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NCI CANCERLIT® Search: Diagnosis-Histopathology-Pathogenesis of Bladder Cancer - January 2002
National Cancer Institute®
Ultima Vez Modificado: 1 de enero del 2002
Table of Contents
1
UI - 11414630
AU - Siddiqui FA; Amirkhosravi A; Amaya M; Meyer T; Biggerstaff J; Desai H;
TI -
Francis JL
Hemoglobin enhances tissue factor expression on human malignant cells.
SO - Blood Coagul Fibrinolysis 2001 Apr;12(3):171-7
AD - Clinical and Research Laboratories, Walt Disney Memorial Cancer
Institute, Florida Hospital, Orlando 32804, USA.
Farooq_Siddiqui_Ph.D.@mail.fhmis.net
Tissue Factor (TF) is a transmembrane glycoprotein that complexes with
factor VII/activated factor VII to initiate blood coagulation. TF may be
expressed on the surface of various cells including monocytes and
endothelial cells. Over-expression of TF in human tumor cell lines
promotes metastasis. We recently showed that hemoglobin (Hb) forms a
specific complex with TF purified from human malignant melanoma cells
and enhances its procoagulant activity (PCA). To further study this
interaction, we examined the effect of Hb on the expression of TF on
human malignant (TF+) cells and KG1 myeloid leukemia (TF-) cells. Human
melanoma A375 and J82 bladder carcinoma cells, which express TF at
moderate and relatively high levels, respectively, were incubated with
varying concentrations (0-1.5 mg/ml) of Hb. After washing, cells were
analyzed for Hb binding and TF expression using flow cytometry and
confocal microscopy. Hb bound to the cells in a concentration-dependent
manner, and increased both TF expression and PCA. The human A375
malignant melanoma cells incubated with Hb (1 mg/ml) expressed up to six
times more TF antigen than cells without Hb. This increase in TF
expression and PCA of intact cells incubated with Hb was significantly
inhibited by cycloheximide at a concentration of 10 microg/ml (P <
0.01). An increase in total cellular TF antigen content was demonstrated
by specific immunoassay. In contrast, Hb (5 mg/ml) did not induce TF
expression and PCA on KG1 cells as determined by flow cytometry and TF
(FXAA) activity. We conclude that Hb specifically binds to TF-bearing
malignant cells and increases their PCA. This effect seems to be at
least partly due to de novo synthesis of TF and increased surface
expression. However, the exact mechanism by which Hb binds and
upregulates TF expression remains to be determined.
2
UI - 11414591
AU - Albert PS; McShane LM; Shih JH; The U.S. National Cancer Institute
TI -
Bladder Tumor Marker Network
Latent class modeling approaches for assessing diagnostic error without
a gold standard: with applications to p53 immunohistochemical assays in
bladder tumors.
SO - Biometrics 2001 Jun;57(2):610-9
AD - Biometric Research Branch, National Cancer Institute, Bethesda, Maryland
20892-7434, USA. albertp@ctep.nci.nih.gov
Improved characterization of tumors for purposes of guiding treatment
decisions for cancer patients will require that accurate and
reproducible assays be developed for a variety of tumor markers. No gold
standards exist for most tumor marker assays. Therefore, estimates of
assay sensitivity and specificity cannot be obtained unless a latent
class model-based approach is used. Our goal in this article is to
estimate sensitivity and specificity for p53 immunohistochemical assays
of bladder tumors using data from a reproducibility study conducted by
the National Cancer Institute Bladder Tumor Marker Network. We review
latent class modeling approaches proposed by previous authors, and we
find that many of these approaches impose assumptions about specimen
heterogeneity that are not consistent with the biology of bladder
tumors. We present flexible mixture model alternatives that are
biologically plausible for our example, and we use them to estimate
sensitivity and specificity for our p53 assay example. These mixture
models are shown to offer an improvement over other methods in a variety
of settings, but we caution that, in general, care must be taken in
applying latent class models.
3
UI - 11432035
AU - Pieras Ayala E; Palou J; Rodriguez-Villamil L; Millan Rodriguez F;
TI -
Salvador Bayarri J; Vicente Rodriguez J
[Cytoscopic follow-up of initial G3T1 bladder tumors treated with BCG]
SO - Arch Esp Urol 2001 Apr;54(3):211-7
AD - Servicio de Urologia, Fundacion Puigvert, Barcelona, Espana.
OBJECTIVE: To evaluate the cystoscopic findings during initial
follow-up, the anatomopathological correlation of tumor endoscopic
features and the results of standard control multiple biopsy performed 6
months after TUR in patients with G3T1 transitional carcinoma treated
with BCG. METHODS: 114 patients with G3T1 bladder tumor (52% associated
with Cis) were treated with 81 mg Connaught BCG intravesical
instillations weekly for 6 consecutive weeks. Follow-up was performed
with cystoscopy and cytology at 3 months, and cystoscopy and standard
multiple biopsy at 6 months. The endoscopic findings were described as
normal bladder, macroscopically tumorous lesion or erythematous lesion.
RESULTS: During the first 6 months of follow-up superficial recurrence
was found in 16% and 5% showed progression to muscle invasion. Tumor
recurrence or progression was found in 61% and 39% at 3 and 6 months,
respectively. Most of the macroscopically tumorous lesions resulted in a
tumor at 3 and 6 months in 56% and 64%, respectively, and the remaining
lesions were mainly inflammatory granulomas produced by BCG therapy.
Twenty biopsies of erythematous areas detected only one case of Cis (5%)
and 98 standard multiple biopsies of endoscopically normal mucosa
detected 10 cases of Cis (overall, 3 at 3 months and 7 at 6 months); all
cases were preceded by initial Cis except in one case. CONCLUSIONS:
Cystoscopy performed at 3 months is very useful since it detected 61% of
the superficial recurrences and 66% of the cases with progression to
muscle invasion during the first 6 months. Routine biopsy of
erythematous areas detected during cystoscopy is of little value since a
large number of these biopsies are unnecessary in view of its diagnostic
yield (5%). Since 90% of the Cis detected during the first 6 months of
follow-up were patients with Cis in the initial tumor, it would be
appropriate to perform standard multiple biopsy for control only in this
subgroup of patients if the sensitivity of cytology is low in high grade
tumors or Cis.
4
UI - 11450846
AU - Fujiwara H; Emi M; Nagai H; Ohgaki K; Imoto I; Akimoto M; Ogawa O;
TI -
Habuchi T
Definition of a 1-Mb homozygous deletion at 9q32-q33 in a human
bladder-cancer cell line.
SO - J Hum Genet 2001;46(7):372-7
AD - Department of Molecular Biology, Institute of Gerontology, Nippon
Medical School, Kawasaki, Japan.
We performed detailed molecular analyses of a suspected homozygous
deletion on chromosome 9q32-q33 in a bladder-cancer cell line (KYBTDS)
derived from a superficial papillary transitional cell carcinoma (TCC).
We examined 13 sequence-tagged site (STS) markers mapped along 9q32-q33
by polymerase chain reaction (PCR), and used 13 bacterial artificial
chromosome (BAC)/bacteriophage P1-derived artificial chromosome (PAC)
genomic clone probes representing these STS markers as probes for
dual-color fluorescence in situ hybridization (FISH) analyses to define
the deleted region cytogenetically and at the molecular level. Southern
blotting confirmed the findings. This combination of techniques revealed
that the homozygous deletion in the KYBTDS cell line involved less than
1 megabase of DNA, flanked by markers A003P42 and SGC33380. This
interval overlaps part of a common region of deletion observed in a
number of primary bladder cancers; moreover, the DNA sequence within the
1-Mb segment corresponds to part of a YAC genomic clone that encompasses
a putative tumor suppressor gene, DBCCR1.
5
UI - 11455029
AU - Planz B; Synek C; Deix T; Bocking A; Marberger M
TI -
Diagnosis of bladder cancer with urinary cytology, immunocytology and
DNA-image-cytometry.
SO - Anal Cell Pathol 2001;22(3):103-9
AD - Department of Urology, University of Vienna, Vienna, Austria.
DNA-image-cytometry and antibodies directed against the Lewis X- and the
486p 3/12 antigen were applied to improve diagnostic accuracy of urinary
cytology for the detection of bladder cancer. Cytology, immunocytology
and DNA-image-cytometry were performed in spontaneously voided urine
samples and barbotage bladder washings from 71 patients. The DNA content
was determined using the CM-1 Cytometer according to the recommendation
of the ESCAP Consensus Report on Standardization of DNA-image-cytometry
(1995). For immunocytological examination we used the monoclonal anti
Lewis X antibody P-12 and antibody 486p 3/12. All patients underwent
subsequent cystoscopy and for any suspicious lesion biopsy or
transurethral resection was done. Histological findings revealed 31
patients with transitional cell carcinomas of different stages and
grades of malignancy. 40 patients had various benign diseases of the
urinary bladder. Cytology yielded a sensitivity of 68% and a specificity
of 100%. DNA aneuploidy was detected in 81% of cancer patients with a
specificity of 100%. By combination of these two methods the overall
sensitivity increased to 87%. Immunocytology with Lewis X and 486p 3/12
antibodies showed reactivity in 84% and 87% in combination with a
specificity of 80% and 70%, respectively. By combining urinary cytology,
immunocytology and/or DNA-image-cytometry the overall sensitivity
increased to 94% with no change in specificity. DNA-image-cytometry
should be used to evaluate particularly urothelial cells suspicious for
malignancy in urinary specimens. Because of low specificity the
monoclonal antibodies against Lewis X- and 486p 3/12 antigens are not
helpful in screening for bladder cancer. Nevertheless, their high
sensitivity may justify their use in case DNA image cytometry is not
available and in the follow up of patients with transitional cell
carcinoma.
6
UI - 11471896
AU - Mady EA
TI -
Cytokeratins as serum markers in egyptian bladder cancer. A comparison
of CYFRA 21-1, TPA and TPS.
SO - Int J Biol Markers 2001 Apr-Jun;16(2):130-5
AD - Department of Biochemistry, Faculty of Science, Faculty of Medicine, Ain
Shams University, Cairo, Egypt.
Cytokeratins (CKs) have been shown to be overexpressed in bladder cancer
and to be valuable as tumor markers. The present study was designed to
evaluate the single and combined use of three cytokeratin fragments,
CYFRA 21-1, TPA, and TPS, in serum of Egyptian bladder cancer patients.
The study subjects comprised 40 healthy controls, 30 patients with
benign bladder diseases, and 60 patients with histologically confirmed
primary bladder cancer. The cutoff was set at 95% specificity versus
benign bladder diseases, resulting in cutoff values of 2.93 ng/mL for
CYFRA 21-1, 158 U/L for TPA and 143.7 ng/mL for TPS. With 41% true
positive results CYFRA 21-1 had a higher sensitivity than TPA (32%) and
TPS (27%). Evaluation by histological findings revealed a highest
sensitivity of CYFRA 21-1 (46%) in transitional cell carcinoma (TCC)
followed by TPA (27%) and TPS (21%). Also in adenocarcinoma CYFRA 21-1
showed the highest sensitivity (38%) followed by TPA (32%) and TPS
(28%). A high percentage (41.6%) of Egyptian bladder cancers is
represented by squamous cell carcinoma (SCC). In this population TPS
showed the highest sensitivity (69%), followed by CYFRA 21-1 (54%) and
TPA (41 %). The sensitivity of each of the three markers increased with
advancing tumor stage and increasing tumor grade. Combined use of two of
the three markers did not raise the sensitivities obtained by single
determination of CYFRA 21-1. The present study suggests that serum CYFRA
21-1 could be a marker of choice in bladder cancer.
7
UI - 10983969
AU - Fergie N; Murty GE
TI -
Second primary neoplasms in patients with laryngeal carcinoma.
SO - Laryngoscope 2000 Sep;110(9):1586-7
8
UI - 11547058
AU - Shigyo M; Sugano K; Tobisu K; Tsukamoto T; Sekiya T; Kakizoe T
TI -
Molecular followup of newly diagnosed bladder cancer using urine
samples.
SO - J Urol 2001 Oct;166(4):1280-5
AD - Division of Clinical Laboratory, Department of Urology, National Cancer
Center Hospital, Tokyo, Japan.
PURPOSE: Patients with superficial bladder cancer can be treated with
transurethral resection. However, 50% to 70% of them have intravesical
recurrence after transurethral resection and muscle invasive disease
develops in 10% to 20%, which is eventually indicated for radical
cystectomy. Therefore, reliable predictors of intravesical recurrence
are required for management of superficial bladder cancer. We
investigated whether detection of the loss of heterozygosity in urine
samples would be available as a sensitive diagnostic modality for
recurrence of bladder cancer. MATERIALS AND METHODS: Urine samples,
cancer tissue and peripheral blood lymphocytes were obtained from 37
patients with newly diagnosed bladder cancer, and analyzed for the loss
of heterozygosity on chromosomes 9 and 17p by single strand DNA
conformation polymorphism analysis. RESULTS: Chromosomal loss was
detected on 24 (65%) cancer tissues and 26 (70%) urine samples. The loss
of heterozygosity on chromosome 17p was detected in 19 (51%) urine
samples, mostly in cancers with higher grades and/or stages. During
postoperative followup of 24 patients with superficial bladder cancer
who had undergone transurethral resection, intravesical recurrence did
not develop in 9 of 10 without chromosomal aberrations in urine samples.
In contrast, intravesical recurrence developed in 11 of 14 patients who
had a loss of heterozygosity in urine samples. This loss showed a
significant correlation with the intravesical disease-free period (p =
0.004). Multivariate analysis revealed that the loss of heterozygosity
in urine samples was a significant predictor of intravesical recurrence.
CONCLUSIONS: Detection of the loss of heterozygosity in urine samples is
available as a sensitive marker for predicting intravesical recurrence
of superficial bladder cancer.
9
UI - 11547059
AU - Gohji K; Okamoto M; Kitazawa S; Toyoshima M; Dong J; Katsuoka Y;
TI -
Nakajima M
Heparanase protein and gene expression in bladder cancer.
SO - J Urol 2001 Oct;166(4):1286-90
AD - Department of Urology, Osaka Medical College, Takatsuki, Japan.
PURPOSE: We determined the association of heparanase protein and
messenger (m)RNA expression with bladder cancer invasion and metastasis.
MATERIALS AND METHODS: The expression of heparanase protein and mRNA was
assessed by immunohistochemical staining and in situ hybridization,
respectively, in 67 bladder cancer specimens resected at various stages
of disease. To our knowledge this is the first systematic study of
heparanase protein and mRNA expression in human bladder cancer. RESULTS:
The expression of heparanase protein in muscular invasive bladder cancer
was significantly higher than in superficial cancer (68% versus 19%, p =
0.0001). It was higher in the primary tumor of patients with lymph node
metastatic cancer than those with nonmetastatic cancer (80% versus 37%,
p = 0.0006). In high grade disease it was significantly higher than in
low grade disease (79% versus 29%, p = 0.0001). The expression of
heparanase mRNA was also significantly higher in stage pT3 or greater
than in stage pT2 or less bladder cancer (96% versus 33%, p = 0.0003).
In metastatic N+ cases it was significantly higher than in nonmetastatic
bladder cancer (93% versus 46%, p = 0.0037). The heparanase gene and
protein showed similar patterns of expression in bladder cancer.
CONCLUSIONS: Our study implies that the expression of heparanase protein
and mRNA is associated with bladder cancer invasion and metastasis, and
heparanase may have a role in disease progression.
10
UI - 11547061
AU - Herr HW; Sogani PC
TI -
Does early cystectomy improve the survival of patients with high risk
superficial bladder tumors?
SO - J Urol 2001 Oct;166(4):1296-9
AD - Department of Urology, Memorial Sloan-Kettering Cancer Center, New York,
New York, USA.
PURPOSE: We compared survival after early versus delayed cystectomy in
patients with high risk superficial bladder tumors. MATERIALS AND
METHODS: Of 307 patients with high risk superficial bladder tumors who
were treated initially with transurethral resection and bacillus
Calmette-Guerin (BCG) therapy 90 (29%) underwent cystectomy for
recurrent tumor during a followup of 15 to 20 years. Disease specific
survival distribution of these 90 patients was determined relative to
the indications for and time of cystectomy. RESULTS: Of the 90 patients
who underwent cystectomy 44 (49%) survived a median of 96 months. Of 35
patients with recurrent superficial bladder tumors 92% and 56% survived
who underwent cystectomy less than 2 years after initial BCG therapy and
after 2 years of followup, respectively. Of 55 patients with recurrent
muscle invasive bladder disease 41% and 18% survived when cystectomy was
performed within and after 2 years, respectively. Multivariate analysis
showed that survival was improved in patients who underwent earlier
rather than delayed cystectomy for nonmuscle invasive tumor relapse.
CONCLUSIONS: Earlier cystectomy improves the long-term survival of
patients with high risk superficial bladder tumors in whom BCG therapy
fails.
11
UI - 11549483
AU - Frimberger D; Zaak D; Stepp H; Knuchel R; Baumgartner R; Schneede P;
TI -
Schmeller N; Hofstetter A
Autofluorescence imaging to optimize 5-ALA-induced fluorescence
endoscopy of bladder carcinoma.
SO - Urology 2001 Sep;58(3):372-5
AD - Department of Urology, Universitaetskrankenhaus Grosshadern der
Ludwig-Maximilians Universitaet, Munich, Germany.
OBJECTIVES: To design an optical system for detecting autofluorescence
(AF) of bladder tumors and to determine the success of reducing the
false-positive rate of 5-aminolevulinic acid-induced fluorescence
endoscopy (AFE). AFE provides significantly higher sensitivity in
detecting and localizing bladder carcinoma compared with white light
endoscopy. The specificity of AFE is equivalent to white light
endoscopy, mostly because of the false-positive fluorescence of chronic
cystitis lesions. Laser-induced spectral autofluorescence detection is
also an efficient method in the diagnosis of bladder carcinoma. METHODS:
Bladder tissue was excited to AF using the D-Light (375 to 440 nm) after
regular AFE with detection of fluorescence-positive areas. The optical
image was produced using a special RGB camera. Biopsies were taken from
AFE-positive areas, the peritumoral edges, and normal bladder mucosa.
The AF images of the suspicious areas were compared with the AFE images
and the histologic results. RESULTS: A total of 43 biopsies were
histologically examined (24 benign and 19 neoplastic). AF imaging showed
contrast differences between papillary tumors, flat lesions, and normal
mucosa. The combination of AFE with AF raised the specificity of AFE
alone from 67% to 88%. CONCLUSIONS: AF imaging is possible. The value of
the method in reducing the false-positive rate of the highly sensitive
AFE needs to be validated with higher numbers. The combination of AF
with AFE had a 20% higher specificity than AFE alone in our study.
12
UI - 11562747
AU - Satoh M; Ito A; Nojiri H; Handa K; Numahata K; Ohyama C; Saito S; Hoshi
TI -
S; Hakomori SI
Enhanced GM3 expression, associated with decreased invasiveness, is
induced by brefeldin A in bladder cancer cells.
SO - Int J Oncol 2001 Oct;19(4):723-31
AD - Department of Urology, Tohoku University School of Medicine, Sendai
980-8574, Japan. msatoh@uro.med.tohoku.ac.jp
We reported previously that non-invasive bladder cancer expresses high
level of GM3 ganglioside, whereas invasive tumors have low levels. Since
glycosphingolipid synthesis in Golgi is modified greatly by a
macrocyclic lactone isolated from fungi, brefeldin A (BFA), we studied
effects of BFA on expression of glycosphingolipids and on invasiveness
of bladder cancer cell lines. Only GM3 synthesis in invasive tumors was
greatly enhanced upon treatment with BFA; synthesis of other
glycosphingolipids with lacto-series type 2 or globo-series structure in
both invasive and non-invasive tumors was not changed. Invasiveness of
bladder cancer cells was greatly decreased in association with the great
increase of GM3 synthesis induced by BFA treatment. Level of sialyl-Lex
expressed in invasive cell line YTS1, which provides the adhesive
property of the cells to E-selectin, was unchanged upon BFA treatment.
All the bladder cancer cell lines, regardless of invasiveness, highly
express tetraspanin CD9. GM3 has been implicated as a co-factor of CD9
in control of tumor cell motility. Down-regulation of CD9 is associated
with metastatic properties of tumor cells and survival of patients with
colonic cancer. Therefore, enhanced synthesis of GM3 induced by BFA,
causing decrease of invasiveness in bladder cancer, is ascribable to the
capability of GM3 to interconnect integrin with CD9, in analogy to
colonic cancer and perhaps many other types of cancer.
13
UI - 11564895
AU - Tomobe M; Shimazui T; Uchida K; Akaza H
TI -
AgNOR count in resting cells (resting NOR) is a new prognostic marker in
invasive bladder tumor.
SO - Anal Cell Pathol 2001;22(4):193-9
AD - Department of Urology, Institute of Clinical Medicine, University of
Tsukuba, Ibaraki, Japan.
PURPOSE: We have previously demonstrated that the AgNOR count in
proliferating cells is a predictor of tumor recurrence in superficial
bladder tumor (J. Urol. 162 (1999), 63-68). In the present study, we
evaluate the type of AgNOR associated with cell cycles as a prognostic
factor in invasive bladder tumor using a double staining technique
employing both AgNOR and MIB-1 labelling. MATERIALS AND METHODS:
Forty-four paraffin sections of invasive bladder tumors were stained
simultaneously with AgNOR and MIB-1. The number of AgNORs in
proliferating (MIB-1 positive) or resting (MIB-1 negative) cells were
counted from a total of 100 nuclei. Correlations between MIB-1
associated AgNOR count and clinicopathological parameters were
statistically analyzed. RESULTS: The AgNOR count in proliferating cells
(proliferating NOR) was significantly higher than that in resting cells
(resting NOR) (p<0.01). The resting NOR in tumors with distant
metastases was significantly higher than that in tumors without
metastases (p<0.05). Patients with a low resting NOR tumor had a better
prognosis than those with a high resting NOR tumor, whereas the
proliferating NOR was not associated with survival. Survival analysis
revealed that the resting NOR was the most powerful prognostic marker in
patients with invasive bladder tumor (p<0.05). CONCLUSIONS: Resting NOR
had a predictive value in the prognosis of patients with invasive
bladder tumor.
14
UI - 11577435
AU - Mizuno K; Sasaki T; Saito Y; Itabashi Y; Miura H; Yodono H; Abe Y;
TI -
Kawaguchi T
[Gadolinium-enhanced MR imaging, T2-weighted MR imaging, and
transurethral ultrasonography]
SO - Nippon Igaku Hoshasen Gakkai Zasshi 2001 Aug;61(9):496-501
AD - Department of Radiology, Iwate Prefectural Central Hospital.
PURPOSE: To assess the value and problems of dynamic gadolinium-enhanced
MR imaging, T2-weighted MR imaging, and transurethral
ultrasonography(TUUS) in staging of urinary bladder cancer. MATERIALS
AND METHODS: Dynamic gadolinium-enhanced MR imaging and FSE T2-weighted
MR imaging of 64 patients with urinary bladder cancer who subsequently
had surgery were retrospectively reviewed and compared with TUUS
findings. RESULTS: Specificity for muscular invasion was 90.5% with
TUUS, significantly better than with dynamic MR imaging (64.9%) (p <
0.05). The rates of overestimation of superficial cancer(pT1) with
dynamic MRI and T2-weighted MR imaging were 35.1%(13/37) and
24.3%(9/37), respectively. The staging accuracy of invasive cancer(pT2
or over) was 85.2% with dynamic MR imaging, which was better than the
rate of 75.0% achieved with T2-weighted MR imaging. CONCLUSION: Although
TUUS was a better modality for diagnosing superficial cancer(pT1),
dynamic MR imaging was found to be better for diagnosing invasive(pT2 or
over) cancer.
15
UI - 11593561
AU - Zhuang L; Zhang Z; Guo Y
TI -
Aberrant expression of growth factor Wnt-5A in six urinary malignant
cell lines.
SO - Chin Med J (Engl) 1999 Mar;112(3):251-5
AD - Department of Urology, First Hospital, Beijing Medical University,
Institute of Urology, Beijing Medical University, Beijing 100034, China.
OBJECTIVE: To investigate the expression of growth factor Wnt-5A in
urinary tumor cell lines. METHODS: By semi-quantitative RT-PCR (reverse
transcriptase polymerase chain reaction), the expression of Wnt-5A in
six urinary malignant cell lines, one primary cultured renal fibroblast
and one case of normal human renal tissue was detected using Gel Doc
1000 computer controlled molecular analysis system. RESULTS: The
expression of Wnt-5A in-urinary tumor cell lines was much higher than
that in primary cultured renal fibroblasts (PRF) and normal human renal
tissue (NRT). The levels of Wnt-5A mRNA were different between six
malignant cell lines. CONCLUSION: The overexpression of growth factor
Wnt-5A has a potential effect on the oncogenesis of urinary
malignancies.
16
UI - 11584321
AU - Troxel DB
TI -
Diagnostic errors in surgical pathology uncovered by a review of
malpractice claims: part VI--urinary bladder and branchial cleft cyst.
SO - Int J Surg Pathol 2001 Jul;9(3):227-9
AD - Department of Pathology, Mt Diablo Medical Center, Concord, California
94520, USA.
17
UI - 11584067
AU - Nersesyan AK
TI -
Re: Biomarker risk assessment and bladder cancer detection in a cohort
exposed to benzidine.
SO - J Natl Cancer Inst 2001 Oct 3;93(19):1492-3
18
UI - 11598176
AU - Iczkowski KA; Shanks JH; Gadaleanu V; Cheng L; Jones EC; Neumann R;
TI -
Nascimento AG; Bostwick DG
Inflammatory pseudotumor and sarcoma of urinary bladder: differential
diagnosis and outcome in thirty-eight spindle cell neoplasms.
SO - Mod Pathol 2001 Oct;14(10):1043-51
AD - Department of Pathology and Laboratory Medicine, University of Florida
and Veterans Administration Medical Center, Gainesville, Florida
32608-1197, USA. iczkoka@pathology.ufl.edu
We assessed diagnostic criteria among 38 spindle cell tumors of the
urinary bladder and obtained follow-up in 36 patients. Patients
comprised 28 males and 10 females aged 2.5 months to 87 years. Hematuria
was the commonest presenting symptom (27 patients). After review and
immunohistochemical workup, 17 patients had inflammatory pseudotumor
(myofibroblastic tumor), 4 postoperative spindle cell nodule, 1
leiomyoma, 13 sarcoma (7 low-grade; 6 high-grade), and 3 carcinoma. Mean
age was 38 years for pseudotumor (range 15 to 74), 65 for postoperative
spindle cell nodule, 51 for sarcoma, and 76 for carcinoma. Size of
pseudotumor averaged 4.4 +/- 0.7 cm (range 1.5 to 13.0), similar to
sarcoma, 4.0 +/- 0.6 cm (range 0.5 to 7.0). Similar proportions of
benign tumors and sarcomas had muscularis propria invasion. The criteria
that best differentiated sarcoma from inflammatory pseudotumor were
presence of necrosis at the tumor-detrusor muscle interface in
muscle-invasive cases, and nuclear atypia. Sarcoma also had less
prominent microvasculature, less variable cellularity, consistently > or
=1 mitotic figure per 10 high-power fields, and predominant acute
inflammation without plasma cells. p53 protein nuclear immunostaining
was moderate, unlike the rare to absent staining in pseudotumors.
Because all 12 sarcomas were desmin-negative, we did not call them
leiomyosarcoma; they overlapped with benign tumor in epithelial,
mesenchymal, and actin immunostaining. Among 12 sarcoma patients, 2 died
of tumor (at 3 months). Two of four experienced tumor recurrence after
partial cystectomy (2 and 26 months). No pseudotumors recurred after
transurethral resection or partial cystectomy, although one patient, 5
months after transurethral resection, had histologically identical
pseudotumor that the surgeon considered residual. Another patient with
pseudotumor, not a candidate for tumor ablation after transurethral
resection, had continued tumor growth and he died of urosepsis. In
conclusion, inflammatory pseudotumor, although overlapping with sarcoma
in presentation, age range, and size, does not metastasize and remains
histologically distinct from low-grade sarcoma.
19
UI - 11597537
AU - Patard J; Moudouni S; Saint F; Rioux-Leclercq N; Manunta A; Guy L;
TI -
Ballanger P; Lanson Y; Hajri M; Irani J; Guille F; Beurton D; Lobel B;
Bernard Lobel and The members of the Groupe Necker
Tumor progression and survival in patients with T1G3 bladder tumors:
multicentric retrospective study comparing 94 patients treated during 17
years.
SO - Urology 2001 Oct;58(4):551-6
AD - Department of Urology, Centre Hospitalo-Universitaire Rennes, Rennes,
France.
OBJECTIVES: To compare tumor recurrence, progression, and patient
survival in T1G3 bladder tumors treated with transurethral resection
(TUR) alone, early cystectomy, or TUR with an adjuvant 6-week course of
bacille Calmette-Guerin (BCG) and followed up for a minimum of 5 years.
METHODS: Between 1979 and 1996, 94 patients with T1G3 bladder tumors
(lamina propria invasion) were treated at nine different centers. The
time to tumor recurrence, tumor stage and grade progression, number of
delayed cystectomies, and patient survival were analyzed retrospectively
in relation to the initial treatment. RESULTS: The mean follow-up was 62
months. Thirty patients were treated by TUR alone (32%), 50 patients by
TUR plus BCG (53%), and 14 patients by primary cystectomy (15%). The
recurrence, progression, and cystectomy rates were significantly
different between patients treated by TUR alone and TUR plus BCG
(Fisher's exact test, P = 0.0005, P = 0.02, and P = 0.005,
respectively). The disease-free survival was also significantly
different when comparing TUR plus BCG with TUR alone or primary
cystectomy (Kaplan-Meier analysis, log-rank test, P = 0.02).
CONCLUSIONS: Endoscopic resection plus BCG treatment of pT1G3 tumors
allows an 80% rate of disease-free 5-year survival with bladder
preservation. This conservative option has been widely accepted as
first-line treatment, offering good cancer control with excellent
quality of life. Very accurate surgical and pathologic evaluations
before treatment and lifelong follow-up are obviously required.
20
UI - 11668518
AU - Seripa D; Parrella P; Gallucci M; Gravina C; Papa S; Fortunato P; Alcini
TI -
A; Flammia G; Lazzari M; Fazio VM
Sensitive detection of transitional cell carcinoma of the bladder by
microsatellite analysis of cells exfoliated in urine.
SO - Int J Cancer 2001 Nov 20;95(6):364-9
AD - Unita Patologia Molecolare e Terapia Genica, IRCCS H. Casa Sollievo
Sofferenza, Opera Padre Pio da Pietrelcina, San Giovanni Rotondo, Italy.
Transitional cell carcinoma (TCC) is the most common bladder tumor.
Urine cytology can identify most high-grade tumors but sensitivity is
lower if one includes lesions of all grades. Microsatellite marker
alterations have been found in many tumor types including bladder cancer
and have been used to detect cancer cells in body fluids including
urine. The aim of our study is to further evaluate feasibility and
sensitivity of microsatellite analysis to detect bladder cancer cells in
urine. We studied 55 individuals: 21 with symptoms suggestive of bladder
cancer, 23 patients with previous history of TCC and 11 healthy
subjects. Genomic DNA was extracted from blood lymphocytes, urine
sediment, bladder washings and tumor or normal bladder mucosa. Twenty
highly informative microsatellite markers were analyzed for loss of
heterozigosity (LOH) and microsatellite instability (MIN) by polymerase
chain reaction. Microsatellite analysis of urine identified 33 of 34
(97%) patients with either primary or tumor recurrence, whereas urine
cytology identified 27 of 34 (79%) patients (p = 0.0001). Detection of
microsatellite abnormalities improved the sensitivity of detecting
low-grade and/or stage bladder tumor: from 75-95% for grades G1-G2 and
from 75-100% for pTis-pTa tumors. Bladder washings from 25 patients were
also analyzed, and in all cases results were identical to those obtained
from voided urine. None of the 16 patients without evidence of TCC
showed LOH and/or MIN in urine samples or bladder washings.
Interestingly, in a patient with persistent bladder mucosa
abnormalities, microsatellite alterations were demonstrated 8 months
before the histopathologic diagnosis of tumor recurrence. These results
further indicate that microsatellite marker analysis is more sensitive
than conventional urine cytology in detecting bladder cancer cells in
urine and represents a potential clinical tool for monitoring patients
with low-grade/stage TCC. Copyright 2001 Wiley-Liss, Inc.
21
UI - 11592769
AU - Zeegers MP; Goldbohm RA; van den Brandt PA
TI -
Are retinol, vitamin C, vitamin E, folate and carotenoids intake
associated with bladder cancer risk? Results from the Netherlands Cohort
Study.
SO - Br J Cancer 2001 Sep 28;85(7):977-83
AD - Department of Epidemiology, Maastricht University, Maastricht, The
Netherlands.
In the Netherlands Cohort Study among 120 852 subjects aged 55-69 years
at baseline (1986), the association between vitamins and carotenoids
intake, vitamin supplement use, and bladder cancer incidence was
examined. Exposure status was measured with a food-frequency
questionnaire. After 6.3 years of follow-up, data from 569 cases and
3123 subcohort members were available for case-cohort analyses. The
age-, sex-, and smoking-adjusted relative risks (RRs) for retinol,
vitamin E, folate, a-carotene, b-carotene, lutein and zeaxanthin, and
lycopene were 1.04, 0.98, 1.03, 0.99, 1.16, 1.11, and 1.08,
respectively, comparing highest to lowest quintile of intake. Only
vitamin C (RR: 0.81, 95% CI: 0.61-1.07, P-trend = 0.08), and
b-cryptoxanthin intake (RR: 0.74, 95% CI: 0.53-1.03, P-trend < 0.01)
were inversely associated with bladder cancer risk. The association with
vitamin C disappeared after adjustment for b-cryptoxanthin but not vice
versa. The RRs for supplemental use of vitamin A, C or E compared to no
use were around unity. We conclude that dietary or supplemental intake
of vitamin A, vitamin C, vitamin E, and intake of folate, and most
carotenoids are not associated with bladder cancer. In this study, only
b-cryptoxanthin intake appeared to be inversely associated. Copyright
2001 Cancer Research Campaign
22
UI - 11678759
AU - Saint F; Patard JJ; Groux Muscatelli B; Lefrere Belda MA; Gil Diez de
TI -
Medina S; Abbou CC; Chopin DK
Evaluation of cellular tumour rejection mechanisms in the peritumoral
bladder wall after bacillus Calmette-Guerin treatment.
SO - BJU Int 2001 Oct;88(6):602-10
AD - Department of Urology, Hopital Henri Mondor, Creteil, France.
OBJECTIVE: To compare the immunological status of normal and peritumoral
bladder walls, and to characterize immunocompetent cells before and
during intravesical instillations of bacillus Calmette-Guerin (BCG).
PATIENTS AND METHODS: Twenty-three patients with superficial urothelial
bladder carcinoma (stages pTa to pT1, grades 1-3) were treated with six
weekly instillations of 150 mg of BCG (Pasteur strain). Biopsies of
cystoscopically normal bladder wall were taken before, 3 weeks and 3
months after BCG instillation. The controls comprised bladder biopsy
specimens from 13 brain-dead ventilated kidney donors. Local
infiltrating cell types, i.e. lymphocyte infiltrates (CD4, CD8, CD20,
CD3, interleukin-2-receptor-positive, natural killer, gammadelta),
macrophages and dendritic cells, adhesion and costimulatory molecules
(ICAM-1 and B7-BB1) and major histocompatibility complex (MHC) class I
and class II antigens were assessed using semi-quantitative
immunohistochemical analysis. RESULTS: Before BCG the peritumoral
bladder wall had fewer macrophages than control bladder wall. BCG
treatment restored normal numbers of macrophages and enhanced T helper
lymphocytes, B lymphocytes, natural killer cells, activated lymphocytes,
dendritic cells, normal MHC class I, adhesion (ICAM-1) and costimulatory
(B7-BB1) expression. The enhancement of these immunological variables
was transient, with a return to baseline 3 months after BCG
instillation. CONCLUSIONS: These results support the concept that there
is a host-immune escape associated with bladder cancer. BCG therapy may
temporarily restore impaired tumour rejection mechanisms in the
peritumoral bladder wall, suggesting a need for maintenance therapy
after the first course of BCG.
23
UI - 11679798
AU - Kaye JA; Myers MW; Jick H
TI -
Acetaminophen and the risk of renal and bladder cancer in the general
practice research database.
SO - Epidemiology 2001 Nov;12(6):690-4
AD - Boston Collaborative Drug Surveillance Program, Boston University School
of Medicine, Lexington, MA 02421, USA.
We conducted a nested, matched case-control study in the General
Practice Research Database (GPRD) to assess whether acetaminophen use is
associated with renal or bladder cancer. We matched 109 cases of renal
cancer and 189 cases of bladder cancer with up to 4 controls each by
age, sex, general practice, duration of drug history in the GPRD, and
index date. We found that use of acetaminophen from 1 to 5 years before
the index date was associated with an increased risk of renal cancer,
with a direct relation between risk and number of prescriptions and an
adjusted odds ratio of 2.3 (95% CI 1.0-5.3) for subjects with 20 or more
prescriptions. There was no evidence for an increase in risk of bladder
cancer with acetaminophen use. We found no association between use of
non-steroidal anti-inflammatory drugs and either renal or bladder
cancer. These results support previous findings from our group and are
consistent with a slight increase in the risk of renal cancer, but not
bladder cancer, with heavy acetaminophen use.
24
UI - 11679802
AU - Michaud DS; Clinton SK; Rimm EB; Willett WC; Giovannucci E
TI -
Risk of bladder cancer by geographic region in a U.S. cohort of male
health professionals.
SO - Epidemiology 2001 Nov;12(6):719-26
AD - Department of Nutrition, Harvard School of Public Health, Boston, MA,
USA.
Large regional variations in bladder cancer rates have been observed for
numerous decades in the United States and persist to date. We examined
the incidence rates of bladder cancer by geographic region among U.S.
male health professionals to determine whether diet or other lifestyle
factors can account for variations observed. During 12 years of
follow-up, 328 cases of bladder cancer were diagnosed in the Health
Professionals Follow-up Study cohort. We inquired about diet, lifetime
history of smoking, race, marital status, and other nondietary factors
using mailed questionnaires. An elevated risk of bladder cancer was
observed in the Northeast compared with the West [relative risk (RR) =
1.71, 95% confidence interval (CI) = 1.23-2.39], which was slightly
attenuated after controlling for smoking (RR = 1.65, 95% CI =
1.18-2.30). Smoking patterns, diet, and other lifestyle factors could
not account for all of the elevated bladder cancer risk in the
Northeast. Bladder cancer risk was highest among men who had a long
residency in the Northeast compared with a long residency in the West
(RR = 1.77, 95% CI = 1.15-2.71, adjusted for smoking). Diet and other
known characteristics do not appear to be responsible for the regional
variations in bladder cancer rates in the United States.
25
UI - 11692897
AU - Roy MK; Islam MF; Kibria SA
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