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PubMed2006

Surgical management of upper tract transitional cell carcinoma.

Upper tract transitional cell carcinoma (TCC) accounts for approximately 5% of urothelial tumors. Surgical therapy for upper tract TCC is based on tumor grade, stage, location, and confounding factors of individual cases. Options for treatment range from minimally invasive procedures, such as ureteroscopy, to open nephroureterectomy. Laparoscopic nephroureterectomy is progressively eclipsing open nephroureterectomy in the surgical management of upper tract TCC. This article discusses the surgical options for managing upper tract TCC and their considerations for use.

Carcinoma, Transitional Cell↗
PubMed1985

[Clinico-morphological characteristics of transitional cell carcinoma of the prostate].

Transitional cell carcinoma was identified in 11 out of 600 autopsied cases of prostatic cancer (1.8%). Invasion into adjacent organs and tissues was recorded in 6 out of 11 cases, metastases--in 9 (bone lesions--5 cases). Most of the cases suffered poorly-differentiated transitional cell carcinoma (areas of undifferentiated small-cell tumor in some cases). Transitional cell carcinoma of the prostate is a highly malignant tumor, resistant to hormonal and radiation treatment.

Aged↗
PubMed2005

Flow cytometric analysis of Th1 and Th2 cytokines in PBMCs as a parameter of immunological dysfunction in patients of superficial transitional cell carcinoma of bladder.

Transitional cell carcinoma (TCC) is the commonest cancer of the bladder. Although majority of TCC can be diagnosed at an early stage and removed easily by transurethral resection of tumor (TURT), the management of this carcinoma is complicated due to frequent recurrences usually within 6 months to one-year period. An imbalance between the Th1 and Th2 immune responses has been attributed to immune dysregulation in various malignancies. The present study aims to evaluate the Th1 and Th2 balance in Peripheral Blood Mononuclear Cells of 41 TCC patients (20 recurrent and 21 non-recurrent) using flow cytometry. It also further assesses immunological and cellular factors influencing the anti-neoplastic activity of the TCC patients and in 21 normal healthy subjects in terms of their cytokine expression and various cell surface markers. The findings of the study revealed that the cell surface markers CD3+, CD4+ and CD8+ along with NK cells were found to be significantly lower in patients than healthy controls (p < 0.01). The mean percent expression of CD4+ was significantly lower in patients showing recurrence (23.9 +/- 9.84) as compared to patients with non-recurrence (31.1 +/- 12.27). The percentage of CD4+T-cells (mean +/- SD) producing IFN-gamma, IL-2 and TNF-alpha were statistically significantly reduced in patients (19.1 +/- 4.94, 52.3 +/- 20.86 and 12.8 +/- 4.49) as compared to healthy controls (23.3 +/- 3.67, 67.5 +/- 12.0 and 17.6 +/- 5.96 respectively), (p < 0.01, 0.018, 0.001). On the contrary, the mean levels of IL-4, IL-6 and IL-10 in patients (63.8+/-17.01, 60.4+/-14.79 and 65.7 +/- 14.84 respectively) were significantly higher as compared to healthy controls (24.4 +/- 8.77, 26.5 +/- 5.28 and 20.6 +/- 3.81 respectively), (p < 0.001). No statistically significant difference was observed in the cytokine expression between patients showing recurrence and non-recurrence. Patients with bladder cancer seem to develop a Th2 dominant status with a deficient type1 immune response. The lymphocyte evaluation along with cytokine measurement can provide a sensitive and valuable tool for evaluating the function of cell-mediated immunity in these patients and can also find application in therapeutic monitoring of bladder cancer patients as new targets for immunotherapy.

Adult↗
PubMed1994

[Fine structural studies on the cytoplasmic membrane morphology of transitional cell carcinoma in men].

Transitional cell carcinomas (TCC) in the human urinary bladder were observed on the fine morphological behaviour of the plasma membrane, with special references to the morphological differences in various grades of TCC utilizing thin sections and freeze fracture replica electron microscopically. The purpose of this study is to clarify the characteristic differences between various grades of human TCC as a indicator suggestive of the TCC malignancy using electron microscopic techniques. (1) The asymmetric unit membrane seen on the luminal membrane of the superficial cells was unique in all of TCC G1 and some TCC G2 cases. In other TCC G2 and TCC G3, there observed the symmetric unit membrane. Fusiform vesicles directly beneath the luminal plasma membrane were recognized only in TCC G1. (2) Microvilli (MV) seen on the luminal plasma membrane in TCC G1 were found to have the same appearance and distribution as on the normal bladder epithelium. As the grades increased in severity, there were less MV being shorter and club-like-forms. Even deformed with bleb formation microvilli were more apparent in TCC G3 cases than in TCC G2. (3) There was no difference observed between the junctional complex of the superficial cells of the all TCC grades and normal cells. As the cellular malignancies develop, however, the interdigitation structures and desmosomal appearances situated between neighboring intermediate cells tended to decrease. (4) Intracytoplasmic tonofilaments proliferation was obvious in TCC G2, but not in G3. (5) With increasing severity of TCC grades, intramembranous particles showed significant decrease in number as seen on freeze-fracture replica. In conclusion, these results suggest that fine structural observation may prove to be a useful parameter to know the grades of TCC in human bladder tumors.

Carcinoma, Transitional Cell↗
PubMed1986

Cytomorphological lesions induced by chemotherapeutic agents in transitional cell carcinoma in vitro.

Transitional cell carcinoma from 20 patients and two human cell lines were maintained in short-term tissue culture. Each was studied ultrastructurally before and after incubation with cisplatinum, adriamycin, or mitomycin C. Sequential ultrastructural changes were noted and were found to be specific for each agent tested. Ultrastructural changes in the nucleoli were produced by exposure to cisplatinum or mitomycin C; alterations in the heterochromatin of the nuclei were characteristic of treatment with adriamycin. The changes in the nucleoli seen with cisplatinum have not been described previously and support an alkylating property as a mechanism of action. Intravesical chemotherapeutic agents are now commonly used in clinical treatments. The morphological changes produced by these agents are specific and may be seen in the clinical setting.

Antineoplastic Agents↗
PubMedDate not supplied

[Diagnostic, clinical and therapeutic aspects of primary transitional cell carcinoma of the prostate].

Transitional cell carcinoma is a rare neoplasm with an reported incidence of 2%. It is biologically different from adenocarcinoma in that it is not hormonally responsive and it is not associated with an elevated serum acid phosphatase. It is marked by local invasiveness and distant metastases. Transitional cell carcinoma has its origin at the level of the periurethral ducts in the area of the junction of the cylindrical and transitional epithelium. Transitional cell carcinoma can be distinguished from adenocarcinoma and carcinoma endometriode exclusively for its histological aspect. Various therapies have been used to treat transitional cell carcinoma but with poor results. Surgical treatment is still today the most efficient with a surviving average of 2 years. The Authors report 3 new cases, discussing diagnostic, clinical and therapeutical aspects of this rare neoplasm.

Aged↗
PubMedDate not supplied

Cercariform cells for helping distinguish transitional cell carcinoma from non-small cell lung carcinoma in fine needle aspirates.

OBJECTIVE: To determine if cercariform cells, a recently described finding in transitional cell carcinomas (TCC), can aid in distinguishing fine needle aspirates (FNA) of TCC from non-small cell lung carcinoma (NSCLC). STUDY DESIGN: We compared the incidence of cercariform cells in FNAs of 14 cases of TCC with 22 cases of NSCLC. RESULTS: Cercariform cells were identified in 8/14 (57%) cases of TCC as compared with 3/22 (14%) cases of NSCLC. Cercariform cells were often present and abundant (> 10 per case) in cases of TCC without squamous differentiation (8/9) but were not present in TCCs with extensive squamous differentiation (0/5). In NSCLCs, cercariform cells were rare (< 10 per case), and the cytoplasmic borders were sometimes not as well defined. The number of cercariform cells was significantly higher in FNAs of TCC without squamous differentiation than in FNAs of NSCLCs (P < .001). CONCLUSION: The presence of numerous cercariform cells in an FNA favors TCC over NSCLC.

Adenocarcinoma↗
PubMedDate not supplied

Effects of calcitriol, seocalcitol, and medium-chain triglyceride on a canine transitional cell carcinoma cell line.

BACKGROUND: Transitional cell carcinoma (TCC) in dogs is associated with high morbidity and mortality. Calcitriol and its analog seocalcitol, combined with medium-chain triglyceride (MCT), have potential for the treatment of this disease. MATERIALS AND METHODS: TCC cells were treated with calcitriol or seocalcitol, alone or combined with MCT. Cell growth, cell cycle kinetics, vitamin D receptor (VDR) localization and expression, and Bcl-2 expression were measured. RESULTS: Canine TCC expresses high levels of nuclear VDR. Furthermore, calcitriol and seocalcitol significantly inhibited cell growth and calcitriol caused G0/G1 cell cycle arrest. Bcl-2 expression was slightly decreased in cells treated with these compounds, although no significant changes in VDR expression were observed. MCT enhanced the growth inhibitory effect of both compounds. CONCLUSION: Calcitriol and seocalcitol inhibited TCC cell growth via induction of cell cycle arrest and MCT enhanced this effect. Therefore, calcitriol and seocalcitol with MCT may have therapeutic potential for canine bladder cancer.

Animals↗
PubMed1978

A transitional cell carcinoma cell line.

A transitional cell carcinoma cell line, COLO 232, was derived from a primary urinary bladder tumor in a Caucasian male. In culture, COLO 232 retained distinct uroepithelial phenotypic traits and produced both carcinoembryonic antigen and adrenocorticotropic hormone. COLO 232 had a chromosome mode of 58 and retained the X and Y chromosomes. Ten marker chromosomes were identified. COLO 232 will be of value for biochemical and immunological studies.

Adrenocorticotropic Hormone↗
PubMed2003

Cyclooxygenase-2 is highly expressed in carcinoma in situ and T1 transitional cell carcinoma of the bladder.

PURPOSE: We describe cyclooxygenase-2 (COX-2) expression patterns in patients with carcinoma in situ and/or stage T1 transitional cell carcinoma. We determined whether expression is associated with clinical outcome in these patients. MATERIALS AND METHODS: Immunostaining for COX-2 was performed on paraffin embedded bladder biopsy specimens from 2 independent groups of patients without muscle invasive carcinoma, including 39 with carcinoma in situ and 34 with stage T1 tumors. Immunoreactivity was scored as the percent of carcinoma in situ cells with cytoplasmic staining for COX-2 in the carcinoma in situ group and as the percent of stage T1 cells expressing COX-2 in the stage T1 transitional cell carcinoma group. We evaluated other molecular alterations, including E-cadherin, p21 and p53, because evidence suggests a biological association of COX-2 with alterations in these molecular markers. RESULTS: In the carcinoma in situ group 5 patients (13%) had no immunoreactivity, while 2 (5%), 5 (13%) and 27 (69%) had 10%, 20% and 30% or greater carcinoma in situ cells positive for COX-2, respectively. In the transitional cell carcinoma group 1 (3%), 4 (12%) and 29 (85%) patients had 10%, 20% and 30% or greater positive cells, respectively. COX-2 expression was not associated with any clinical or pathological parameters, or with molecular markers regardless of the cutoff used. It was also not associated with clinical outcomes in the stage T1 transitional cell carcinoma group. In the carcinoma in situ group COX-2 expression was significantly associated with disease recurrence using cutoffs of 0% and greater than 10% positive cells, and with disease progression using a greater than 20% cutoff. However, it was not associated with bladder cancer related survival. CONCLUSIONS: COX-2 is expressed in a high percent of patients with carcinoma in situ and stage T1 transitional cell carcinoma, supporting the rationale for chemoprevention studies with selective COX-2. We could not substantiate a role for COX-2 immunohistochemistry for the staging and prognosis of carcinoma in situ and/or stage T1 transitional cell carcinoma.

Adult↗
PubMed1999

CD1a dendritic cells predominate in transitional cell carcinoma of bladder and kidney but are minimally activated.

PURPOSE: In this study, we employed similar techniques to detail dendritic cell subsets within bladder transitional cell carcinoma and kidney transitional cell carcinoma. MATERIALS AND METHODS: To identify both the CD1a+ and CD1a- antigen-expressing dendritic cell populations we employed a double labeling technique to identify non-lineage-expressing leukocytes similar to that employed to isolate blood dendritic cells. RESULTS: Dendritic cells were found in significant numbers within both bladder and kidney derived transitional cell carcinoma. Almost all the dendritic cells among the tumor cells belonged to the CD1a+ subset of epithelial dendritic cells. Similar numbers of dendritic cells were observed in the lamina propria adjacent to the tumor. These dendritic cells belonged predominantly to the CD1a- subset. These differences appear to reflect the different dendritic cell phenotypes reported for the epidermis and dermis. CONCLUSIONS: The number of dendritic cells increased as the grade of the tumor increased, reflecting an overall higher leukocyte density in higher grade tumors. However, a possible trend for less dendritic cell activation in higher grade cancers was noted, raising the intriguing possibility that this might be a relevant prognostic factor, to be confirmed in a larger study.

Antigens, CD1↗
PubMed1993

Combined small-cell and transitional cell carcinoma of the renal pelvis. A light microscopic, immunohistochemical, and ultrastructural study of a case with literature review.

Primary small-cell carcinomas of the kidney are rare, locally aggressive, and rapidly fatal neoplasms in elderly people. We report an example of combined small-cell and transitional cell carcinoma of the renal pelvis in a 71-year-old woman who had a history of heavy smoking. The cells that pertained to the small-cell component were morphologically mostly of an intermediate type. Immunohistochemically, they reacted with synaptophysin, carcinoembryonic antigen, and epithelial markers (Lu-5, EAB902, EAB903, and cytokeratin 19), and they contained scanty neurosecretory granules at the ultrastructural level. We review the literature on small-cell carcinoma of the kidney and renal pelvis, and we discuss the histogenesis of such a tumor.

Aged↗
PubMed1988

Features of squamous and adenocarcinoma in the same cell in a xenografted human transitional cell carcinoma: evidence of a common histogenesis?

Ultrastructural features of squamous differentiation have been found in adenocarcinomatous cells in a xenografted line (UCRU-BL-17) established in nude mice from a primary human bladder transitional cell carcinoma (grade III, stage T4) with a tetraploid DNA component. The line has been characterized by light and electron microscopy, flow cytometry and immunocytochemistry. The initial xenograft showed predominantly adenocarcinomatous differentiation with mucin secretion, whilst the subsequent passages also contained cells showing squamous differentiation. A xenograft subline established from a cell culture of the initial xenograft shows the emergence of a population of cells with near triploid DNA, which are less differentiated, grow more quickly, show decreased expression of carcinoembryonic antigen, and a change in the distribution of staining with peanut lectin from cell surface to cytoplasm. These lines offer an unusual opportunity to study the histogenetic relationships between the histological subtypes of bladder cancer.

Adenocarcinoma↗
PubMed1986

Chromosome change in transitional cell carcinoma of ureter.

Primary transitional cell carcinoma of the ureter is a relatively rare cancer. A case of transitional cell carcinoma of the mid-portion of the ureter in an adult male has been studied cytogenetically and has been found to have trisomy of chromosome #7 (+7) as the only karyotypic abnormality. In an earlier instance of transitional cell carcinoma of the ureter, we observed trisomy 7 together with monosomy 9 and an isochromosome for 5p. The relation of this observation to the cytogenetic findings in transitional cell carcinoma of the bladder is discussed and their possible significance evaluated. The rarity of the cytogenetic findings in these tumors is stressed, as is the possible role played by the chromosomal change in this condition, which may possibly involve the c-erb B oncogene.

Carcinoma, Transitional Cell↗
PubMed1985

Primary transitional cell carcinoma of the prostate.

Transitional cell carcinoma of the prostate is an unusual finding usually associated with transitional cell carcinoma of the bladder. We recently treated two patients with transitional cell carcinoma of the prostate without evidence of bladder involvement. Their histories are reviewed and the literature pertinent to this entity is discussed.

Aged↗
PubMed1993

Expression of the multidrug transporter, P-glycoprotein, in renal and transitional cell carcinomas.

BACKGROUND: Renal cell carcinomas (RCC) respond poorly to anthracyclines, Vinca alkaloids, and other agents. P-glycoprotein is overproduced in multidrug-resistant cells and thought to function as an energy-dependent drug efflux pump. The authors thus examined the expression level of P-glycoprotein in RCC and transitional cell carcinomas (TCC). METHODS: P-glycoprotein was detected using immunoblotting with a monoclonal antibody against it, C219. RESULTS: Thirty-three of 38 patients with RCC and 3 of 17 patients with TCC had P-glycoprotein positive tumors. The expression level of P-glycoprotein in most of RCC was lower than that in the normal kidney tissues and that of P-glycoprotein in the TCC was very low. The size of P-glycoprotein in 14 RCC and 3 TCC was 5-10 kilodaltons smaller than in the normal renal tissues. The variation of P-glycoprotein size in the RCC was attributed to differential N-linked glycosylation. P-glycoprotein in a RCC was photolabeled by tritiated azidopine, and the labeling was inhibited by some organic agents. P-glycoprotein distributed on the apical or marginal cell surface of the RCC. CONCLUSIONS: These data show that P-glycoprotein was expressed in many RCC, and its expression level, glycosylation, and distribution were altered. These data also suggest that the P-glycoprotein in RCC had similar drug binding site(s) to that in multidrug-resistant cells.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1999

Multifocality of transitional cell carcinoma results from genetic instability of entire transitional epithelium.

OBJECTIVES: Multifocality of transitional cell carcinoma (TCC) has been attributed to seeding of exfoliated tumor cells or to a general sensitivity of the entire urothelium to carcinogenic stimuli. By contrast, TCC has been shown to evolve as a consequence of genetic defects and chromosomal instability. We analyzed chromosomal patterns, total DNA content, and p53 and Ki67 expression in malignant and normal transitional cells to evaluate their relationship to the development of multifocal TCC. METHODS: Included in the study were 47 patients, 16 women and 31 men, with a mean age of 70.04 years (range 37 to 83). Of 47 patients, 45 had TCC of the urinary bladder and 7 of those had synchronous ureteral involvement. Two patients had ureteral TCC and a history of TCC of the bladder. Using fluorescence in situ hybridization, numerical aberrations of chromosomes 7, 9, and 17 were detected in imprint specimens of histologically verified tumor and "normal" urothelium and were compared with static ploidy and p53 and Ki67 expression. RESULTS: Chromosome 7 was altered in 93.6%, chromosome 9 in 63.8% (including monosomy), and chromosome 17 in 87.2% of the 47 analyzed tumor and normal imprints. Differences between tumor and normal epithelium were observed in aberrational frequencies (number of cells showing chromosomal aberrations calculated on 200 cells counted, given in percentages). DNA content was aneuploid in all tumor specimens, but diploid in 20 (42.5%) of 47 normal specimens, according to lower aberration frequencies in these patients. p53 detection was positive in 82.9% of the tumor specimens and 76.6% of the normal specimens. Ki67 was positive in 87.2% of the tumor imprints and in 72.3% of the normal specimens. CONCLUSIONS: These data suggest a general genetic instability as a reason for multifocality in the entire transitional epithelium.

Adult↗