Immunohistochemical Expression of Retinoblastoma Gene Product and p53 Protein in Transitional Cell Carcinoma of the Urinary Bladder and its Relationship to Different Clinicopathological Parameters

BACKGROUND: Carcinoma of urinary bladder is one of the most common malignancies worldwide and constitutes a major health problem. Multiple risk factors are associated with this tumor and its prognosis will depend on different clinicopathological parameters. Over expression of P53 protein and mutant Rb gene is associated with more aggressive clinical and histopathological features of the tumor such as advanced stage and higher grade. AIM: The immunohistochemical expression of Rb gene and P53 gene will be assessed through their protein products in transitional cell carcinoma (TCC) of the urinary bladder and then will be correlated with other well-known risk factors and prognostic parameters of bladder TCC, such as grading, tumor size, smoking, alcohol drinking, and family history. METHODS: Patients were recruited from the uro-surgical department/Surgical Subspecialties Teaching Hospital during the period from November 2020 through April 2021. In this study, patients enrolled were those suspected to have bladder carcinoma. The work up included a full history and clinical examination. Surgical samples were taken from the patients for histopathological evaluation; the study’s samples represented either endoscopic cup biopsy, transurethral resection of the tumor, or radical cystectomy. Sections obtained from these samples were stained with the conventional hematoxylin and eosin stain. Then, immunohistochemical staining for P53 and pRB was applied only for patients diagnosed with TCC. RESULTS: The differences between low-grade and high-grade tumors regarding pRb percentage score were statistically significant (p = 0.026), but were not significant regarding the intensity score (p = 0.094). There were significant correlations between tumor stage and both pRb intensity and percentage scores (p = 0.044 and 0.042, respectively). Differences between low-grade and high-grade tumors regarding p53 intensity score were significant (p = 0.022). The differences between low-grade and high-grade tumors regarding p53 percentage score were significant (p = 0.049). The differences between different tumor stages regarding p53 intensity score were significant (p = 0.018). The differences between different tumor stages regarding P53 percentage score were significant (p = 0.019). CONCLUSIONS: Tumor’s grade was found to be correlated with the tumor stage with no correlation with the age, gender, smoking, family history of TCC, history of urinary tract infection, bladder stones, nor the recurrence of the tumor. The pRb intensity and the percentage scores were correlated to each other and to tumor’s grade and stage, except for the pRb intensity which showed no correlation with the tumor’s grade. The P53 intensity and percentage scores were correlated to each other and also to tumor’s grade and stage, so that P53 is over-expressed in tumors with higher grade and stage.

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Urothelial Tumours of the Urinary Bladder: A Histopathological Study of Cystoscopic Biopsies

Journal of Nepal Medical Association ◽

10.31729/jnma.2053 ◽

2013 ◽

Vol 52 (191) ◽

Cited By ~ 3

Author(s):

Sujan Vaidya ◽

Mamata Lakhey ◽

Sabira KC ◽

Suspana Hirachand

Keyword(s):

Urinary Bladder ◽

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Bladder Tumour ◽

Transitional Cell ◽

Histopathological Study ◽

Low Grade ◽

High Grade ◽

Urothelial Tumours ◽

Bladder Tumours

Introduction: Bladder tumours constitute one of the most common urological conditions. Urothelial(transitional cell) carcinoma accounts for 90% of all primary tumours of the bladder. These tumoursare an important cause of morbidity and mortality. The objective of this study was to present thehistopathological patterns of urothelial tumours and to determine the grade and stage of thesetumours.Methods: This is a 3 year descriptive study of urothelial tumours carried out in the Departmentof Pathology, Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. Data of all cystoscopicbiopsies collected during this period were analyzed.Results: Of the 83 urinary bladder tumours, 81 (97.59%) cases were urothelial (transitional cell)tumours. Transitional cell carcinoma (TCC) was the most common bladder tumour which was seenin 67 (80.72%) cases. Thirty two (47.76%) cases of TCC were low grade while 35 (52.24%) were highgrade. Forty three (64.18%) cases of TCC were superficial or in early stage (pTa and pT1) while 24(35.82%) showed muscle invasion.Conclusions: Transitional cell carcinoma was the most common bladder cancer. Most of thesetumours were high grade. A large percentage of high grade carcinomas presented with muscleinvasion. Pathological grade and muscle invasion are the most valuable prognostic predictorsof survival. The importance of including smooth muscle in the biopsy specimens needs to beemphasized._______________________________________________________________________________________Keywords: cancer; high grade; low grade; transitional tumour; urinary bladder._______________________________________________________________________________________

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Immunohistochemical analysis of beta-catenin expression: a probable prognostic marker and potential therapeutic target in renal cell carcinoma

Medicine and Pharmacy Reports ◽

10.15386/mpr-1767 ◽

2021 ◽

Author(s):

Ayan Kundu ◽

Anway Sen ◽

Shouvik Choudhury ◽

Tapan Kumar Mandal ◽

Debasish Guha ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Tumor Stage ◽

Low Grade ◽

Beta Catenin ◽

High Grade ◽

Positive Correlation ◽

Score Difference

Background and aims. Renal cell carcinoma (RCC) seems to be the most aggressive type of genitourinary neoplasm. Down regulation of normal beta-catenin expression contributes to development of RCC, reflecting the role of beta-catenin/Wnt signaling pathway in pathogenesis. This study aims to evaluate the significance of beta-catenin expression and its correlation with the prognostic parameters. Methods. A cross-sectional observational study was carried out in a tertiary care center on 58 RCC cases using variables like histological grade and type, tumor stage, necrosis. Formalin fixed, paraffin-embedded blocks were evaluated for beta-catenin expression by immunohistochemistry using scoring system. Data were analyzed by mean ± SD, χ2 test, Pearson’s correlation test. Results. Membranous score (MS) had a strong negative correlation with tumor stage (r = -0.407, p = 0.044) and grade (r = -0.787, p = <0.001). Mean membranous score difference between low (Stage 1 and 2) vs. high stage (Stage 3 and 4) and low (Grade 1 and 2) vs. high grade (Grade 3 and 4) was statistically significant (p < 0.001). Cytoplasmic score (CS) had positive correlation with tumor stage (r = 0.586; p = 0.002). No significant correlation was evident between cytoplasmic scores and tumor grade, however the mean cytoplasmic score difference between low grade vs. high grade was statistically significant (p < 0.001). Conclusion. Beta-catenin may play a crucial role in the pathogenesis of RCC and has a positive correlation with the biological behavior of this tumor. The important role of beta-catenin as a prognostic parameter and probably a critical evaluator of targeted chemotherapy cannot be overemphasized.

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Urothelial Tumors of the Urinary Bladder in Young Patients: A Clinicopathologic Study of 59 Cases

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2012-0322-oa ◽

2013 ◽

Vol 137 (10) ◽

pp. 1337-1341 ◽

Cited By ~ 23

Author(s):

Melissa L. Stanton ◽

Li Xiao ◽

Bogdan A. Czerniak ◽

Charles C. Guo

Keyword(s):

Urinary Bladder ◽

Clinical Outcomes ◽

Young Patients ◽

Muscularis Propria ◽

Low Grade ◽

High Grade ◽

Urothelial Carcinomas ◽

Pathologic Features ◽

Urothelial Tumors

Context.—Urothelial tumors are rare in young patients. Because of their rarity, the natural history of the disease in young patients remains poorly understood. Objective.—To understand the pathologic and clinical features of urothelial tumors of the urinary bladder in young patients. Design.—We identified 59 young patients with urothelial tumors of the urinary bladder treated at our institution and analyzed the tumors' pathologic features and the patients' clinical outcomes. Results.—All patients were 30 years or younger, with a mean age of 23.5 years (range, 4–30). Thirty-eight patients (64%) were male, and 21 (36%) were female. Most tumors were noninvasive, papillary urothelial tumors (49 of 59; 83%), including papillary urothelial neoplasms of low malignant potential (7 of 49; 14%), low-grade papillary urothelial carcinomas (38 of 49; 78%), and high-grade papillary urothelial carcinomas (4 of 49; 8%). Only a few (n = 10) of the urothelial tumors were invasive, invading the lamina propria (n = 5; 50%), muscularis propria (n = 4; 40%), or perivesical soft tissue (n = 1; 10%). Clinical follow-up information was available for 41 patients (69%), with a mean follow-up time of 77 months. Of 31 patients with noninvasive papillary urothelial tumors, only 1 patient (3%) later developed an invasive urothelial carcinoma and died of the disease, and 30 of these patients (97%) were alive at the end of follow-up, although 10 (32%) had local tumor recurrences. In the 10 patients with invasive urothelial carcinomas, 3 patients (30%) died of the disease and 5 others (50%) were alive with metastases (the other 2 [20%] were alive with no recurrence). Conclusion.—Urothelial tumors in young patients are mostly noninvasive, papillary carcinomas and have an excellent prognosis; however, a small subset of patients may present with high-grade invasive urothelial carcinomas that result in poor clinical outcomes.

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High-Grade Transitional Cell Carcinoma and Melanosis of Urinary Bladder: Case Report and Review of the Literature

Urology ◽

10.1016/j.urology.2008.05.039 ◽

2009 ◽

Vol 73 (4) ◽

pp. 928.e13-928.e15 ◽

Cited By ~ 18

Author(s):

Sharon L. Sanborn ◽

Gregory MacLennan ◽

Matthew M. Cooney ◽

Ming Zhou ◽

Lee E. Ponsky

Keyword(s):

Case Report ◽

Urinary Bladder ◽

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Transitional Cell ◽

High Grade ◽

Review Of The Literature

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Adaptive genetic algorithms combined with high sensitivity single cell-based technology derived urine-based score to differentiate between high-grade and low-grade transitional cell carcinoma of the bladder.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.6_suppl.572 ◽

2020 ◽

Vol 38 (6_suppl) ◽

pp. 572-572

Author(s):

Shaheen Riadh Alanee ◽

Zade Roumayah ◽

Musatafa Deebajah ◽

James O. Peabody ◽

Rodrigo Mora ◽

...

Keyword(s):

Flow Cytometry ◽

Bladder Cancer ◽

Single Cell ◽

Transitional Cell ◽

Low Grade ◽

High Grade ◽

Median Score ◽

Adaptive Genetic Algorithms ◽

Cell Flow Cytometry ◽

Carcinoma Of The Bladder

572 Background: We previously showed that adaptive genetic algorithms (AGA), in combination with single-cell flow cytometry technology, can be used to develop a noninvasive urine-based score to detect bladder cancer with high accuracy. Our aim in this analysis was to investigate if that same score can differentiate between high grade (HG) and low grade (LG) transitional cell carcinoma of the bladder (BC). Methods: We collected urine samples from cystoscopy confirmed HG and LG superficial bladder cancer patients and healthy donors in an optimized urine collection media. We then examined these samples using an assay developed from AGA in combination with single-cell flow cytometry technology. Results: We examined 50 BC and 15 healthy donor urine samples. Patients were majorly White (59.2%), males (61.2%), and had HG BC (66.7%). AGA derived score of 1.1 differentiated between BCa and healthy patients with high precision (AUC 0.92). The median score was 2.8 for LG BC and 6 for LG BC. Mann-Whitney Rank Sum Test indicated that the difference between the median score of HG and LG BC was significant at P value = 0.003. The score performed well independent of patients’ sex or smoking history. Conclusions: Using single-cell technology and machine learning, we developed a new urine-based score that can potentially differentiate between HG and LG bladder cancer. Future studies are planned to validate this score.

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Spectrum of histomorphological diagnosis in cystoscopic bladder biopsies

Journal of Pathology of Nepal ◽

10.3126/jpn.v7i1.16913 ◽

2017 ◽

Vol 7 (1) ◽

pp. 1062-1065

Author(s):

R Thapa ◽

M Lakhey ◽

AD Bhatta

Keyword(s):

Urinary Bladder ◽

Urothelial Carcinoma ◽

Clinical Symptoms ◽

Transitional Cell ◽

Research Centre ◽

Low Grade ◽

Bladder Tumors ◽

Primary Tumors ◽

Neoplastic Lesions ◽

Papillary Urothelial Carcinoma

Background: Urinary bladder lesions are the main source of significant clinical symptoms which are more disabling than lethal. Bladder tumors constitute one of the most common urological pathology. Urothelial carcinoma accounts for 90% of all primary tumors of the bladder. This study aimed to determine the frequency of different types of lesions of the urinary bladder and to determine the grade and stage of urothelial tumors.Materials and Methods: This is a 2 years cross sectional study of cystoscopic biopsies carried out in the Department of Pathology, Medicare National Hospital and Research Centre, Kathmandu, Nepal.Results: Out of 87 cases, 58 (66.67%) cases were neoplastic lesions and 29(33.33%) cases were non- neoplastic lesions. Majority of neoplastic lesions 96.55% were urothelial (transitional cell) tumors comprising predominantly of low grade papillary urothelial carcinoma 50.91%. Muscle invasion was seen only in high grade papillary urothelial carcinomas.Conclusion: Among bladder tumors low grade papillary urothelial carcinoma is the most common.

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A Single-Institutional Study of Human Immunodeficiency Virus-Related Bladder Cancer

10.21203/rs.3.rs-705534/v1 ◽

2021 ◽

Author(s):

Mengmeng Zhang ◽

Yanyan Zhang ◽

Zhiqiang Zhu ◽

Yu Zhang

Keyword(s):

Bladder Cancer ◽

Cancer Patients ◽

Clinical Characteristics ◽

Transitional Cell ◽

Invasive Bladder Cancer ◽

Low Grade ◽

High Grade ◽

Muscle Invasive Bladder Cancer ◽

Tumor Pathology ◽

Muscle Invasive

Abstract Purpose: We wished to investigate the clinical characteristics, treatments for tumor, pathology and outcomes of bladder cancer patients with HIV-infected.Patients and methods: We identified 10 cases of bladder cancer with HIV-infected from 2015 to 2020.We retrospectively investigated the clinical characteristics of the cases including demographic information, clinical presentation, TNM stage and so on. We investigated treatments for tumor, pathology, outcomes and HIV-relevant parameters during patients’ hospitalization course as well. Results: In our study, it was astonished to find that bladder cancer patients with HIV-infected were males at the median age of 51 years old, and no females were diagnosed on the contrary. Nine (90%)patients presented with painless gross hematuria, while one patient with incidental findings on ultrasonic examination. Six(60%) patients co-infected with another kind of infectious disease, four with syphilis, and two with HBV respectively. The median CD4+ T-lymphocyte cell count was 493/ul withthin 2 weeks prior to the diagnosis bladder cancer. Cystoscope examination manifested that the lesions were located in the trigonum of the bladder in four(40%)patients. All patients underwent surgeries successfully, six underwent transurethral resection of bladder tumor(TURBT),two of whom relapsed once, and one underwent TURBT twice due to recurrence and then RC and urethrectomy because of urethral invasion. All non muscle-invasive bladder cancer(NMIBC)patients received intravesical chemotherapy with pirarubicin 30mg for at least half year conventionally, and only one patient occurred mild adverse reaction of irritative symptoms of bladder. Pathologic analysis documented that all patients(100%) had transitional cell carcinoma(TCC). Tumor grade classification showed that three cases were identified with low grade TCC, and six cases with high grade or invasive TCC, two of whom occurred recurrence for once or twice respectively. One patient was identified with low grade TCC of primary tumor and high grade TCC of recurrent focal(Figure 2).Five cases(50%) were ascertained as (NMIBC) with pT1N0M0, while the rest five patients(50%) were muscle-invasive bladder cancer(MIBC) with at least pT2N0M0. During the median follow-up of 56 months (range from 5 months to 68 months) six cases(five were MIBC patients )died due to distant metastases. No patients acceptted adjuvent immunotherapy mainly due to the role of PD-1+ T cells in HIV transcription in treated aviremic individuals, concerns of unknown adverse effects and economic factors.Conclusions: It seemed like that bladder caner patients had higher tumor stage and more aggressive pathology. we did not find any evidence on the relationship between immunodeficiency and cancer progression because of relatively stable HIV status of this crew in our study. MIBC patients with HIV-infected really have worse outcomes, and more attention is warranted to pay to this special population in this situation when they present with hematuria extraordinarily.

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Utility of first order MRI-Texture analysis parameters in the prediction of histologic grade and muscle invasion in urinary bladder cancer: a preliminary study

British Journal of Radiology ◽

10.1259/bjr.20201114 ◽

2021 ◽

pp. 20201114

Author(s):

Abdul Razik ◽

Chandan J Das ◽

Raju Sharma ◽

Sundeep Malla ◽

Sanjay Sharma ◽

...

Keyword(s):

Bladder Cancer ◽

Urinary Bladder ◽

Texture Analysis ◽

Urinary Bladder Cancer ◽

Histologic Grade ◽

Low Grade ◽

High Grade ◽

First Order ◽

Muscle Invasive ◽

Muscle Invasion

Objective: To explore the utility of first-order MRI-texture analysis (TA) parameters in predicting histologic grade and muscle invasion in urinary bladder cancer (UBC). Methods: After ethical clearance, 40 patients with UBC, who were imaged on a 3.0-Tesla scanner, were retrospectively included. Using the TexRADTM platform, two readers placed freehand ROI on the sections demonstrating the largest dimension of the tumor, evaluating only one tumor per patient. Interobserver reproducibility was assessed using the intraclass correlation coefficient (ICC). Mann–Whitney U test and ROC curve analysis were used to identify statistical significance and select parameters with high class separation capacity (AUC >0.8), respectively. Pearson’s test was used to identify redundancy in the results. Results: All texture parameters showed excellent ICC. The best parameters in differentiating high and low-grade tumors were mean/ mean of positive pixels (MPP) at SSF 0 (AUC: 0.897) and kurtosis at SSF 5 (AUC: 0.828) on the ADC images. In differentiating muscle invasive from non-muscle invasive tumors, mean/ MPP at SSF 0 on the ADC images showed AUC >0.8; however, this finding resulted from the confounding effect of high-grade histology on the ADC values of muscle invasive tumors. Conclusion: MRI-TA generated few parameters which were reproducible and useful in predicting histologic grade. No independent parameters predicted muscle invasion. Advances in knowledge: There is lacuna in the literature concerning the role of MRI-TA in the prediction of histologic grade and muscle invasion in UBC. Our study generated a few first-order parameters which were useful in predicting high-grade histology.

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