Institute, Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences (KNAW) and University Medical Center Utrecht, 3584 CT, Utrecht, The Netherlands
| | - Trudy N Jonges
- Department of Pathology, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
| | | | - Johan H van Es
- Oncode Institute, Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences (KNAW) and University Medical Center Utrecht, 3584 CT, Utrecht, The Netherlands
| | - Onno Kranenburg
- Laboratory Translational Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, 3584CX, Utrecht, The Netherlands
- Utrecht Platform for Organoid Technology, Utrecht University, 3584 CX, Utrecht, The Netherlands
| | - Richard P Meijer
- Laboratory Translational Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, 3584CX, Utrecht, The Netherlands.
- Department of Oncological Urology, Division of Imaging and Oncology, University Medical Center Utrecht, 3584CX, Utrecht, The Netherlands.
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Huele EH, Veenboer PW, Wessels FJ, Jonges TN, Meijer RP. Value of multiparametric magnetic resonance imaging for local staging of invasive urinary bladder tumours. Urol Oncol 2023; 41:49.e7-49.e12. [PMID: 36441069 DOI: 10.1016/j.urolonc.2022.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Initial tumour staging in bladder cancer mainly relies on the histo-pathological outcome of the transurethral bladder tumour resection (TURBT) and imaging by means of a CT-scan (CT-intravenous urography; CT-IVU). The reported risk of understaging varies from 24-50%. To further improve the the evaluation of depth of invasion of the bladder tumour the application of magnetic resonance imaging (MRI) may be useful. To substantiate the additional value of this imaging modality the present observational study was designed. STUDY DESIGN This is a prospective observational study to analyse bladder tumour staging with multiparametric magnetic resonance imaging (mpMRI) in patients with a known bladder tumour, who are planned for radical cystectomy. STUDY POPULATION Patients with an invasive bladder cancer who are planned for radical cystectomy. INTERVENTION Patients were accrued during their visit to the outpatient department of urology. They underwent routine cystoscopy, laboratory tests (including serum Creatinin) and CT-IVU investigations and subsequently a mpMRI. MAIN STUDY PARAMETERS/ENDPOINTS To demonstrate the value of mpMRI in the initial staging of bladder tumours using radiological bladder tumour stage (T-stage) based on mpMRI and pathological bladder tumour stage based on 'whole-mount' histo-pathology after radical cystectomy. RESULTS Thirty-seven participants with known bladder tumours underwent mpMRI and subsequent cystectomy. After mpMRI 10 participants were diagnosed with non-muscle-invasive bladder cancer (NMIBC) and 27 participants with muscle-invasive bladder cancer (MIBC). In the 'whole-mount' pathology results 12 participants had NMIBC and 25 participants had MIBC. We found a sensitivity and specificity of 0.88 en 0.58 respectively, for the evaluation of MIBC. The positive and negative predictive value were 81% and 70% respectively. The diagnostic accuracy of mpMRI to differentiate between NMIBC and MIBC was 78%. CONCLUSIONS We found a sensitivity of 88% and a specificity of 58% for mpMRI to discriminate NMIBC from MIBC.
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Affiliation(s)
- Eline H Huele
- Department Oncological Urology, University Medical Center Utrecht, The Netherlands
| | - Paul W Veenboer
- Department Oncological Urology, University Medical Center Utrecht, The Netherlands
| | - Frank J Wessels
- Department Radiology, University Medical Center Utrecht, The Netherlands
| | - Trudy N Jonges
- Department Pathology, University Medical Center Utrecht, The Netherlands
| | - Richard P Meijer
- Department Oncological Urology, University Medical Center Utrecht, The Netherlands.
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Hack AP, Zweemer RP, Jonges TN, van der Leij F, Gerestein CG, Peters M, Jürgenliemk-Schulz IM, van Rossum PSN. Prognostic impact of waiting time between diagnosis and treatment in patients with cervical cancer: A nationwide population-based study. Gynecol Oncol 2022; 165:339-346. [PMID: 35300853 DOI: 10.1016/j.ygyno.2022.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Prior research underlined the importance of timely oncological care as longer waiting times from diagnosis to treatment may result in poorer survival outcomes. The aim of this study was to determine the impact of waiting time from diagnosis to treatment on overall survival (OS) in patients with cervical cancer treated with curative intent. METHODS Patients from a nationwide population-based cohort with newly diagnosed cervical cancer between 2010 and 2019 were studied. Patients who underwent surgery or (chemo)radiotherapy with curative intent were selected. Waiting time (i.e. interval between first pathologic confirmation and treatment) was modelled as continuous (i.e. linear per week), dichotomized (i.e. ≤8 versus >8 weeks), and polynomial (i.e. restricted cubic splines). The association with OS was examined using Cox regression analyses. RESULTS Among 6895 patients with cervical cancer, 2755 treated with primary surgery and 1898 who received primary (chemo)radiotherapy were included. Mean waiting time was 8.5 (±4.2) weeks to surgery and 7.7 (±2.9) weeks to (chemo)radiotherapy. Adjusted for confounders, waiting time to surgery was not significantly associated with OS (continuous HR 0.97 [95%CI: 0.93-1.01], dichotomized HR 0.93 [95%CI: 0.68-1.27], polynomial HR not significant). Similarly, a longer waiting time to (chemo)radiotherapy was not significantly associated with poorer OS (continuous HR 0.97 [95%CI: 0.93-1.00], dichotomized HR 0.91 [95%CI: 0.75-1.09], polynomial HR not significant). CONCLUSIONS This large population-based study demonstrates that a longer waiting time (of up to 12 weeks) from diagnosis to treatment in patients with cervical cancer treated with curatively intended surgery or (chemo)radiotherapy does not negatively impact survival.
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Affiliation(s)
- Amy P Hack
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ronald P Zweemer
- Department of Gynecologic Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Trudy N Jonges
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Femke van der Leij
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Cornelis G Gerestein
- Department of Gynecologic Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Max Peters
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Peter S N van Rossum
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
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Hoogstraat M, de Pagter MS, Cirkel GA, van Roosmalen MJ, Harkins TT, Duran K, Kreeftmeijer J, Renkens I, Witteveen PO, Lee CC, Nijman IJ, Guy T, van ’t Slot R, Jonges TN, Lolkema MP, Koudijs MJ, Zweemer RP, Voest EE, Cuppen E, Kloosterman WP. Genomic and transcriptomic plasticity in treatment-naive ovarian cancer. Genome Res 2014; 24:200-11. [PMID: 24221193 PMCID: PMC3912411 DOI: 10.1101/gr.161026.113] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 10/17/2013] [Indexed: 12/23/2022]
Abstract
Intra-tumor heterogeneity is a hallmark of many cancers and may lead to therapy resistance or interfere with personalized treatment strategies. Here, we combined topographic mapping of somatic breakpoints and transcriptional profiling to probe intra-tumor heterogeneity of treatment-naïve stage IIIC/IV epithelial ovarian cancer. We observed that most substantial differences in genomic rearrangement landscapes occurred between metastases in the omentum and peritoneum versus tumor sites in the ovaries. Several cancer genes such as NF1, CDKN2A, and FANCD2 were affected by lesion-specific breakpoints. Furthermore, the intra-tumor variability involved different mutational hallmarks including lesion-specific kataegis (local mutation shower coinciding with genomic breakpoints), rearrangement classes, and coding mutations. In one extreme case, we identified two independent TP53 mutations in ovary tumors and omentum/peritoneum metastases, respectively. Examination of gene expression dynamics revealed up-regulation of key cancer pathways including WNT, integrin, chemokine, and Hedgehog signaling in only subsets of tumor samples from the same patient. Finally, we took advantage of the multilevel tumor analysis to understand the effects of genomic breakpoints on qualitative and quantitative gene expression changes. We show that intra-tumor gene expression differences are caused by site-specific genomic alterations, including formation of in-frame fusion genes. These data highlight the plasticity of ovarian cancer genomes, which may contribute to their strong capacity to adapt to changing environmental conditions and give rise to the high rate of recurrent disease following standard treatment regimes.
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Affiliation(s)
- Marlous Hoogstraat
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Netherlands Center for Personalized Cancer Treatment, 3584 CG Utrecht, The Netherlands
| | - Mirjam S. de Pagter
- Department of Medical Genetics, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Geert A. Cirkel
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Netherlands Center for Personalized Cancer Treatment, 3584 CG Utrecht, The Netherlands
| | - Markus J. van Roosmalen
- Department of Medical Genetics, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | | | - Karen Duran
- Department of Medical Genetics, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Jennifer Kreeftmeijer
- Department of Medical Genetics, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Ivo Renkens
- Department of Medical Genetics, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Petronella O. Witteveen
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | | | - Isaac J. Nijman
- Netherlands Center for Personalized Cancer Treatment, 3584 CG Utrecht, The Netherlands
- Department of Medical Genetics, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Tanisha Guy
- Department of Medical Genetics, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Ruben van ’t Slot
- Department of Medical Genetics, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Trudy N. Jonges
- Department of Pathology, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Martijn P. Lolkema
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Netherlands Center for Personalized Cancer Treatment, 3584 CG Utrecht, The Netherlands
| | - Marco J. Koudijs
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Netherlands Center for Personalized Cancer Treatment, 3584 CG Utrecht, The Netherlands
| | - Ronald P. Zweemer
- Department of Reproductive Medicine and Gynaecology, Division Woman and Baby, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Emile E. Voest
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Netherlands Center for Personalized Cancer Treatment, 3584 CG Utrecht, The Netherlands
| | - Edwin Cuppen
- Netherlands Center for Personalized Cancer Treatment, 3584 CG Utrecht, The Netherlands
- Department of Medical Genetics, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
- Hubrecht Institute, KNAW and University Medical Center Utrecht, 3584 CT Utrecht, The Netherlands
| | - Wigard P. Kloosterman
- Department of Medical Genetics, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
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Borren A, Groenendaal G, van der Groep P, Moman MR, Boeken Kruger AE, van der Heide UA, Jonges TN, van Diest PJ, van Vulpen M, Philippens MEP. Expression of hypoxia-inducible factor-1α and -2α in whole-mount prostate histology: relation with dynamic contrast-enhanced MRI and Gleason score. Oncol Rep 2013; 29:2249-54. [PMID: 23588703 DOI: 10.3892/or.2013.2392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 03/04/2013] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to investigate the association between the immunohistochemical expression of hypoxia-inducible factor (HIF)-1α and HIF-2α and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters Ktrans and kep in prostate cancer. Therefore, 15 patients with biopsy-confirmed prostate cancer underwent a pre-operative 3T DCE-MRI scan. Immunohistochemical analysis of HIF-1α and HIF-2α, and of CD31 for microvessel density (MVD) was performed. Tumor areas were delineated on whole-mount histopathological sections. Nuclear HIF expression was correlated with the quantitative DCE-MRI parameters Ktrans and kep, MVD and Gleason score. HIF expression was highly heterogeneous within tumors and between patients. Pronounced expression of HIF-2α was present, while HIF-1α expression was more limited. Larger tumors showed higher HIF-2α expression (p=0.041). A correlation between HIF-2α and Ktrans p5th was found (r=0.30, p=0.02), but no differences in Ktrans, kep and MVD were observed for different levels of HIF expression. HIF expression was not associated with Gleason score. In conclusion, in this whole-mount prostate cancer study, larger prostate tumors showed frequently high HIF-2α expression, suggesting that larger tumors are clinically most relevant. However, HIF-1α and HIF-2α were not correlated with DCE-MRI parameters. Given the pronounced expression of HIF-2α and independence of Gleason score, HIF expression may function as a biomarker to guide boost dose prescription.
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Affiliation(s)
- Alie Borren
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
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Basten SG, Davis EE, Gillis AJM, van Rooijen E, Stoop H, Babala N, Logister I, Heath ZG, Jonges TN, Katsanis N, Voest EE, van Eeden FJ, Medema RH, Ketting RF, Schulte-Merker S, Looijenga LHJ, Giles RH. Mutations in LRRC50 predispose zebrafish and humans to seminomas. PLoS Genet 2013; 9:e1003384. [PMID: 23599692 PMCID: PMC3627517 DOI: 10.1371/journal.pgen.1003384] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 01/29/2013] [Indexed: 01/07/2023] Open
Abstract
Seminoma is a subclass of human testicular germ cell tumors (TGCT), the most frequently observed cancer in young men with a rising incidence. Here we describe the identification of a novel gene predisposing specifically to seminoma formation in a vertebrate model organism. Zebrafish carrying a heterozygous nonsense mutation in Leucine-Rich Repeat Containing protein 50 (lrrc50 also called dnaaf1), associated previously with ciliary function, are found to be highly susceptible to the formation of seminomas. Genotyping of these zebrafish tumors shows loss of heterozygosity (LOH) of the wild-type lrrc50 allele in 44.4% of tumor samples, correlating with tumor progression. In humans we identified heterozygous germline LRRC50 mutations in two different pedigrees with a family history of seminomas, resulting in a nonsense Arg488* change and a missense Thr590Met change, which show reduced expression of the wild-type allele in seminomas. Zebrafish in vivo complementation studies indicate the Thr590Met to be a loss-of-function mutation. Moreover, we show that a pathogenic Gln307Glu change is significantly enriched in individuals with seminoma tumors (13% of our cohort). Together, our study introduces an animal model for seminoma and suggests LRRC50 to be a novel tumor suppressor implicated in human seminoma pathogenesis.
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Affiliation(s)
- Sander G. Basten
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Erica E. Davis
- Center for Human Disease Modeling, Department of Pediatrics, and Department of Cell Biology, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Ad J. M. Gillis
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Daniel den Hoed Cancer Center, Josephine Nefkens Institute, Rotterdam, The Netherlands
| | - Ellen van Rooijen
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
- Hubrecht Institute, KNAW and University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans Stoop
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Daniel den Hoed Cancer Center, Josephine Nefkens Institute, Rotterdam, The Netherlands
| | - Nikolina Babala
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ive Logister
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
- Hubrecht Institute, KNAW and University Medical Center Utrecht, Utrecht, The Netherlands
| | - Zachary G. Heath
- Center for Human Disease Modeling, Department of Pediatrics, and Department of Cell Biology, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Trudy N. Jonges
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nicholas Katsanis
- Center for Human Disease Modeling, Department of Pediatrics, and Department of Cell Biology, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Emile E. Voest
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Freek J. van Eeden
- Hubrecht Institute, KNAW and University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rene H. Medema
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - René F. Ketting
- Hubrecht Institute, KNAW and University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stefan Schulte-Merker
- Hubrecht Institute, KNAW and University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Rachel H. Giles
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
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de Kort LMO, Kok ET, Jonges TN, Rosier PFWM, Bosch JLHR. Urodynamic effects of transrectal intraprostatic Ona botulinum toxin A injections for symptomatic benign prostatic hyperplasia. Urology 2012; 80:889-93. [PMID: 22854138 DOI: 10.1016/j.urology.2012.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 05/26/2012] [Accepted: 06/02/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate urodynamic, symptomatic, and histologic effects of intraprostatic injection with Ona botulinum toxin A for benign prostatic hyperplasia. METHODS Patients >55 years with symptomatic benign prostatic hyperplasia failing medical therapy were treated. Inclusion criteria were International Prostate Symptom Score >7, prostate volume 30-50 cm(3), and urodynamic bladder outlet obstruction >Schäfer grade 2. A transrectal intraprostatic injection of 200 IU Ona botulinum toxin A was given. Filling cystometry and pressure flow studies were performed at 3, 6, and 12 months post injection. International Prostate Symptom Score, International Prostate Symptom Score quality of life, prostate-specific antigen, and prostate volume were measured up until 12 months; prostate biopsies before and after Ona botulinum toxin A injection were done for histology and cell proliferation. RESULTS Fifteen men (mean age 64.9 years) were included. Ona botulinum toxin A injection was well tolerated with few complications. Postvoid residual improved (170 to 80 mL), but maximum flow rate and bladder outlet resistance parameters did not change during follow-up. International Prostate Symptom Score and International Prostate Symptom Score quality of life improved (22 to 13 and 5 to 2, respectively), whereas prostate-specific antigen and prostate volume remained unaltered. Cell proliferation did not decrease and in 37% and 64% of pre- and posttreatment biopsies, respectively, some degree of prostatitis was found. Ten of 15 patients eventually underwent transurethral prostate resection because of persisting symptoms. CONCLUSION Intraprostatic Ona botulinum toxin A for symptomatic benign prostatic hyperplasia did not affect urodynamic outcomes, except for postvoid residual. Although symptom scores improved, we were not able to show change in prostate volume, prostate-specific antigen, or histologic outcomes. A placebo effect of intraprostatic Ona botulinum toxin A could not be ruled out.
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Affiliation(s)
- Laetitia M O de Kort
- Department of Urology, University Medical Center Utrecht, Utrecht, the Netherlands.
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Draga RO, Grimbergen MC, Kok ET, Jonges TN, van Swol CF, Bosch RJ. The Quality of 5-Aminolevulinic Acid-Induced Photodynamic Diagnosis and Transurethral Resection of Bladder Tumors: Does the Urologist Play a Role? Urol Int 2012; 89:326-31. [DOI: 10.1159/000341897] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 07/14/2012] [Indexed: 11/19/2022]
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Huisman A, Ploeger LS, Dullens HFJ, Jonges TN, van Diest PJ. Discrimination between benign and malignant prostate biopsies using three-dimensional chromatin texture analysis by confocal laser scanning microscopy. Anal Quant Cytol Histol 2011; 33:265-270. [PMID: 22611753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate the clinical usefulness of computing three-dimensional (3-D) nuclear texture features on prostate biopsy specimens to discriminate among benign, prostatic intraepithelial neoplasia (PIN), and malignant specimens. STUDY DESIGN Twelve prostate cancer biopsy specimens were selected, diagnosed as either benign (N = 4), PIN (N = 4), or malignant (N = 4). Sections 14 microm thick were stained. 3-D image stacks of selected benign and malignant areas were obtained by confocal laser scanning microscopy (CLSM) and analyzed off-line using in-house-developed software for 3-D semiautomated segmentation and calculation of texture features. The power of the 3-D texture features to discriminate among the pooled benign (N = 1,507), PIN (N = 673), and malignant nuclei (N = 1,251) was established by multivariate linear discriminant analysis. RESULTS A total of 68.8% of the benign nuclei, 77.2% of the PIN nuclei, and 78.5% of the malignant nuclei could be classified correctly after cross validation. CONCLUSION Quantification of changes in the distribution of nuclear chromatin by means of 3-D texture feature computation on CLSM images allows discriminating most benign and malignant prostate nuclei, which could be useful in cases that are difficult to diagnose morphologically.
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Affiliation(s)
- André Huisman
- Department of Pathology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
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Draga ROP, Grimbergen MCM, Kok ET, Jonges TN, van Swol CFP, Bosch JLHR. Photodynamic diagnosis (5-aminolevulinic acid) of transitional cell carcinoma after bacillus Calmette-Guérin immunotherapy and mitomycin C intravesical therapy. Eur Urol 2009; 57:655-60. [PMID: 19819064 DOI: 10.1016/j.eururo.2009.09.037] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Accepted: 09/25/2009] [Indexed: 11/29/2022]
Abstract
BACKGROUND Photodynamic diagnosis (PDD) is a technique that enhances the detection of occult bladder tumors during cystoscopy using a fluorescent dye. OBJECTIVE To study the differential effects of bacillus Calmette-Guérin (BCG) and mitomycin C (MMC) intravesical therapy on the false-positive rate of PDD of bladder cancer. DESIGN, SETTING, AND PARTICIPANTS This study included 552 procedures and 1874 biopsies. INTERVENTION Tumors were resected and biopsies were taken from suspicious areas, under guidance of white-light endoscopy and 5-ALA (5-aminolevulinic acid)-induced fluorescence cystoscopy. MEASUREMENTS The influence of intravesical BCG immunotherapy and intravesical MMC chemotherapy on pyuria, inflammation, and PDD specificity was examined in univariate analyses. RESULTS AND LIMITATIONS BCG significantly results in inflammation (odds ratio [OR]: 1.53, p=0.002), leukocyturia (OR: 1.84, p=0.034), and false positives in PDD (OR: 1.49, p=0.001). However, a single BCG instillation within 3 mo before PDD is most likely not associated with increased false-positive rates (OR: 0.35, p=0.26). Leukocyturia normalizes within 6 wk after the last BCG instillation, but PDD specificity is reduced up to 3 mo. CONCLUSIONS BCG is an important predictor for false positives in PDD (5-ALA). More than one BCG instillation within 3 mo before fluorescence cystoscopy decreases the specificity of PDD.
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Affiliation(s)
- Ronald O P Draga
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
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Huisman A, Ploeger LS, Dullens HFJ, Jonges TN, Belien JAM, Meijer GA, Poulin N, Grizzle WE, van Diest PJ. Discrimination between benign and malignant prostate tissue using chromatin texture analysis in 3-D by confocal laser scanning microscopy. Prostate 2007; 67:248-54. [PMID: 17075809 DOI: 10.1002/pros.20507] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Analysis of chromatin texture may improve both the diagnosis and the assessment of the prognosis of prostate cancer. Confocal laser scanning microscopy (CLSM) allows performing measurements in nuclei reconstructed in 3-D. The aim of this study was to evaluate the clinical usefulness of 3-D texture analysis of prostate tissue. METHODS Image stacks of eight prostate cancer sections were obtained by CLSM of both benign and malignant areas. Texture feature values were computed for individual nuclei. The discriminative power of the texture features was established by receiver operating characteristic (ROC) analysis and linear discriminant analysis (LDA). RESULTS Texture features were identified that could discriminate between benign and malignant nuclei. LDA correctly classified 89% of the nuclei of the pooled set of benign and malignant nuclei. CONCLUSIONS 3-D nuclear texture features allow discrimination of most benign and malignant prostate nuclei. We estimate that the classification rates can be increased by improving the image quality.
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Affiliation(s)
- André Huisman
- Department of Pathology, University Medical Center, Utrecht, The Netherlands
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