膀胱移行细胞癌DNA测定的临床意义

应用图像分析技术对３７例膀胱移行癌细胞核ＤＮＡ含量进行测定，３５例得到随访，结果发现，膀胱移行细胞癌ＤＮＡ含量和异倍体出现率随种瘤恶性程度的增加而明显升高，肿瘤的复发和病人存活时间与肿瘤异倍体出率亦明显相关。结果表明，ＤＮＡ含量测定对膀胱瘤的诊断及预后是一个可靠指标。     

膀胱移行细胞癌复发风险评价

目的　探讨与膀胱移行细胞癌复发时间相关的显著因素以对膀胱肿瘤患者预后作出准确评价。方法　应用COX风险比例回归方法,对200例膀胱移行细胞癌患者的临床表现、治疗、病理特点及免疫组化检测方面的20项因素与复发时间进行统计分析。结果　肿瘤数目是与复发时间相关最显著的因素,相对风险度（Hr)为3.47（P<0.01),其次为是否应用术中化疗(Hr=0.15,P<0.01)、肿瘤p53表达程度(Hr=1.89,P<0.01)、VEGF表达程度(Hr=1.60,P<0.01)。结论　根据上述四个因素对膀胱移行细胞癌患者预后可作出较为准确的评价,并对肿瘤复发时间进行估计。     

膀胱移行细胞癌术后再发膀胱小细胞癌1例

患者,男,74岁。因无痛性血尿1个月余,以膀胱肿瘤复发入院。患者于16年前因无痛性血尿,经膀胱镜检查诊断为膀胱左侧壁肿瘤,并行膀胱部分切除术,术后病理诊断为膀胱移行细胞癌Ⅲ级,术后膀胱灌注噻替哌60mg/次,共6次,定期复查膀胱镜无肿瘤复发。1个月前再次出现血尿。体检:一般情况可,心肺腹无异常,B超膀胱右前壁1.0cm×1.5cm肿瘤,双肾无异常。X线片:双肺未见肿块阴影,膀胱镜检查:膀胱右前壁1.5cm×1.5cm×1.0cm菜花状肿物,基底部宽,周围膀胱黏膜正常,于2004年10月18日在硬脊膜外阻滞麻醉下行TURBT,术中见膀胱右前壁1.5cm×1.5cm×1.0cm菜花…     

小儿膀胱移行细胞癌1例

患儿 ,女 ,1 1岁。因间歇性无痛全程肉眼血尿 8d,于 1 999年 8月 3日入院。体检无特殊病征。实验室检查血色素 1 1 2 g/ L,尿常规白细胞 1～ 5个 /HP,红细胞 2 0～ 2 6个 / HP;尿细胞学检查巴氏细胞 级 ;血生化及肝、肾功能正常。 B超显示双肾及双侧输尿管无异常 ,膀胱后壁光滑 ,底部偏左见有约3.0 cm× 2 .4cm形态不规则的中低回声团块 ,带蒂 ,不随体位活动。彩色多普勒显示其内有血流。IVP亦见到类似于 B超下形态的肿瘤充盈缺损。为进一步确诊 ,在局部麻醉下行膀胱镜检查 ,见三角区后侧偏左有一直径约 3.0 cm乳头状肿物 ,蒂长0 .8cm,…     

E-Cadherin在膀胱移行细胞癌中的表达

目的 探讨Ｅ－Ｃａｄｈｅｒｉｎ在膀胱移行细胞癌中表达的临床意义。方法 采用免疫组织化学方法,检测６３例膀胱移行细胞癌石蜡标本Ｅ－Ｃａｄｈｅｒｉｎ表达情况。结果 ６３例膀胱癌组织标本中Ｅ－Ｃａｄｈｅｒｉｎ表达异常者４２例（６７％）,异常表达率与膀胱癌的病理分期、分级、肿瘤复发和生存率间的差别均有显著性意义。结论 Ｅ－Ｃａｄｈｅｒｉｎ的异常表达与膀胱癌的恶性程度及复发密切相关,可作为判定肿瘤预后和复发     

Uroplakin Ⅱ基因在膀胱移行细胞癌中的表达及相关性研究

目的　探讨UroplakinⅡ基因 (UPⅡ )在原发和转移性膀胱移行细胞癌 (TCC)中表达与意义。方法　收集 45例膀胱癌 (其中TCC 3 9例 ,非TCC 6例 )患者的癌组织 ,外周静脉血标本 ,提取总RNA ,行逆转录 聚合酶链反应 (RT PCR ) ,检测UPⅡ基因mRNA的表达。 2 5例其他部位肿瘤及 8例非肿瘤患者组织标本和静脉血作为对照。结果　 45例膀胱肿瘤组织标本中 ,UPⅡ基因在TCC组织中平均阳性率 82 .1% (3 2 /3 9) ,6例非TCC类型膀胱癌 0表达。在T1、T2、T3、T4期膀胱TCC患者组织中UPⅡ基因阳性率分别为 76.5 %、71.4%、90 .9%、10 0 .0 % ;在患者外周血中UPⅡ基因阳性率分别为 5 .9%、14 .2 %、72 .7%、10 0 .0 %。在组织和外周血中低分期 (T1、T2 )与高分期 (T3、T4)TCC表达UPⅡ基因阳性率差异有显著性 (P <0 .0 5 )。其中 4例转移者均阳性 ,接受全身化疗后 3例未再表达。 2 5例其他部位肿瘤组织标本 ,7例肺癌在组织中有 1例阳性表达 ,外周静脉血中 0表达 ;5例肾移行细胞癌在组织中 2例阳性 ,外周静脉血 0表达 ;8例非肿瘤患者组织标本及外周静脉中 0表达。结论　组织及外周血中UPⅡ表达阳性率与肿瘤分期 ,是否转移呈相关性 ;检测TCC患者血中UPⅡ基因可作为监测TCC患者是否转移的指标 ,并可在一定程度上反映化疗疗效 ;     

膀胱移行细胞癌中Survivin基因的检测及临床意义

目的：探讨Survivin基因在膀胱移行细胞癌中的表达及其临床意义。方法：通过逆转录一聚合酶链反应（RT-PCR）检测40例膀胱癌和12例非膀胱癌组织及尿液标本中Survivin基因mRNA的表达,采用免疫组织化学方法（SP法）复检Survivin基因的表达并确定其临床病理分期和分级。结果：40例膀胱癌组织中Survivin基因的阳性表达率为67．5％,mRNA表达结果与免疫组织化学结果一致;在尿液中的阳性表达率为55．5％。12例非膀胱癌组织中Survivin基因的阳性表达率仅为8．3％;尿液中未见Survivin基因表达。显示Survivin基因在膀胱癌中的表达显著高于在非膀胱癌中的表达（P〈0．05）;而组织标本与尿液标本对Survivin基因的检出率无明显差异（P〉0．05）;Survivin的阳性表达与膀胱癌的恶性程度、临床病理分级或是否复发关系密切（P〈0．05）,Survivin基因的阳性表达与患者年龄、性别、肿瘤的分期无明显相关性。结论：Survivin基因在膀胱癌的恶性程度、肿瘤转移及预后等方面可能有较大的临床意义,而检测尿液中Survivin基因的表达可作为膀胱癌的早期发现、早期诊断、术后复查的新方法。     

神经生长因子在膀胱移行细胞癌中表达的意义

应用免疫组化方法检测神经生长因子 (ＮＧＦ)在膀胱癌中的表达 ,探讨其临床意义及与细胞增殖、血管形成之间的关系 ,报告如下。材料与方法　膀胱移行细胞癌患者83例 ,年龄 15～ 81岁。Ⅰ级 2 5例、Ⅱ级 34例、Ⅲ级 2 4例。Ｔ0～ 15 4例、Ｔ2～ 42 9例。 72例获随访 1年以上 ,其中复发18例。 16例正常膀胱粘膜组织作为对照。石蜡包埋存档标本均经病理组织学证实。免疫组化采用ＳＰ方法。ＮＧＦ(1∶80 )和Ⅷ抗原相关因子 (1∶10 0 )为多克隆抗体。增殖细胞核抗原 (ＰＣＮＡ ,1∶5 0 )为单克隆抗体。ＳＰ试剂盒由北京中山生物公司提供。ＤＡＢ…     

膀胱移行细胞癌差异表达基因的克隆与鉴定

应用抑制消减杂交(ssH)构建膀胱移行细胞癌差异表达的消减文库，再应用Dot blot方法筛选出差异表达的基因，为研究膀胱癌发生、发展提供实验依据。现报告如下。     

膀胱移行细胞癌表皮生长因子受体基因扩增及其表达

运用免疫组织化学技术和分子杂交技术研究了膀胱移行细胞癌表皮生长因子受体（ＥＧＦｒ）表达状况以及ＥＧＦｒ基因扩增和其ｍＲＮＡ与受体蛋白表达的相关性。结果表明：４例正常膀胱粘膜ＥＧＦｒ染色阴性；５６例膀胱肿瘤中，２９例呈不同程度的阳性染色，并与肿瘤的分期、分级有显著性差异；１３例膀胱肿瘤中，ＥＧＦｒ基因未见扩增，５例ｍＲＮＡ过表达，７例ＥＧＦｒ过表达，但二者表达的量并无相关性。提示ＥＧＦｒ表达可作为膀     

人膀胱浅表性移行细胞癌基因表达变化的基因芯片研究

目的研究人膀胱浅表性移行上皮细胞癌（TCC）和正常膀胱组织差异表达基因。方法应用基因芯片技术对6例膀胱浅表性TCC癌组织和正常膀胱组织的总RNA进行检测。结果在13939条目的基因中共发现差异表达基因720条。在癌组织中234条表达增加，486条表达降低；678条能在GeneBank中登录。结论膀胱浅表性TCC的发生、发展足多基因异常引起多条传导通路异常致使细胞恶性转化的结果，基因芯片技术可同时定量研究大量基因表达水平，是一种稳定、高效的方法。     

Clinical study of transitional cell carcinoma of the prostate associated with bladder transitional cell carcinoma

BACKGROUND: Transitional cell carcinoma of the prostate in patients with bladder cancer appears to influence the prognosis and affects the decision about therapeutic modality. Therefore, it is important to characterize transitional cell carcinoma associated with bladder cancer. METHODS: From April 1980 to December 1998, 81 male patients underwent total cystoprostatectomies for transitional cell carcinoma of the bladder. The 81 cystoprostatectomy specimens were examined to clarify the characteristics of prostatic involvement by transitional cell carcinoma. The extent, origin, mode of spread and risk factor of prostatic involvement as well as the prognosis were investigated. In 13 of 15 patients with prostatic involvement the prostate was examined by sequential step sections. RESULTS: Prostatic involvement was observed in 15 of 81 patients (18.5%). Prostatic urethral involvement, invasion to prostatic duct/acinus, prostatic stromal invasion and extraprostatic extension and/or seminal vesicle involvement were recognized in 12 (80%), 14 (93.3%), six (40%), and five (33.3%) of the 15 patients, respectively. Twelve of the 15 patients (80%) with prostatic involvement had papillary or non-papillary tumors (i.e. carcinoma in situ) both in the prostatic urethra and prostatic duct. In 10 of these 12 patients (88.3%), there was contiguity between prostatic urethral and ductal tumors. Seven of the 23 patients (30.4%) with carcinoma in situ of the bladder showed prostatic involvement, which increased to 50% in the presence of carcinoma in situ of the trigone or bladder neck. CONCLUSIONS: Eighty per cent of the patients with prostatic involvement showed papillary or non-papillary tumors both in the prostatic urethra and prostatic duct. There was a high level of contiguity between both tumors. Patients with carcinoma in situ of the trigone or bladder neck revealed significantly higher incidence of prostatic involvement.     

应用基因芯片技术筛查膀胱移行细胞癌差异表达基因的研究

目的:研究膀胱移行细胞癌(BTCC)中差异表达基因,初步探讨这些基因与BTCC发生、发展的关系。方法:提取3例膀胱移行细胞癌(分别为G1Ta、G1T1和G2T2)组织块和1例正常膀胱黏膜组织块RNA,对样品RNA进行荧光标记,用包含21522条70mer长度的OligoDNA表达谱芯片3张进行检测。结果:21522条相关基因中,3例肿瘤标本共同出现的差异表达基因有307条,占总基因条数的1.42%,其中表达上调198条,表达下调109条。这些差异基因按其功能主要可以分为以下几类:原癌基因和抑癌基因、细胞周期调节蛋白、细胞信号和传递蛋白、细胞粘附分子、生长因子、免疫相关基因、细胞受体、离子通道和运输蛋白、细胞骨架和运动相关蛋白、细胞凋亡相关蛋白以及一些未知功能基因。结论:基因芯片技术为研究膀胱癌的分子生物学特性提供了一个比较理想的方法;膀胱癌的发生、发展与多个肿瘤相关基因的异常表达有关,是多基因、多途径作用的结果;BTCC明显表达异常的基因包括GJB2、DKFZP434K0410、NESCA、CKS2、ALB、MYOC、PCOLCE2、AREG、DPT等,其具体机制有待进一步研究。     

PTEN在膀胱移行细胞癌中的表达及其临床意义

日曲探讨膀胱移行细胞癌中PTEN的表达及其临床意义。方珐应用免疫组织化学（S-P）法对50例膀胱移行细胞癌组织和10例正常膀胱黏膜中PTEN蛋白的表达进行检测。结果膀胱癌组织中PTEN蛋白阳性表达率为54．0％（27／50），明显低于正常膀胱组织100．0％（10／10），两组间的差异有统计学意义（P〈0．01）；且其表达水平在不同病理分级、临床分期间也有显著差异（P〈0．01）。结论PTEN蛋白表达的缺失可能在膀胱移行细胞癌的发生及进展过程中起着重要作用，并影响其生物学行为；检测PTEN蛋白表达水平有助于膀胱癌的诊断和预后判断。     

A comparison of the pathology of transitional cell carcinoma of the bladder and upper urinary tract

OBJECTIVE: To clarify the histopathological patterns of upper and lower urinary tract transitional cell carcinomas (TCCs), as previous reports suggest that upper urinary tract TCCs have a greater tendency towards high-grade disease than bladder TCCs, of which most are low-grade and low-stage tumours. PATIENTS AND METHODS: All patients presenting with TCC of bladder or upper urinary tract between February 1991 and December 2001 at one institution were identified. Further patient information was obtained from the hospital database and case-note review. RESULTS: In all, 164 patients with upper urinary tract TCC and 2197 with bladder TCC were identified. There was a correlation between grade and stage of both upper urinary tract and bladder TCCs. 35% of the upper tract TCCs were classified as grade 2 and 44% as grade 3, while for bladder TCCs, 31% of lesions were classified as grade 2 and 35% as grade 3 (P = 0.003). Of the upper urinary tract lesions 33% were stage pT2-T4, compared with only 20% of bladder TCCs (P = 0.001). CONCLUSIONS: Upper urinary tract TCC is a higher grade and stage disease than bladder cancer, a finding that emphasizes the need for aggressive treatment of upper urinary tract TCC. If endourological management of upper urinary tract TCC is considered, histopathological determination of tumour grade before treatment is essential.     

血管生成素-2在膀胱移行细胞癌中的表达及意义

目的　初步探讨血管生成素 2 (Ang 2 )在膀胱移行细胞癌组织中的表达及其与临床分期、病理分级的关系。方法　应用免疫组织化学S P法检测 4 3例初治膀胱癌及 2 8例正常膀胱组织中的Ang 2表达水平 ,并与临床资料对照进行统计分析。 结果　正常膀胱组织中未见Ang 2阳性染色 ;4 3例膀胱移行细胞癌中Ang 2阳性染色者 2 1例 ,Ang 2在许多膀胱癌细胞和癌组织中微血管内皮上呈强阳性染色 ,且染色率随膀胱癌病理分级、临床分期的上升而升高 (P <0 .0 5 )。结论　①Ang 2促进肿瘤新生血管形成 ,参与膀胱癌的发生和发展。②Ang 2的表达与膀胱移行细胞癌的临床分期、病理分级正相关。     

Contemporary management of stage T1 transitional cell carcinoma of the bladder

PURPOSE: Transitional cell carcinoma involving the lamina propria (stage T1) is associated with a high recurrence and progression rate with implications for patient survival and quality of life. A better understanding of the natural history of and treatment alternatives for this tumor may improve the outcome in patients with this stage of bladder cancer. MATERIALS AND METHODS: Literature of the last decade was comprehensively reviewed in regard to clinical and pathological diagnosis, adjuvant treatments, prognosis, and the role and timing of cystectomy. The information was gathered from MEDLINE, current urology journals, abstracts from recent urological meetings and personal experience. RESULTS: High grade and the depth of lamina propria invasion are important prognostic factors. Early diagnosis and accurate pathological assessment are essential for determining the most adequate treatment pathway. Initial treatment consists of complete transurethral resection and adjuvant treatment with intravesical instillation of bacillus Calmette-Guerin (BCG). Immediate postoperative instillation of mitomycin C decreases the risk of recurrence possibly related to tumor implantation. Intravesical treatment does not substantially decrease the chance of progression. Lack of a complete response to BCG at 3 to 6 months, high grade, the depth of lamina propria invasion, the association of carcinoma in situ and prostate mucosa or duct involvement represent significant predictors for progression. Cystectomy should be suggested for recurrent stage T1 tumor after BCG, new onset or persistent carcinoma in situ, tumor located at a difficult site for resection, prostatic duct or stromal involvement and muscle invasion. CONCLUSIONS: High grade stage T1 transitional cell carcinoma is a highly malignant tumor. Complete resection followed by immediate mitomycin C instillation and 6 weekly BCG instillations results in an acceptably low recurrence and progression rate. Rigorous long-term surveillance and continuous reconsideration of radical cystectomy in concordance with the evolution of the disease are essential.     

小分子肽CSNRDARRC与膀胱移行细胞癌组织特异性结合的研究

目的明确小分子肽CSNRDARRC与膀胱移行细胞癌组织结合的特异性及其结合位点。方法选用膀胱移行细胞癌、肾癌、胃癌及腺性膀胱炎石蜡组织块,分别为107、43、68、16例;进行连续切片、烤片、脱蜡、抗原修复,封闭,再采用免疫荧光技术加FITC-六氨基己酸-CSNRDARRC复合物,荧光显微镜定性分析,单纯加FITC作为阴性对照。采用SPSS13.0软件进行统计分析,P〈0.05为有显著性统计学差异。结果单纯FITC标记的各蜡块组织（阴性对照组）均未见有高亮荧光点,FITC-六氨基己酸-CSNRDARRC复合物标记的膀胱移行细胞癌组织有99例出现高亮荧光点,特异性为92.52%（99/107）,而在肾癌、胃癌及腺性膀胱炎组织分别有6例、5例、2例有荧光亮点,特异性分别为9.52%（5/43）,8.82%（6/68）,12.50%（2/16）,通过DAPI着色确定高亮荧光点主要定位于细胞核。CSNRDARRC与膀胱移行细胞癌组织的结合较其与肾癌、胃癌及腺性膀胱炎组织的结合有显著差异（P〈0.05）,而CSNRDARRC与肾癌、胃癌及腺性膀胱炎组织间结合比较无统计学意义（P〉0.05）。结论小分子肽CSNRDARRC与膀胱移行细胞癌特异性结合率显著高于其他肿瘤组织,但对其他组织仍有标记,且结合位点在细胞核内,这为该肽段对膀胱移行细胞癌临床诊断提供理论基础;为膀胱癌的治疗奠定一定的理论依据。     

Micropapillary variant of transitional cell carcinoma of the bladder

A 77-year-old man visited the Kobe City General Hospital complaining of macroscopic hematuria. A computed tomography scan found a bladder tumor with left iliac and para-aortic lymph node metastasis. Two courses of cisplatin, cyclophosphamide and doxorubicin chemotherapy resulted in a minimal response. Radical cystectomy and a retroperitoneal lymph node dissection with bilateral ureterocutaneostomy reconstruction were then performed. A pathological examination revealed a micropapillary variant of transitional cell carcinoma (Grade 3, pT1pN2M1). The patient died of pelvic recurrence 7 months after the initiation of chemotherapy. Peritonitis carcinomatosa and lung metastases were observed at autopsy.