共查询到20条相似文献,搜索用时 15 毫秒
1.
Shin-ichi Honda Yoshiro Sakamoto Makoto Fujime Ryuichi Kitagawa 《International journal of urology》1997,4(1):68-73
Background This study investigated changes in the phenotypic characteristics of tumor-infiltrating lymphocytes during intravesical bacillus Calmette-Guérin (BCC) treatment using an immunohistochemical technique.
Methods A total of 16 patients with superficial bladder cancer underwent intravesical BCG treatment for therapeutic purposes. Tissue specimens were obtained from these patients before and after BCG treatment by cold cup biopsies.
Results The numbers of CD3
Conclusions γ/δT cells may play an important role in the immune response of the host to the tumor in intravesical BCG treatment (although this correlation was statistically insignificant). 相似文献
2.
Nobuyuki Oyama Kazuya Tanase Hironobu Akino Hirotaka Mori Hiroshi Kanamaru Kenichiro Okada 《International journal of urology》1998,5(2):185-187
A 76-year-old-man was admitted to our hospital for a recurrent bladder tumor. He had received intravesical bacillus Calmette-Guérin (BCG) treatment for a transitional cell carcinoma of the bladder. A follow-up cystoscopy revealed a solitary papillary tumor in the left bladder wall. A transurethral cold cup biopsy revealed a nephrogenic adenoma without any evidence of malignant cells. We discuss the pathogenesis of nephrogenic adenoma and suggest that prolonged cystitis caused by intravesical BCG may play an etiological role. 相似文献
3.
Hiroshi Kanamaru Shigeki Saikawa Koji Muranaka Hirotaka Mori Hironobu Akino Yoshiji Miwa Naohiro Nakamura Tomohiro Fujita Kenichiro Okada 《International journal of urology》1996,3(1):18-22
Background : Disease progression after Bacillus Calmette-Guérin (BCG) instillation therapy for bladder cancer is not rare. The purpose of this study was to evaluate the outcome of patients treated with BCG for superficial bladder cancer, focusing on the patients who developed invasive disease during follow-up. The possible mechanism and risk factors for early progression after BCG therapy are discussed. Methods : A total of 25 patients with superficial bladder cancer (pTa, pT1, and/or pTis) were treated with intravesical BCG instillation (80 mg in 80 mL saline) once a week for eight weeks. Four of the 25 patients received maintenance therapy with BCG (once a month for 3 to 10 months). Patients were followed every three months and underwent cystoscopy, biopsy, and urinary cytology at these intervals. Disease progression was defined as invasion to muscle or prostate, or development of metastatic disease. Clinicopathological features of the patients, especially those with progression, were analyzed. Results : Progression was observed in six of the 25 patients (including four of 19 patients with carcinoma in situ and two of five patients treated prophylactically with BCG). The average time to progression was 8.7 months. Four patients died of cancer despite intensive treatment. Two patients are alive: one without evidence of disease after cystectomy and the other with metastatic disease. Conclusions : Proper patient selection, careful follow-up, and immediate aggressive therapy in case of progression were considered to be important factors to obtain satisfactory results with BCG therapy for bladder cancer. 相似文献
4.
Background :
Prediction of a response to intravesical bacillus Calmette-Guérin (BCG) therapy for bladder cancer is clinically important. We determined whether several molecular markers have prognostic value in intravesical BCG therapy for multiple, high-grade, stage T1 bladder cancers. Methods: The expressions of p53 (clone D07), bcl-2 (100-D5), cathepsin-D (C5), c-myc(9E11), c-erbB-2 (CB11) and Ki-67 (MM1) were determined by immunohistochemistry in paraffin-embedded tissues from 32 multiple, T1, grade II–III bladder cancer patients (1 5 BCG responders, 1 7 nonresponders) who had undergone a single course of BCG therapy (Pasteur strain, 5 × 108 CFU weekly for 6 weeks) after complete removal of the tumors. The association between the expression of these markers and the response to BCG was assessed by univariate and multivariate analyses.
Results :
There was no difference in patient and tumor characteristics between the 2 groups. Using multivariate analysis, the only useful marker was p53, with the overexpression of the p53 protein inversely related to the response to BCG therapy (P = 0.0182).
Conclusion :
Our results suggest that the status of p53 expression offers significant clinical information and may be a useful tool in the selection of suitable candidates for BCG therapy in multiple, high-grade stage T1 bladder cancer patients. 相似文献
Prediction of a response to intravesical bacillus Calmette-Guérin (BCG) therapy for bladder cancer is clinically important. We determined whether several molecular markers have prognostic value in intravesical BCG therapy for multiple, high-grade, stage T1 bladder cancers. Methods: The expressions of p53 (clone D07), bcl-2 (100-D5), cathepsin-D (C5), c-myc(9E11), c-erbB-2 (CB11) and Ki-67 (MM1) were determined by immunohistochemistry in paraffin-embedded tissues from 32 multiple, T1, grade II–III bladder cancer patients (1 5 BCG responders, 1 7 nonresponders) who had undergone a single course of BCG therapy (Pasteur strain, 5 × 10
Results :
There was no difference in patient and tumor characteristics between the 2 groups. Using multivariate analysis, the only useful marker was p53, with the overexpression of the p53 protein inversely related to the response to BCG therapy (P = 0.0182).
Conclusion :
Our results suggest that the status of p53 expression offers significant clinical information and may be a useful tool in the selection of suitable candidates for BCG therapy in multiple, high-grade stage T1 bladder cancer patients. 相似文献
5.
Cherifa Ayari Hélène LaRueHélène Hovington Marc DecobertFrançois Harel Alain BergeronBernard Têtu Louis LacombeYves Fradet 《European urology》2009
Background
The clinical significance of tumor-infiltrating dendritic cells (TIDCs) and tumor-associated macrophages (TAMs) as markers of immune response has been reported for many cancers.Objective
To measure tumor infiltration by CD83+ dendritic cells (DCs) and CD68+ macrophages in non–muscle-invasive urothelial cancer (NMIUC) prior to bacillus Calmette-Guérin (BCG) immunotherapy and to evaluate their significance in the response to immunotherapy.Design, setting, and participants
Patients with NMIUC at high risk of recurrence and progression were recruited for a study on markers of the response to BCG.Intervention
Patients were treated by transurethral resection followed by maintenance BCG.Measurements
Immunohistochemical staining with anti-CD83 and anti-CD68 monoclonal antibodies on 53 and 46 NMIUC tumors, respectively, prior to BCG treatment. A scoring index was calculated based on the average density of positive cells within the papillary axis, the stroma, lymphoid aggregates, and infiltration into tumors.Results and limitations
CD83+ TIDCs were observed mostly within lymphoid aggregates. Multivariate Cox regression analysis showed that maintenance BCG (more than one maintenance cycle) was highly effective in patients with a low level of CD83+ TIDCs at time of resection (hazard ratio [HR]: 0.035; p = 0.002) but showed reduced efficacy in patients with a high level of CD83+ TIDCs (HR: 0.87; p = 0.810). A high level of infiltration by CD83+ TIDCs slightly decreased the risk of recurrence in patients treated with one or no maintenance BCG cycle (HR: 0.4; p = 0.117). In the same population, a strong infiltration of CD68+ TAMs was associated with an increased risk of recurrence (HR: 3.8; p = 0.013).Conclusions
These results suggest that patients with a high level of infiltration by CD83+ TIDCs or CD68+ TAMs do not respond as well to BCG immunotherapy. If confirmed in larger cohorts, the pretreatment level of infiltration by these cells may be useful to influence the choice of treatment strategy. 相似文献6.
Amit R. Patel Edmund S. Sabanegh J. Stephen Jones Steven M. Gordon Mitchell Ballin Paul M. Ruggieri Andrew J. Stephenson 《European urology》2010
A 66-yr-old male presented with progressively worsening back pain 5 mo after undergoing radical cystectomy and bilateral extended pelvic lymph node dissection for bacillus Calmette-Guérin–refractory pTisN0M0 urothelial carcinoma of the bladder. Imaging revealed lytic lesions in the 10th and 11th vertebral bodies of the thoracic spine that were suspicious for metastasis and cord compression. The patient underwent computed tomography–guided biopsy of the abnormalities, which showed no evidence of malignancy but revealed chronic inflammatory infiltrate with cultures positive for Mycobacterium bovis. The patient was treated with isoniazid, rifampin, ethambutol, and pyrazinamide. 相似文献
7.
目的:研究5-氨基乙酰丙酸(5-ALA)诱导荧光光动力学对膀胱肿瘤的早期诊断价值。方法:对血尿患者行5-ALA诱导荧光膀胱镜检查及活组织检查,以5-ALA膀胱灌注,2h后采用D-light光源系统进行膀胱镜检,对荧光阳性区域及白光下肉眼可见异常但荧光阴性区域进行活检,活检后行经尿道膀胱肿瘤电切术。结果:31例患者中有4例荧光阴性且普通光肉眼观阴性者未活检。余27例患者共取活检96处,其中荧光阳性区域取活检89处(包括普通光肉眼观阴性区域35处),切缘取活检7处。病理检查结果显示:尿路上皮癌65处,阳性率为73.03%(65/89),非肿瘤性病变24例,假阳性率为27%(24/89),切缘活检7处为阴性。荧光下阳性而白光下阴性的肿瘤位点11处,切缘活检7处均为阴性。结论:5-ALA诱导荧光光动力学诊断对膀胱肿瘤有较高价值,能发现早期肿瘤,同时进行电切将更彻底。 相似文献
8.
Maurizio Brausi Jorg Oddens Richard Sylvester Aldo Bono Cees van de Beek George van Andel Paolo Gontero Levent Turkeri Sandrine Marreaud Sandra Collette Willem Oosterlinck 《European urology》2014
Background
Although bacillus Calmette-Guérin (BCG) has proven highly effective in non–muscle-invasive bladder cancer (NMIBC), but it can cause severe local and systemic side effects.Objectives
The objective was to determine whether reducing the dose or duration of BCG was associated with fewer side effects. Efficacy comparisons of one-third dose versus full dose BCG given for 1 yr versus 3 yr have previously been published.Design, setting, and participants
After transurethral resection, patients with intermediate- and high-risk NMIBC without carcinoma in situ were randomised to one-third dose or full dose BCG and 1 yr or 3 yr of maintenance.Outcome measurements and statistical analysis
Local and systemic side effects were recorded at every instillation and divided into three time periods: during induction, during the first year after induction, and during the second and third years of maintenance.Results and limitations
Of the 1316 patients who started BCG, 826 (62.8%) reported local side effects, 403 (30.6%) reported systemic side effects, and 914 (69.5%) reported local or systemic side effects. The percentage of patients with at least one side effect was similar in the four treatment arms (p = 0.41), both overall and in the different time periods. The most frequent local and systemic side effects were chemical cystitis in 460 (35.0%) patients and general malaise in 204 patients (15.5%); 103 patients (7.8%) stopped treatment because of side effects. No significant difference was seen between treatment groups (p = 0.74). In the 653 patients randomised to 3 yr of BCG, 35 (5.4%) stopped during the first year, and 21 (3.2%) stopped in the second or third year.Conclusions
No significant differences in side effects were detected according to dose or duration of BCG treatment in the four arms. Side effects requiring stoppage of treatment were seen more frequently in the first year, so not all patients are able to receive the 1–3 yr of treatment recommended in current guidelines.This study was registered at ClinicalTrials.gov with identifier NCT00002990 (http://clinicaltrials.gov/ct2/show/record/NCT00002990). 相似文献9.
10.
Jorg R. Oddens Richard J. Sylvester Maurizio A. Brausi Wim J. Kirkels Cees van de Beek George van Andel Theo M. de Reijke Stephen Prescott J. Alfred Witjes Willem Oosterlinck 《European urology》2014
Background
Although maintenance bacillus Calmette-Guérin (BCG) is the recommended treatment in high-risk non–muscle-invasive bladder cancer (NMIBC), its efficacy in older patients is controversial.Objective
To determine the effect of age on prognosis and treatment outcome in patients with stage Ta T1 NMIBC treated with maintenance BCG.Design, setting, and participants
A total of 957 patients with intermediate- or high-risk Ta T1 (without carcinoma in situ) NMIBC were randomized in European Organization for Research and Treatment of Cancer (EORTC) trial 30911 comparing six weekly instillations of epirubicin, BCG, and BCG plus isoniazid followed by three weekly maintenance instillations over 3 yr.Outcome measurements and statistical analysis
Cox multivariate proportional hazards regression models were used to assess the relative importance of age for recurrence, progression, overall survival, and NMIBC-specific survival with adjustment for EORTC risk scores.Results and limitations
Overall, 822 eligible patients were included: 546 patients in the BCG with or without INH arms and 276 in the epirubicin arm. In patients treated with BCG with or without INH, 34.1% were >70 yr of age and 3.7% were >80 yr. With a median follow-up of 9.2 yr, patients >70 yr had a shorter time to progression (p = 0.028), overall survival (p < 0.001), and NMIBC-specific survival (p = 0.049) after adjustment for EORTC risk scores in the multivariate analysis. The time to recurrence was similar compared with the younger patients. BCG was more effective than epirubicin for all four end points considered, and there was no evidence that BCG was any less effective compared with epirubicin in patients >70 yr.Conclusions
In intermediate- and high-risk Ta T1 urothelial bladder cancer patients treated with BCG, patients >70 yr of age have a worse long-term prognosis; however, BCG is more effective than epirubicin independent of patient age.Patient summary
Intravesical bacillus Calmette-Guérin for non–muscle-invasive bladder cancer is less effective in patients >70 yr of age, but it is still more effective than epirubicin.Trial registration
This study was registered with the US National Cancer Institute clinical trials database (protocol ID: EORTC 30911; http://www.cancer.gov/clinicaltrials/search/view?cdrid=77075&version=HealthProfessional&protocolsearchid=12442243#StudyIdInfo_CDR0000077075). 相似文献11.
12.
13.
Jorg Oddens Maurizio Brausi Richard Sylvester Aldo Bono Cees van de Beek George van Andel Paolo Gontero Wolfgang Hoeltl Levent Turkeri Sandrine Marreaud Sandra Collette Willem Oosterlinck 《European urology》2013
Background
The optimal dose and duration of intravesical bacillus Calmette-Guérin (BCG) in the treatment of non–muscle-invasive bladder cancer (NMIBC) are controversial.Objective
To determine if a one-third dose (1/3D) is not inferior to the full dose (FD), if 1 yr of maintenance is not inferior to 3 yr of maintenance, and if 1/3D and 1 yr of maintenance are associated with less toxicity.Design, setting, and participants
After transurethral resection, intermediate- and high-risk NMIBC patients were randomized to one of four BCG groups: 1/3D-1 yr, 1/3D-3 yr, FD-1 yr, and FD-3 yr.Outcome measurements and statistical analysis
The trial was designed as a noninferiority study with the null hypothesis of a 10% decrease in the disease-free rate at 5 yr. Times to events were estimated using cumulative incidence functions and compared using the Cox proportional hazards regression model.Results and limitations
In an intention-to-treat analysis of 1355 patients with a median follow-up of 7.1 yr, there were no significant differences in toxicity between 1/3D and FD. The null hypotheses of inferiority of the disease-free interval for both 1/3D and 1 yr could not be rejected. We found that 1/3D-1 yr is suboptimal compared with FD-3 yr (hazard ratio [HR]: 0.75; 95% confidence interval [CI], 0.59–0.94; p = 0.01). Intermediate-risk patients treated with FD do not benefit from an additional 2 yr of BCG. In high-risk patients, 3 yr is associated with a reduction in recurrence (HR: 1.61; 95% CI, 1.13–2.30; p = 0.009) but only when given at FD. There were no differences in progression or survival.Conclusions
There were no differences in toxicity between 1/3D and FD. Intermediate-risk patients should be treated with FD-1 yr. In high-risk patients, FD-3 yr reduces recurrences as compared with FD-1 yr but not progressions or deaths. The benefit of the two additional years of maintenance should be weighed against its added costs and inconvenience.Trial registration
This study was registered at ClinicalTrials.gov, number NCT00002990; http://clinicaltrials.gov/ct2/show/record/NCT00002990. 相似文献14.
J. Alexa Sanders Connor Frasier Justin T. Matulay Nury M. Steuerwald Jason Zhu Claud M. Grigg James T. Kearns Stephen B. Riggs Kris E. Gaston Cory R. Brouwer R. Tucker Burks Aaron L. Hartman David M. Foureau Earle F. Burgess Peter E. Clark 《Translational andrology and urology》2021,10(7):2998
BackgroundIntravesical bacillus Calmette-Guérin (BCG) therapy is standard treatment for high-risk non-muscle invasive bladder cancer (NMIBC) but overall efficacy is low, and no reliable predictive biomarkers currently exist to refine patient selection. We performed genomic analysis on high-grade (HG) T1 NMIBCs to determine if response to therapy is predicted by certain mutational and/or expressional changes.MethodsPatients with HG T1 NMIBC treated with induction BCG were stratified by response into durable and non-durable responders. Baseline tumor samples were subjected to targeted DNA sequencing and whole-exome RNAseq. Genomic variants differing significantly between response groups were analyzed using Ingenuity Pathway Analysis (IPA) software. Variant selection was refined to target potential biomarker candidates for responsiveness to BCG.ResultsAmong 42 patients, the median follow-up was 51.7 months and 40.5% (n=17) were durable BCG responders. Deleterious mutations in the RNA sequence of JCHAIN, S100A7, CLEC2B, and ANXA10 were more common in non-durable responders. Mutations in MCL1 and MSH6 detected on targeted sequencing were more commonly found in durable responders. Of all deleterious DNA and RNA mutations identified, only MCL1 was significantly associated with longer recurrence free survival (RFS) (P=0.031).ConclusionsDifferences in the genomic profiles of HG T1 NMIBC tumors exist between those who show durable response to BCG and those who do not. Using pathway analysis, those differences imply upregulation of several interconnected inflammatory pathways among responders. Specific variants identified here, namely MCL1, are candidates for further study and, if clinically validated, may serve as useful biomarkers in the future. 相似文献
15.
16.
Biodistribution of Evans blue in an orthotopic AY‐27 rat bladder urothelial cell carcinoma model: implication for the improved diagnosis of non‐muscle‐invasive bladder cancer (NMIBC) using dye‐guided white‐light cystoscopy 下载免费PDF全文
Sanne Elsen Evelyne Lerut Ben Van Cleynenbreugel Frank van der Aa Hein van Poppel Peter A. de Witte 《BJU international》2015,116(3):468-477
17.
18.
19.
20.
Wei Shen Tan Anesh Panchal Laura Buckley Adam J. Devall Laurence S. Loubière Ann M. Pope Mark R. Feneley Jo Cresswell Rami Issa Hugh Mostafid Sanjeev Madaan Rupesh Bhatt John McGrath Vijay Sangar T.R. Leyshon Griffiths Toby Page Dominic Hodgson Shibendra N. Datta John D. Kelly 《European urology》2019,75(1):63-71