Evaluation of β-Catenin in Bladder Transitional Cell Carcinoma

Abstract Background Bladder cancer is the fourth most common cancer occurring in United States, second most prevalent cancer in men and tenth most prevalent cancer in women, with age adjusted incidence rate of 24.5 per 100.000 population and mortality rate of 4.2 per 100.000 population per year Because of its high recurrence rate, the actual prevalence of active bladder cancer is estimated to be about 10 times the number of new cases. Aim of the Work This study aims at investigating β-catenin protein expression in bladder transitional cell carcinoma and its possible relation to the clinic-pathological data. Patients and Methods The study was carried out on 80 patients; 60 patients with urothelial Bladder Carcinoma (UBC) and 20 patients with non-malignant lesions (control group); between May 2015 and May 2017. The 60 UBC cases were further divided, according to histopathological criteria, into non-muscle invasive UBC (30 patients) and muscle invasive UBC (30 patients). Results There was a highly a significant difference between β-catenin expression and tumor grade (P = 0.03) ,lymphnode metastasis (P = 0.005), tumor necrosis (P = 0.001) vascular invasion(P = 0.004), and perineural invasion (P = 0.001) No statistical significant relation was found between β-catenin expression either bilharziasis (P = 0.08) ,muscl invasion (p = 0.54) ,or stage (p = 0.7). Conclusion 1-β-Catenin has a role in carcinogenises of UB due to absence of nucleocytoplasmic pattern of β-catenin expression in non- neoplastic cases with its expression in a considerable number of invasive malignant cases and dysplastic urothelium adjacent to carcinoma could refer to the oncogenic role of this expression pattern. Recommendations Further studies on large number of cases of urothelial carcinoma on a longer period of follow up using more accurate diagnostic tools is recommended to elicit the predictive value of these markers on patients’ survival; also further studies on new therapies that target β-catenin or other component of Wnt pathway to detect its efficacy in preventing tumor recurrence or progression especially in non-muscle invasive bladder carcinoma.

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STRUCTURAL ALTERATION OF p53 PROTEIN IN PATIENTS WITH MUSCLE INVASIVE BLADDER TRANSITIONAL CELL CARCINOMA

The Journal of Urology ◽

10.1016/s0022-5347(05)65525-5 ◽

2001 ◽

Vol 166 (6) ◽

pp. 2155-2160 ◽

Cited By ~ 13

Author(s):

RABI TIGUERT ◽

FERNANDO J. BIANCO ◽

PETER OSKANIAN ◽

YIWEI LI ◽

DAVID J. GRIGNON ◽

...

Keyword(s):

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

P53 Protein ◽

Transitional Cell ◽

Structural Alteration ◽

Bladder Transitional Cell Carcinoma ◽

Muscle Invasive

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bcl-2 expression and possibility of bladder preservation using combined modality treatment in muscle-invasive transtional cell carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16133 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16133-e16133

Author(s):

H. A. Gaffar ◽

A. Elfayomy ◽

A. Elmaghraby ◽

M. M. Elnemr ◽

W. H. Elsawy

Keyword(s):

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Transitional Cell ◽

Neoadjuvant Chemoradiotherapy ◽

Treatment Modalities ◽

Combined Modality Treatment ◽

Bladder Preservation ◽

Combined Modality ◽

Significant Difference ◽

Muscle Invasive

e16133 Background: whether combined chemoradiotherapeutic approaches can obtain the same local control as radical surgery, reducing the rate of distant metastases and improving survival with preservation of bladder for carefully selected patients. The BCL2 inhibits apoptosis. The apoptosis inhibiting action of BCL2 confirms a poor prognosis by current treatment modalities. To evaluate the combined modality treatment and selective bladder preservation and to evaluate BCL-2 expression that may predict treatment response and survival. Methods: 66 eligible patients with T2–4a NxM0 transitional cell carcinoma received two courses of gemcitabine and cisplatin followed by 45 Gy of pelvic radiotherapy in 1.8 Gy fractions with concomitant cisplatin. Tumor response was evaluated by cystoscopy and biopsy. Those responding completely were given 20 Gy bladder boost; patients with residual tumor were assigned to immediate cystectomy. Immunohistochemistry was used to assess the tumor cell expression of BCL-2. Results: After neoadjuvant chemotherapy, a complete response (CR) observed in 14 patients, a partial response (PR) in 26 and no change (NC) in 26. At cystoscopy after the pelvic irradiation with 45 Gy plus cisplatin, a CR was achieved in 33 patients, a PR in 14 and NC in 19. Immediate cystectomy was performed in 21 patients with PR or NC after neoadjuvant chemoradiotherapy. Bcl-2 was expressed in 35 (53%) of the patients. Bcl-2 immunoreactivity was inversely correlated with of histological grade (p = 0.0232) and was not correlated with gender distribution (p = 0.4666), the clinical stage (T) (p = 0.4325) or response to treatment (p = 0.6234). No significant difference was noted between the cause-specific survival rate of patients with positive Bcl-2 expression and those with negative BCL-2 expression. Conclusions: this combined approach of chemotherapy and radiation therapy with bladder preservation should be considered as an option for muscle-invasive transitional cell carcinoma of bladder. Initial results suggest the possibility of retaining a functioning bladder in many patients, without compromising survival. Assessment of Bcl-2 protein expression may be used to predict a clinical response to this combined modality approach. No significant financial relationships to disclose.

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