ABO(H) Blood Group Antigens and Carcinoembryonic Antigens as Indicators of Malignant Potential in Patients with Transitional Cell Carcinoma of the Bladder

Epithelial membrane antigen (EMA) was immunohistochemically localized in transitional cell carcinomas of the bladder to clarify EMA staining pattern’s relationship to the histological grading and staging of tumors and patient prognosis. Formalin-fixed, paraffin-embedded sections from 101 patients with bladder carcinoma were stained by the indirect immunoperoxidase method. In the lower histological grade and stage of transitional cell carcinoma, the localization of EMA was restricted to the luminal surface of the superficial cells. Membrane and cytoplasmic staining of EMA was frequently found in the intermediate and basal layers of the tumor cells, and the incidence of cytoplasmic staining increased with advancing grade and stage. Stromal staining was frequently observed in cases of higher grade and stage. In addition, these distribution patterns of EMA were well correlated with patient survival. Thus, we differentiated three types of EMA distribution: a luminal type, with very good prognosis; a cytoplasmic type, with fair prognosis; and a stromal type, with relatively poor prognosis. These findings suggest that EMA distribution in bladder cancer could be a valuable indicator for histological grading or staging in pathological diagnosis and for predicting the survival of bladder cancer patients.

Section: Discussionmentioning

confidence: 99%

Epithelial Membrane Antigen as an Immunohistochemical Marker for Transitional Cell Carcinoma of the Urinary Bladder

Takashi¹,

Murase²,

Kinjo³

et al. 1987

“…Furthermore, size, irritative symp toms, age and grade should be taken into consideration when planning effective treatment and predicting the prognosis. Host immunocompétence [2,6], treatment regimens and such markers of malignant potential as chromosomal abnormality [27] and depletion of ABH antigen and appearance of CEA in immunohistochemi cal study [22,32] are other variables which should be evaluated simultaneously with the factors considered here.…”

Section: Methodsmentioning

confidence: 99%

“…Histological grade, which is closely related to stage, is regarded as another important determinant [1,17], Survival also depends on the degree of lymphatic and vascular invasion, growth pattern, mode of local spread [10,13,18,20] and lymph node métastasés [5], Chromo somal abnormalities [27] and localization of such immu nohistochemical markers as ABH antigens and carcinoembryonic antigen (CEA) [22,32] have recently been investigated in relation to prognosis of bladder cancer patients. Combinations of surgical excision, chemother apy, immunotherapy and radiation are currently prac ticed to improve survival.…”

Section: Introductionmentioning

confidence: 99%

Multivariate Evaluation of Prognostic Determinants in Bladder Cancer Patients

Takashi¹,

Murase²,

Mizuno

et al. 1987

To clarify the relative importance of factors affecting the survival of patients with bladder cancer, a multivariate analysis by Cox’s proportional hazards model was performed on 264 patients initially treated from 1973 to 1984 at Nagoya University Hospital. Clinicopathological data included in the analysis were sex, age, symptoms, interval from onset of symptoms to first consultation, smoking history and tumor characteristics (location, size, number, shape, histoiogicai grade and stage). The analysis revealed that stage is the most statistically significant determinant for survival, followed by size, irritative symptoms, age and grade in this order. The model composed of the above five determinants yielded hazard ratios of: 4.6 for stage (pT₂––pT₄ vs. pT_a––pT₁); 3.1 for size ( > 3 vs. ≤ 3 cm); 2.5 for irritative bladder symptoms (present vs. absent); 2.7 for age (70 years or more vs. younger), and 2.1 for grade (high grade vs. low grade tumors). We conclude that these findings quantitatively confirm previous clinical impressions that accurate staging of the tumors is most important for improving the prognosis of bladder cancer patients, and that each of the above five determinants should be considered when planning an effective initial treatment regimen.

“…There were many predictive methods of evaluat ing the invasive potentials. In addition to grades and stages, the indirect immunoperoxidase test to detect uro-thelial cell surface blood group antigens has been used for this purpose [15,16], Also N-acetyltransferase status [17], DNA/RNA ratio [18], and chromosomes [19] have been analyzed for evaluating the invasiveness of superfi cial bladder cancer. However, no methods should be def initely applied using these criteria.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Invasive Potential of Superficial Bladder Cancer by Adenosine Triphosphate Measurement

Koiso

Nemoto²,

Ohtani³

et al. 1991

In order to predict the malignant potential of superficial bladder cancer, in 121 patients with this malignancy adenine nucleotide levels (adenosine triphosphate, adenosine diphosphate, and adenosine monophosphate) and energy charge in bladder cancer cells were determined. The nucleotides were analyzed according to the method of Bücher, and the energy charge was calculated by applying the formula of Atkinson. It was clearly pointed out that superficial bladder tumors, which became invasive and/or metastatic, had higher levels of adenylate compounds than those which became not. Our results show that a high correlation exists between adenine nucleotide content and tumor progression.