[A prognostic value of level of antiviral antibodies in the development of recurrence of bladder cancer]

INTRODUCTION

Serological diagnosis of virus-associated tumors attracts the attention of many specialists. The changes in the level of antiviral antibodies in tumors of different localizations are proved. In some cases, the authors suggest using these data either for screening of tumors or for controlling the cure.

AIM

to evaluate the predictive value of antiviral antibodies for the recurrence of bladder cancer.

MATERIALS AND METHODS

a level of antiviral antibodies (IgG, M) against Epstein-Barr virus (EBV), herpes simplex virus (HSV) 1 and 2 types, cytomegalovirus (CMV) of 100 patients with bladder cancer (72 men and 28 women) aged from 38 to 90 years (mean age 65+/-10) was studied. Multivariate analysis with a construction of classification tree was performed. The recurrence of the bladder cancer was used as the dependent variable.

RESULTS

in patients with recurrence of bladder cancer there was an increase in the level of anti-CMV IgG (616.5+/-501.46 U/ml vs. 339.06+/-306.61 U/ml, p=0.0017) and anti-EBV IgG-EBNA (246,7+/-207 U/ml vs. 141,5+/-163,7 U/ml, p=0.0118). After the construction of the classification tree, anti-CMV IgG, anti-EBV IgG-EBNA, tumor stage and the presence of CMV DNA in tumor tissue were selected. It allowed to classify correctly 20 of 24 patients with recurrence and 58 of 72 patients without relapse. The most significant predictors included anti-CMV IgG level (100%), anti-BNA IgG level (78%) and tumor stage (50%). The sensitivity, specificity, positive prognostic value (probability of tumor detection in patients with a positive test result), negative prognostic value (probability of absence of the tumor in persons with a negative test result) and accuracy were 83.33%, 80.56%, 58.82%, 93.55% and 81.25%, respectively. A multivariate analysis (binary logistic regression) was performed and a reliable model (2=22,438, p=0,00043) was created, including the following parameters: anti-CMV IgG more than 670 u/ml, anti-BNA IgG more than 130 u/ml, the degree of anaplasia, the presence CMV and/or EBV DNA in tumor tissue. Based on the regression equation, an accuracy test for prediction of tumor recurrence was carried out, which resulted in fairly high predictive results: specificity and sensitivity were 95.2% and 33.3%, respectively.

CONCLUSIONS

anti-CMV IgG level more than 670 U/ml and anti-BNA IgG level more than 130 U/ml are reliable predictors for the recurrence of bladder cancer.

[High oncogenic risk human papillomavirus and urinary bladder cancer]

AIM

To determine the role of human papillomavirus (HPV) of high oncogenic risk in the development of urinary bladder cancer.

MATERIALS AND METHODS

100 patients (72 men and 28 women) aged 38 to 90 years (mean age 65+/-10 years) diagnosed with bladder cancer were examined and underwent treatment. Clinical assessment was complemented by enzyme-linked immunosorbent assays for the presence of antiviral antibodies to herpes simplex virus (HSV) type 1 and type 2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), urethra scraping for detecting high oncogenic risk HPV. Tumor tissue was sampled for PCR virus detection. Semi-quantitative analysis was used to evaluate the components of lymphocyte-plasmocyte and leukocyte infiltrates and cytopathic changes in tumor tissue.

RESULTS

There were positive correlations between cytopathic cell changes (koylocytosis and intranuclear inclusions, as manifestations of HPV) and the level of antiviral antibodies, the presence of viruses in the tumor, as well as with the components of the lymphoid-plasmocyte infiltrate. Negative correlations were found between the presence of papillomatosis and the above changes.

CONCLUSION

Human papillomavirus is believed to be a trigger for the initiation of a tumor in young patients with a latent infection (CMV and EBV, HSV, HPV). Cytopathic changes (kylocytosis and intranuclear inclusions) were associated with the activity and morphological features of herpes-viral infections. Their degree varied depending on the stage of the process, but not on the anaplasia degree. Papillomatosis is associated with a more favorable course of the tumor process.