Transitional cell carcinoma of the prostate following intravesical therapy for transitional cell carcinoma of the bladder

From 1983 to 1986, 63 male patients received various regimens of intravesical therapy for superficial transitional cell carcinoma of the bladder. Of these 63 patients 10 were subsequently diagnosed as having transitional cell carcinoma of the prostate. Five of the 10 patients had no tumor remaining in the bladder at diagnosis of transitional cell carcinoma of the prostate. In 3 patients tumor in the prostate was more invasive than tumor in the bladder. In 2 patients tumor involvement was greater in the bladder than in the prostate. Patients undergoing treatment with intravesical therapy for transitional cell carcinoma of the bladder, especially those receiving multiple courses for prolonged periods, should be monitored closely for the development of transitional cell carcinoma of the prostate.     

膀胱移行细胞癌VEGF表达和MVD检测的临床意义

目的　探讨膀胱移行细胞癌组织中血管内皮细胞生长因子（ＶＥＧＦ） 的表达与肿瘤间质微血管密度（ＭＶＤ）检测的临床意义。　方法　采用免疫组化方法对７７ 例膀胱移行细胞癌及１０ 例正常膀胱组织进行ＶＥＧＦ多克隆抗体及第Ⅷ因子相关抗原（ＶＷＦ：Ａｇ） 单克隆抗体染色,观察膀胱移行细胞癌ＶＥＧＦ的表达与ＭＶＤ 之间的相关性。　结果　ＶＥＧＦ的表达与肿瘤间质微血管密度之间存在正相关性,二者均与膀胱移行细胞癌的病理分级显著相关,浸润性肿瘤明显高于浅表性肿瘤（Ｐ＜０ ．０５） ;术后随访６ 年,术后２ 年内复发组明显高于６ 年内未复发组（ Ｐ＜ ０ ．０５） ,但与肿瘤大小、性别、年龄无关。　结论　ＶＥＧＦ的表达为膀胱移行细胞癌的恶性表型,并与膀胱肿瘤间质微血管形成有关,上述二项指标对评估膀胱移行细胞癌的预后有重要意义。     

The prognostic value of cell surface antigens in low grade, non-invasive, transitional cell carcinoma of the bladder.

Tumors in 23 patients who presented with a low grade, non-invasive transitional cell carcinoma of the bladder were studied for blood group antigens A, B or O on the cell surface. Of 14 patients without cell surface antigens initially 13 suffered an invasive tumor subsequently and 1 had diffuse carcinoma in situ. Of 9 patients with cell surface antigens initially 8 did not have an invasive recurrence during a 5 or more-year followup and 1 did. The presence or absence of blood group cell surface antigen on a low grade, non-invasive transitional cell carcinoma of the bladder would seem to have value in predicting future recurrence with muscle invasion.     

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。     

Transitional cell carcinoma of bladder originating from transitional cell carcinoma of anus

A unique case of transitional cell carcinoma of the bladder with the primary being in the anus is reported. The patient presented with acute urinary retention from a large bladder tumor, which was thought to be primary to the bladder. Biopsy of the bladder revealed transitional cell carcinoma, microscopically indistinguishable from the primary cloacogenic carcinoma diagnosed seven years previously.     

A case of synchronous multifocal urothelial tumors in a patient with phenacetin abuse]

A 79-year-old male with phenacetin abuse was admitted to our University Hospital for treatment of asymptomatic gross hematuria. Intravenous urograpdy and computed tomography revealed synchronous right renal pelvic carcinoma and bladder carcinoma. Right nephroureterectomy and transurethral resection of bladder tumor (TUR-Bt) were performed. Histologically, right renal pelvic tumor and bladder tumor were both transitional cell carcinomas of grade 2, pT1, and grade 1 = 2, Ta, respectively. Additionally, pathological examination revealed two distal ureteral tumors, which were transitional cell carcinomas of grade 2, pTa. He also had a history of heavy tobacco-smoking (20 cigarettes per day for 50 years). We discuss the relationship between transitional cell carcinoma and phenacetin abuse as well as the influence of tobacco-smoking, and review the literature.     

膀胱移行细胞癌患者血清骨形成蛋白-2和血管内皮生长因子水平变化

目的：检测骨形成蛋白-2和血管内皮生长因子水平在膀胱移行细胞癌患者血清中的水平。方法：采用ELISA法检测20例健康人、58例膀胱移行细胞癌患者术前的血清BMP-2和VEGF的含量,评价二者在膀胱移行细胞癌发生发展中的意义。结果：膀胱移行细胞癌患者血清中BMP-2和VEGF的水平明显高于健康人,并与肿瘤的浸润深度和分化程度及淋巴结转移、远处转移和临床病理分期密切相关（P〈0.05）,且两者存在明显相关性（P〈0.05）。结论：检测膀胱移行细胞癌患者血清中VEGF、BMP-2的水平,有助于临床诊疗和预后评估。     

p53与端粒酶逆转录酶在膀胱移行上皮癌的表达和作用

目的探讨p53和端粒酶逆转录酶（hTERT）在膀胱移行上皮癌的表达和作用。方法应用免疫组织化学方法和原位分子杂交检测膀胱移行上皮癌的组织学标本的p53蛋白和hTERT mRNA表达，结合病理学和临床资料进行相关分析。结果62例标本中p53阳性表达21例（33．87％），hTERT阳性表达48例（77．42％）。p53的表达与肿瘤的病理学分级显著相关（P〈0．01），与肿瘤的复发显著相关（P〈0．01）。hTERT的表达与肿瘤的分级、分期及复发无相关性。结论p53基因和端粒酶参与了膀胱移行上皮癌的发生和进展。p53蛋白阳性表达有较高的肿瘤分级，并且更可能复发。hTERT可作为临床膀胱移行上皮癌的诊断指标之一。     

A case of synchronous ipsilateral renal cell carcinoma and transitional cell carcinoma]

A case of synchronous ipsilateral renal cell carcinoma with renal pelvic and ureteral transitional cell carcinoma is reported. A 80-year-old man, who had had transurethral resection of bladder tumor three times, was admitted on August, 1989 for recurrence of bladder tumor. Excretory pyelography revealed a filling defect of left renal pelvis. Findings of retrograde pyelography and computed tomography were in accord with those of the excretory urograms. Under a diagnosis of the left renal pelvic and ureteral tumor associated with the bladder tumor, left nephroureterectomy with bladder cuff resection was performed. Pathological diagnosis was renal pelvic and ureteral transitional cell carcinoma with renal cell carcinoma, which existed incidentally in the same kidney. Double unrelated primary carcinoma in urinary tract, especially, double dissimilar primary carcinoma in the same kidney, is rare. To our knowledge, this case is the 20th double cancer in upper urinary tract reported in Japan.     

Recurrent transitional cell carcinoma of the bladder in a young woman: report of a case]

A rare case of transitional cell carcinoma of the bladder in an 18-year-old female is presented. The chief complaint was gross hematuria and pain on urination. Transurethral resection was performed and pathological findings were low grade transitional cell carcinoma without invasion. During a 5-year follow up, she had relapse of the bladder tumor twice. Transitional cell carcinoma of the bladder in children and adolescents may be low grade, low stage and rarely recurrent, but the possibility of recurrence does exist. We emphasize the necessity of periodic cystoscopy for following up young adolescents with transitional cell carcinoma of the bladder.     

膀胱移行上皮癌患者尿及癌组织中Survivin表达的临床意义

目的：探讨Survivin对膀胱癌早期发现、常规筛选且无损伤的方法,研究其与肿瘤病理分级（期）的相关性。方法：留取53例膀胱移行上皮癌、20例泌尿系其他疾病、10例健康志愿者新鲜中段晨尿,同上53例术后癌组织。利用巢式RT—PCR、实时定量PCR技术检测Survivin的表达,同时行尿脱落细胞学及膀胱镜病检。结果：53例膀胱癌患者尿及癌组织中Survivin均有表达,敏感性为100％,特异性为90％。与尿脱落细胞学敏感性比较两者差异有统计学意义（P〈0．05）,与膀胱镜检比较差异无统计学意义。三种方法特异性比较差异无统计学意义（P〉0．05）。癌组织中Survivin的量与肿瘤病理分级（期）正相关（P〈0．01）。结论：检测尿脱落细胞中Survivin的表达有望成为临床诊断、筛检膀胱癌的较可靠方法。Survivin在膀胱的演进过程中可能起重要作用,可望作为检测膀胱癌恶化进展的指标。     

Prognostic variables in patients with transitional cell carcinoma of the renal pelvis and proximal ureter

Recent technological advances in urological endoscopic surgery of the renal pelvis and proximal ureter via ureteroscopy or percutaneous nephroscopy have made it possible to consider parenchymal-sparing procedures in patients with transitional cell carcinoma. To define the role of these procedures in the management of renal pelvic or proximal ureteral transitional cell carcinoma we analyzed retrospectively 31 patients who underwent nephroureterectomy for transitional cell carcinoma of the renal pelvis and/or proximal ureter. High grade upper urinary tract transitional cell carcinoma and a history of metachronous or synchronous bladder transitional cell carcinoma were independent adverse prognostic factors. However, patients with low grade upper urinary tract transitional cell carcinoma and no evidence of a urothelial field change had a 100 per cent 5-year survival rate. It would appear that parenchymal-sparing endoscopic techniques should be regarded with caution in patients with either high grade transitional cell carcinoma of the renal pelvis and proximal ureter or a history of bladder cancer.     

MDM2、p53基因在膀胱癌中的表达及其临床价值

目的　探讨癌基因ＭＤＭ２ 和抑癌基因ｐ５３ 在膀胱癌中的表达及其临床价值。　方法　采用免疫组织化学方法对２３ 例膀胱癌标本进行检测。　结果　ＭＤＭ２ 、ｐ５３ 基因蛋白在肿瘤中阳性表达为３９ ％ 和４８ ％ ,与肿瘤分级分期,肿瘤复发性相关,两者异常表达呈负相关（ｒ＝ － ０ ．２ ９４６ ,Ｐ＜０ ．０５）。两者在癌旁组织中亦有一定表达率。　结论　ＭＤＭ２ 、ｐ５３ 基因的异常表达是膀胱癌中的基因事件,与膀胱癌发生发展密切相关,可作为临床判断肿瘤进展及可能预后的瘤标。     

黑色素瘤抗原A8和A12在膀胱移行细胞癌中超表达的临床研究

目的:研究肿瘤特异性黑色素瘤抗原(Melanoma antigen,MAGE)家族成员MAGE-A8、MAGE-A12基因在膀胱移行细胞癌(Transitional cell carcinoma,TCC)组织中的表达情况及其与相应病例临床特点的关系,评价这些基因或基因产物作为膀胱TCC组织免疫学检测和免疫治疗、基因治疗分子标志物的可行性。方法:选择膀胱TCC组织标本42例,相应的癌旁组织8例,采用逆转录聚合酶链反应(RT-PCR)方法对MAGE-A8、MAGE-A12基因的表达情况进行检测。结果:42例膀胱TCC组织中,MAGE-A8mRNA阳性表达26例(62%),MAGE-A12mRNA阳性表达18例(43%),MAGE-A8及MAGE-A12同时表达8例(19%)。8例癌旁组织均不表达MAGE-A8和MAGE-A12。结论:MAGE-A8、MAGE-A12基因在膀胱TCC中超表达,有可能作为膀胱TCC组织免疫学检测的分子标志物,并且具有作为免疫治疗、基因治疗特异性靶位的潜在价值。     

The effect of antisense Bcl-2 oligonucleotides on Bcl-2 protein expression and apoptosis in human bladder transitional cell carcinoma

PURPOSE: Bcl-2 is an important determinant of transitional cell carcinoma of the bladder recurrence and progression as well as a factor in patient response to chemotherapy or radiotherapy. We determined Bcl-2 down-regulation after antisense oligonucleotide therapy and synergism with mitomycin C in transitional cell carcinoma of the bladder. MATERIALS AND METHODS: Bcl-2 protein was quantified using flow cytometry and immunohistochemistry in 4 bladder cancer cell lines, in bladder washings from 6 patients with carcinoma in situ and in 16 patient tumor samples. The synergistic effects of antisense oligonucleotides G3139 and 2009, and mitomycin C were investigated in 4 cell lines, while 2009 down-regulation was examined in 20 tumor explants in an ex vivo model. RESULTS: Bcl-2 protein expression was found in all 4 cell lines and in 5 of the 6 cell populations derived from patients with carcinoma in situ. Of the 16 tumors 7 were classified positive by frozen section immunohistochemistry and quantitative flow cytometry. G3139 and 2009 down-regulated Bcl-2 protein expression in all 4 cell lines and 2009 down-regulated Bcl-2 protein expression in half of the Bcl-2 positive tumor specimens. There was only evidence in 1 cell line, T24/83, that Bcl-2 protein expression down-regulation enhanced mitomycin C induced apoptotic cell death. CONCLUSIONS: Bcl-2 was expressed in a significant proportion of bladder tumors and in carcinoma in situ. Therefore, antisense oligonucleotides represent a viable strategy for Bcl-2 protein down-regulation. However, it may not always translate into an increased level of mitomycin C induced apoptosis in transitional cell carcinoma of the bladder.     

Ureteral stump transitional cell carcinoma in a patient with recurrent superficial bladder cancer: an argument for complete nephroureterectomy in selected patients

A 62-year-old white man had diffuse transitional cell carcinoma of a right ureteral stump 2 1/2 years after initial transurethral resection of a bladder tumor and right radical nephrectomy for renal cell carcinoma. This case and review of the literature suggest an indication for complete ureterectomy in nephrectomy candidates with prior or concurrent transitional cell carcinoma of the bladder.     

Clinical and pathological studies of the urothelial tumors with inverted proliferation

We reported a case of inverted papilloma of the bladder, and six cases (two of ureteral cancer and four of bladder cancer) of transitional cell carcinoma with inverted proliferation. These tumors were superficial and pedunculated as well as transitional papilloma or ordinary papillary transitional cell carcinoma though they showed a non-papillary and polyp-like configuration. Moreover, these urothelial cancers with inverted proliferation were thought to be similar to papillary cancer with regard to grading, multiplicity, invasiveness and recurrence. Therefore, transurethral resection or segmental ureterectomy may be recommended for the tumor of low grade malignancy and radical treatment including systemic chemotherapy may be recommended for the tumor of high grade malignancy.     

A case of carcinoma of the bladder diverticulum

Carcinoma of the bladder diverticulum is a relatively rare disease. However, its preoperative diagnosis is often difficult. Also, infiltration occurs easily because the diverticulum wall is thin, and prognosis is said to be relatively poor. Histologically, the occurrence rate of squamous cell carcinoma is markedly high. We have experienced a case of squamous cell carcinoma in the bladder diverticulum occurring simultaneously with transitional cell carcinoma of the bladder; and, report this case along with a review of the literature. The patient, a 79-year-old male, had sudden macroscopic hematuria on December 15, 1980, and went to the urology department of a separate hospital. IVU showed distortion of the right ureter, and the patient was referred to our hospital. Cystoscopy revealed a diverticulum in the right wall of the bladder. In the posterior wall of the bladder 2 papillary sessile tumors were also detected. Pathological diagnosis by cold punch biopsy done after the patient was admitted to hospital revealed a grade III transitional cell carcinoma. Total cystectomy + bilateral cutaneous ureterostomy was performed. The diverticulum was in the right wall of the bladder and a papillary sessile tumor with a diameter of 4 cm was found in the diverticulum. A papillary sessile tumor 2 cm in diameter was found in the left bladder wall. Histopathological diagnosis of the tumor in the diverticulum was squamous cell carcinoma ( pG2 , pT3b , ly1, v(-) INF beta) and that of the tumor in the bladder was transitional cell carcinoma ( ( pG3 , pT2 , ly1, v(-), INF gamma).(ABSTRACT TRUNCATED AT 250 WORDS)     

尿核基质蛋白22在膀胱癌术后复发监测中的应用

目的:探讨尿核基质蛋白22(NMP22)检测在膀胱癌术后复发监测中的应用价值.方法:采用ELISA法检测93例膀胱癌术后患者尿NMP22值,并分为复发组和未复发组进行比较.结果:复发组患者尿NMP22值高于未复发组(P＜ 0.01),以6 IU/L为最适临界值,敏感性 95.1%,特异性 69.2%,阳性预测值 70.9%,阴性预测值 94.7%.结论:尿NMP22检测可作为膀胱癌术后复发的常规监测方法,以6 IU/L为临界值是较适宜的.     

5-ALA诱导荧光膀胱镜下膀胱肿瘤电切除术(附31例报告)

目的:探讨5-ALA诱导荧光膀胱镜下膀胱肿瘤电切治疗的彻底性.方法:对31例血尿患者在5-ALA诱导荧光染色膀胱镜下行活组织检查及电切术.结果:31例呈荧光阳性,其中26例经术后病理证实为尿路上皮癌,5例为良性病变.其中11例移行细胞癌患者在癌旁或远处发现普通膀胱镜下无法识别的微小荧光阳性区域,经活检均证实有肿瘤存在.对该区域均在荧光指示下进行电切或电灼术.结论:5-ALA诱导荧光膀胱镜检对膀胱肿瘤诊断高度敏感,能发现微小及癌旁肿瘤,在荧光指示下能彻底切除肿瘤,减少复发.