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  • 1
    ISSN: 1432-1335
    Keywords: Bladder cancer ; Cell adhesion molecule ; E-cadherin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A series of 161 bladder cancer biopsy specimens (survival data available in 122 cases) was analysed immunohistochemically for the expression of E-cadherin (E-CD), the most important cell-to-cell adhesion molecule in epithelial cells. Altogether, 81% of the tumours were E-CD-positive, the staining being heterogeneous in nearly all tumours. Normal transitional epithelium was positive for E-CD while in carcinomas the expression was reduced or even absent (18%). Lower levels of E-CD were detected in rapidly proliferating high-grade muscle-invasive tumours. Reduced expression of E-CD was related to a dense inflammatory cell reaction in tumour stroma. The median clinical follow-up was 12.0 years. Short recurrence-free survival of Ta-T1 tumours (P=0.02) was related to expression of E-CD fewer than 50% of cancer cells. In survival analysis the fraction of E-CD-positive cells (P=0.1) and the expression intensity of E-CD (P=0.09) showed a non-significant association to prognosis. Multivariate survival analysis indicated that expression of E-CD has no independent prognostic value over grade or stage while recurrence-free survival was related to E-CD expression.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1434-0879
    Keywords: Superficial bladder cancer ; bcl-2 ; p53 ; EGFr ; MIB-1
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Immunoreactivity of bcl-2, p53, the epidermal growth factor (EGFr) and Ki-67 (MIB-1) proteins was assessed by immunohistochemistry in 185 patients with superficial bladder cancer (SBC) in order to evaluate their usefulness as indicators of tumor progression. Forty-one percent of the tumors were bcl-2 positive, 36% of them were positive for p53 (over 20% of nuclei), while 41% were positive for EGFr, and 30% of the tumors were MIB-1 positive (proliferation index 〉 15%). Immunoreactivity of all analyzed proteins was highly significantly related to tumor grade and stage. Tumors which were bcl-2, p53 or EGFr positive were also rapidly proliferative (MIB-1 score 〉 15%). The obtained results suggest that all analyzed proteins may have prognostic significance in SBC. The prognostic value of the abnormal immunolabeling of the analyzed proteins will be established after an adequate follow-up period of this same cohort of patients.
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  • 3
    ISSN: 1434-0879
    Keywords: Superficial bladder cancer ; MIB-1 ; S-phase fraction ; M/V index
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cell proliferation of transitional cell bladder cancer (TCC) was determined by MIB-1 immunolabeling, volume-corrected mitotic index (M/V index) and S-phase fraction measurement in 207 patients with superficial (Ta-T1) bladder cancer. The results were compared to T category, WHO grade and DNA-ploidy. The MIB-1 score was related to T category (P〈0.001), WHO grade (P〈0.001), DNA ploidy (P〈0.0001), M/V index (P〈0.0001) and fraction of cells in S phase (P〈0.0001). The mean MIB-1 score was 6.37% for G1, 14.59% for G2 and 28.59% for G3 carcinomas (P〈0.001). The MIB-1 score for Ta tumors was 9.24% and for T1 tumors 25.34% (P〈0.001). The M/V index was 3.9 for G1, 11.5 for G2 and 25.9 for G3 tumors (P〈0.0001). The M/V index for Ta tumors was 6.4 and 25.3 for T1 tumors (P〈0.0001). WHO grade 1 tumors had 7.7%, grade 2 tumors 13.8% and grade 3 tumors 21.8% of cells in S phase (P〈0.001). Of grade 1 tumors, 97% were diploid and 3% aneuploid, and 78% of grade 2 tumors were diploid and 22% aneuploid. Of grade 3 tumors, 30% were diploid and 70% aneuploid (P〈0.001). Of Ta tumors, 92% were diploid and 8% aneuploid, respectively, whereas 40% of T1 tumors were diploid and 60% aneuploid (P〈0.0001). The results show that quantitative cell proliferation indices are associated with T category and WHO grade in superficial bladder cancer. The prognostic value of the S-phase fraction and mitotic index has been demonstrated in several previous analyses of prognostic factors while the value of MIB-1 score on bladder cancer prognosis remains to be established in further follow-up studies.
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  • 4
    ISSN: 1432-1335
    Keywords: Transitional cell ; Bladder tumour ; Nuclear image analysis ; Mitotic index ; WHO grade ; Papillary status ; Clinical stage ; Progression ; Survival
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A retrospective histological analysis has been carried out on 537 cases of transitional-cell bladder carcinoma, followed-up over a period of 9 years. In the first part of the study WHO grade 2 tumours were analysed and a number of independent factors predictive for survival identified. In a multivariate analysis the T category and M/V index (number of mitotic figures/mm2 neoplastic epithelium) were the most important prognostic factors. In a subsequent analysis of the whole series of 537 cases, overall the M/V index was not as important in predicting survival as the stage of the tumour. However, in superficial tumours (Ta−T1) subsequent analysis showed that the M/V index alone could be used to predict survival.
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  • 5
    ISSN: 1432-1335
    Keywords: Bladder cancer ; Type IV collagen ; Basement membrane ; Vascular density ; Lymphocyte ; Morphometry ; WHO grade ; Papillary status ; Progression ; Survival
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This analysis evaluated the prognostic importance of clinical, histological (WHO grade, papillary status, tumour-infiltrating lymphocytes) and morphometric factors (mitotic index, mean nuclear area, SD of nuclear area) in a cohort of 132 patients with a Ta-Tl transitional cell bladder cancer followed-up for over 8 years. Special attention was given on the state of the subepithelial basement membrane (BM) and subepithelial vascular density as demonstrated by type IV collagen immunostaining. Defects in the BM and dense vascular network were related to nodular growth pattern, high histological grade, rapid cancer cell proliferation and a dense inflammatory cell infiltrate (tumour-infiltrating lymphocytes, TIL) in tumour stroma. The most important predictor of progression was the mitotic index (P〈0.0001) followed by vascular density (P=0.0054), the state of the BM (P=0.0056), density of TIL (P=0.0193), WHO grade (P=0.0356) and papillary status (P=0.0448). In univariate survival analysis the mitotic index (P〈0.0001), the state of the BM (P〈0.0001), subepithelial vascular density (P=0.0013) and WHO grade (P=0.01) predicted survival. In a multivariate analysis the mitotic index (P〈0.0001) and the state of the BM (P=0.008) were independent predictors. The results show that the evaluation of the mitotic rate and investigation of the continuity of the BM should be done whenever the prognosis of Ta-Tl tumours of the bladder is assessed invasive (Torti and Lum 1984). At present we are not able to identify accurately those patients who are at an increased risk of an invasive disease. Flow cytometry (Blomjous et al. 1989; Masters et al. 1989) and morphometry (Blomjous et al. 1989; Lipponen et al. 1990, 1992a, b) provide more objective prognostic information than WHO grade in superficial TCC. Recent analyses suggest that the host defence mechanisms play an important role in the modulation of progression of TCC (Lipponen et al. 1992 a). The subepithelial basement membrane (BM) is a mechanical barrier through which the cancer cells must penetrate before TCC becomes invasive, and basement-membrane-degrading proteases play an important part in this process (Liotta 1984). At present, commercially available antibodies against collagen type IV and laminin identify structures related to BM with a high specificity and thus the state of the BM can be easily assessed (Christensen 1992). In TCC the importance of intact BM as a prognostic marker has been previously assessed only in few studies without long clinical follow-up (Conn et al. 1987; Daher et al. 1987; Schapers et al. 1990). The role of the BM has been rarely evaluated in superficial tumours although in these the state of the BM should have importance in preventing invasion. In this study the primary biopsy specimens from 132 superficial TCC were stained with type IV collagen antibody and the staining results were related to clinical, histological, morphometric and follow-up data.
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