The role of early re-resection in pTaG3 transitional cell carcinoma of the urinary bladder

Background: There is a dearth of reliable blood and urine markers for transitional cell carcinoma of urinary bladder. CA 19-9 is a well-known marker for gastrointestinal malignancies and is being investigated for other malignancies including carcinoma bladder. In this prospective study, we evaluated the role of serum CA 19-9 as a tumor marker and correlated its level with tumor grade and stage.Methods: One hundred and fifteen patients with transitional cell carcinoma of urinary bladder and 69 healthy volunteers, as controls were included in the study. Preoperative blood sample was analysed for level of CA 19-9 using ELISA kit (normal - 0 U/ml to 37U/ml) and were correlated with grade and TNM stage of tumor.Results: The range of the control group is 2-38U/ml (mean: 17.67±9.68U/ml); TCC group is 1-94U/ml (mean: 37.12±31.52U/ml) (p=0.304). When CA 19-9 level >37IU/ml was taken as cut-off for a positive test, sensitivity of detecting T3 disease, T4 disease, MIBC, presence of node and high grade tumour were 80%, 75%, 70.3%, 78% and 57.8% respectively. However, there was a statistically significant increase in levels of CA19-9 in relation to higher grade (<0.001), presence of muscle invasion (<0.001), T stage (<0.001) and N stage (<0.001).Conclusions: Serum CA19-9 is almost invariably raised in patients with high grade and invasive disease. Thus, it has a place as a prognostic marker rather than as a diagnostic tool due to its low sensitivity for TCC bladder.

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Muscle-Invasive Transitional Cell Carcinoma of the Urinary Bladder is Associated with Down-Regulated CPP32 Expression and BCL-2 Positivity

Journal of Medical Biochemistry ◽

10.2478/v10011-009-0009-8 ◽

2009 ◽

Vol 28 (2) ◽

pp. 101-107

Author(s):

Marija Plješa-Ercegovac ◽

Jasmina Mimić-Oka ◽

Dejan Dragičević ◽

Ana Savić-Radojević ◽

Marija Matić ◽

...

Keyword(s):

Urinary Bladder ◽

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Transitional Cell ◽

Tumor Grade ◽

Tumor Stage ◽

Positive Rate ◽

Muscle Invasive ◽

Invasive Transitional Cell Carcinoma

Muscle-Invasive Transitional Cell Carcinoma of the Urinary Bladder is Associated with Down-Regulated CPP32 Expression and BCL-2 Positivity The objective was to get insight into the role of executive apoptotic enzyme caspase 3 (CPP32) and regulatory antiapoptotic protein Bcl-2 in the malignant phenotype of TCC. Samples were obtained from 84 TCC patients, who underwent transurethral resection, partial or radical cystectomy. Staging showed a superficial growth pattern in 41 patient, while other 43 showed invasive characteristics. Expression of CPP32 and Bcl-2 was determined by immunocytochemistry. Levels of expression were correlated with tumor stage and grade. Expression of CPP32 was positive in 80% of TCC patients. Low-, medium- and high positive status were observed in 18%, 24% and 38% of patients, respectively. There was a signifficant difference in the CPP32 expression between groups with superficial and invasive TCC tumors (p = 0.032), with frequency of CPP32 negative samples being higher and CPP32 high-positive samples being lower in patients with muscle-invasive tumors. Significant association was also found between CPP32 expression and tumor stage (p = 0.043). The positive rate of Bcl-2 protein expression was 48%. There was a statisticaly signifficant difference in the rate of Bcl-2 positivity between superficial and invasive TCC (p = 0.005), with frequency of Bcl-2 positive patients being higher in muscle-invasive TCC. Significant association was also found between Bcl-2 expression and both tumor grade (p=0.032) and stage (p=0.007). Muscle invasive TCC of the urinary bladder is associated with down-regulated expression of CPP32 and Bcl-2 positivity. Down-regulation of CPP32 and up-regulated Bcl-2 might, at least partially, play a role in the development of invasive characteristics of TCC.

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