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PubMed1990

Gadolinium-enhanced magnetic resonance imaging in the staging of urinary bladder neoplasms.

Magnetic resonance imaging (MRI) proved to be an important diagnostic tool in the correct staging of bladder neoplasms. The advantage of multiplane imaging and high soft-tissue contrast may be extended by the use of MRI contrast media such as the gadoliniumdiethylene-triaminepentaacetic acid complex. In 60 patients with suspected or proved bladder tumors, the results of preoperative gadolinium-enhanced MRI were correlated with the histopathologic findings. The staging accuracy of infiltrating tumors was 83% and sensitivity and specificity 86% and 83%, respectively. Three tumors could only be localized after administration of gadolinium. All active tumors demonstrated significant contrast enhancement after intravenously injected gadolinium. Small papillary tumors or carcinoma in situ remain problematic to preoperative staging procedures. The advantages of gadolinium-enhanced MRI will best be employed in the exact pretherapeutic staging of infiltrative bladder neoplasms or in restaging procedures after chemotherapy and radiotherapy.

Adenocarcinoma↗
PubMed1978

Accuracy of CT staging of bladder neoplasms using the gas-filled method: report of 21 patients with surgical confirmation.

CT staging of bladder neoplasms is a highly accurate procedure with a proven accuracy rate of 81% and a potential accuracy rate probably above 90%. At this institution, CT staging has become a routine procedure for all patients with bladder neoplasms prior to surgery or radiotherapy as well as to follow the progress of therapy. Staging of bladder carcinoma is performed by cystoscopy with biopsy, intravenous urography, and CT of the gas-filled bladder. Of 21 patients with surgical confirmation, 17 were correctly staged solely from the CT image. Overstaging in the four errors resulted from confusion produced by normal contiguous extravesical structures and by tangential viewing of the normal bladder wall. Negative contrast allowed precise demonstration of the morphology of the intravesical portion of the tumor.

Aged↗
PubMed2002

Expression of UPA and UPAR is associated with the clinical course of urinary bladder neoplasms.

The expression of urokinase plasminogen activator (uPA) and its receptor (uPAR) mRNA was determined in 194 subjects with newly detected bladder neoplasms, selected from a larger population-based series. An association was found between uPA and uPAR expression (n = 172; Spearman r(s) = 0.60, p < 0.001). Both uPA and uPAR mRNA levels were higher in muscle invasive (T2+) tumors than in noninvasive mucosal tumors (Ta) or those invading submucosa (T1). The relative hazard ratios (RHRs) for cancer-specific death associated with elevated expression (95% CI), adjusted for age and gender in a Cox proportional hazard model, were 1.8 (1.0-3.3) for uPA (upper quartile cut-line), 2.2 (1.3-4.0) for uPAR (median quartile cut-line) and 2.5 (1.3-4.9) for uPA + uPAR. An RHR for metastatic disease of 4.0 (1.6-9.9) was observed for uPAR. Restricting the analyses to T2+ tumors, the corresponding figures were: 2.1 (1.1-3.9) for uPA, 1.6 (0.8-3.3) for uPAR and 2.5 (1.1-5.6) for both. We conclude that expression of uPA and uPAR is associated with the clinical behaviour of bladder neoplasms, possibly providing means for refined staging of muscle invasive tumors and target proteins for novel therapies.

Gene Expression↗
PubMed1994

Local mitomycin-C therapy in relapse-prevention of superficial bladder neoplasms treated by means of laser.

Authors report on local mitomycin-C (MTM-C) therapy applied subsequent to the treatment by means of Nd-YAG laser in 59 superficial (Ta-T1) bladder neoplasms. Relapse-rate in the neoplasms could be reduced by using MTM-C accompanied by minor side-effects. Seventy-two % of patients have been free from relapse for the mean 44-month follow-up period. Authors also suggest that laser therapy may favourably be completed by local chemoprophylaxis in "high-risk" type superficial bladder neoplasms.

Adult↗
PubMed2003

Bladder neoplasms--regions at chromosome 9 with putative tumour suppressor genes.

OBJECTIVES: To investigate the prevalence of loss of heterozygosity (LOH) at 12 different loci on chromosome 9 in patients with bladder neoplasms using a newly developed fluorescent multiplex polymerase chain reaction. PATIENTS AND METHODS: In a population-based study, freshly frozen tissue was collected from all cases of newly detected bladder neoplasms in the Stockholm region during 1995 and 1996 (n = 538) and 156 representative cases were subsequently studied in the present series. RESULTS: In total, at one or more loci of chromosome 9, 89% (139/156) of the tumours showed LOH. Loss of heterozygosity in informative cases was in the range from 33.1% (41/124) at the 9p21 locus to 67% (77/115) at the 9q31.3-32 loci. When minor LOH was studied, representing a single LOH with retention of heterozygosity at both adjacent markers, relatively frequent losses were detected at 9q22.3 harbouring the PTCH gene (7.7%), at 9q32-33.1 (6.6%) and at 9q33.2 harbouring the DBCCR1 gene (7.5%). In relation to clinical information, LOH at 9p22.1 was statistically significantly correlated with tumour grade (p = 0.01), but not with tumour stage. Replication errors were observed in 14 of 156 (9%) tumours. CONCLUSIONS: Our observation of relatively frequent minor LOH at 9p22.1, 9q22.3 and 9q32-33.1 identifies regions within which putative tumour suppressor genes, including the PTCH and the DBCCR1 genes, may reside.

Carcinoma, Transitional Cell↗
PubMedDate not supplied

CT and MR imaging in staging bladder neoplasms.

Thirteen patients with bladder carcinoma were examined by magnetic resonance (MR) imaging and CT to determine the relative accuracy of the modalities in staging bladder carcinoma. Magnetic resonance correctly identified the presence or absence of extravesical spread of carcinoma in 10 of 13 patients (77%). Two patients were understaged and one was overstaged. Computed tomography correctly staged nine of 13 patients (69%), with three patients understaged and one patient overstaged. Neither MR nor CT was able to determine depth of invasion of the bladder wall in the absence of extravesical spread.

Humans↗
PubMedDate not supplied

Relationship between AgNORs, MIB-1 and oncogene expression in male breast carcinoma and papillary superficial bladder neoplasm.

The expression of p53, c-erbB-2, bcl-2 and c-myc proteins was compared to the quantity of the nucleolar organiser regions (AgNORs) and MIB-1 antigen to elucidate the relationship between oncogene expression and rapidity of cell proliferation and tumor growth fraction. Sections from 50 male breast carcinomas (MBC) and 62 superficial papillary bladder neoplasias were stained with the standardised AgNOR method and monoclonal antibodies MIB-1, DO7, CB11, bcl-2 124 and 9E11. p53 immunopositivity was associated with high AgNOR quantity and MIB-1 scores both in MBC and bladder neoplasm. c-erbB-2 expression was associated with high AgNOR quantity in bladder neoplasm. bcl-2 expression was associated with low AgNOR quantity in MBC. c-myc expression was associated with high AgNOR quantity in MBC. MBC patients with low AgNOR quantity, and p53, c-erbB-2 and c-myc immunonegativity had the longest overall survival. Patients with bladder neoplasia with low AgNOR quantity, negative p53 and positive c-erbB-2 immunostaining had the longest disease-free survival time. Our results indicate that p53 overexpression reflects both the rapidity of cell proliferation, as assessed by AgNOR quantity, and tumor growth fraction, as assessed by MIB-1 scores, while c-erbB-2, c-myc and bcl-2 expression mainly reflects the rapidity of cell proliferation. The combination of AgNOR quantity and oncogene expression may stratify patients into different risk groups.

Adult↗
PubMed1977

Computed tomography of gas-filled bladder: method of staging bladder neoplasms.

Current methods of staging bladder carcinoma have many disadvantages. A new method of staging bladder tumors employing computed tomography (CT) of the gas-filled bladder is presented. Representative cases are demonstrated. Direct visualization of the extent of the tumor and adjacent soft tissue structures is possible. CT scanning of the gas-filled bladder is a promising new method for staging bladder tumors and following their response to therapy.

Aged↗
PubMed1985

[Value of nuclear magnetic resonance tomography in the diagnosis and stage determination of urinary bladder neoplasms].

We arrived at the following conclusions in our study on the ranking of magnetic resonance tomography in diagnosis and staging of urinary bladder neoplasms: MR tomography possesses high sensitivity but only low specificity in diagnosing the local spread of the tumour. Sensitivity of MR seems to be better in respect of determining the paravesical tumorous spread, than that of other methods. However, it is not possible to determine the tumour status of a space-occupying growth. No advantages of MR over other methods, especially computed tomography, were seen in the examination of lymph node metastases in the minor pelvis.

Humans↗
PubMed1989

Intraepithelial lumina in urothelial bladder neoplasms. A histochemical, immunohistochemical and electron microscopy study.

Intraepithelial lumina observed in 12 urothelial bladder neoplasms were studied histochemically, immunohistochemically and ultrastructurally. Both intercellular and intracytoplasmic lumina could be demonstrated showing an alcianophilic margin and containing non-sulphated acid mucins. The presence of secretory component (SC) was identified in neoplastic urothelial cells around or adjacent to intercellular lumina as well as in cells with intracytoplasmic lumina. The cells surrounding intercellular lumina revealed ultrastructurally tight junctions, microvilli and a prominent glycocalyx while cellular remnants were found quite often within the lumen. As similar histochemical, immunohistochemical and ultrastructural characteristics are also expressed in surface umbrella cells of normal urothelium it is suggested that a focal differentiation of neoplastic urothelial cells towards surface umbrella-like cells takes place and that this process is intimately related to the formation of lumina.

Carcinoma↗