Telocytes and ezrin expression in normal-appearing tissues adjacent to urothelial bladder carcinoma as predictors of invasiveness and recurrence

Abstract

Recurrence and progression rates vary widely among different histological subtypes of bladder cancer (BC). Normal-appearing mucosa in non-muscle invasive bladder cancer and muscle-invasive bladder cancer in cystoscopy and histopathology is a factor in staging and treatment. Telocytes (TCs) are spindle-shaped cells that connect with other cell types allowing communication though cytoskeletal signaling. They are involved in tissue regeneration and pathogenesis of diseases and cancer. In this study, 12 normal-appearing tissues from urinary bladder with BC, both invasive and non-invasive were evaluated in patients who had either trans-urethral resection of bladder tumor or cystectomy. In each case, cystoscopy, intraoperative inspection, and histopathology all confirmed the absence of cancerous elements. Five patients with neurogenic bladder were used as a control group. Immunohistochemistry revealed that c-Kit + cells were intensively distributed in bladder layers from BC samples, while they were seldom detected in the control group. Ultrastructural examination of reprocessed tissue showed an intense distribution of TCs and telopodes in the submucosa and between smooth muscle cells in BC. Telopodes were numerous, arborizing, and intercommunicating. Whereas TCs and telopodes were scarce in the neurogenic bladder. Also, cancerous tissue had the highest expression level of ezrin protein, and this level gradually decreased as we moved away from the tumor. Our finding of TCs number in normal-appearing tissues in conjunction with ezrin expression may compete invasiveness and possibly a trail to reduce recurrence rates.

Is bladder outlet obstruction rat model to induce overactive bladder (OAB) has similarity to human OAB? : Research on the events in smooth muscle, collagen, interstitial cell and telocyte expression

“…At adolescence they had closure the vesicostomy, the tract of the vesicostomy was excised and bladder was closed. Excised tissues were examined for light microscopy, IHC, and EM (20).…”

“…17 The role played by telocytes in various organs in health and disease has drawn more attention recently, and it has been demonstrated that telocytes play a signi cant role in the urinary system. [18][19][20][21] The aim of this study is to create a minimally invasive experimental model in female rats to induce BOO to investigate the changes in smooth muscles, collagen, interstitial cells, and the expression of telocytes.…”

Telocytes and inflammation: A review

“…The subtypes of TCs in the submucosa and detrusor of the bladder are positive for CD34 and negative for α-smooth muscle actin, platelet-derived growth factor receptor alpha (PDGFR-α) and CD117. [31] In the respiratory system, TCs are mainly distributed among the basement membrane of the fine bronchial epithelium, clusters of airway smooth muscle cells in the muscular layer, respiratory epithelium at the bronchoalveolar junction, and clusters of peripheral vessels, nerves, and stem cells, and in the above tissues, TCs show positive expression of CD34 and C-Kit and play a role in cellular communication and structural support. [32] In addition, TCs express different positive biomarkers in the reproductive and digestive systems as well as in the skeleton and skin.…”

“…Thus, TCs and ezrin may serve as predictors of bladder cancer invasiveness and recurrence. [31] In fibrosis, when pathological loss occurs, the number of fibroblasts increases, producing large amounts of extracellular matrix (ECM) that disrupts tissue integrity. A study showed that TCs can synthesize ECM in response to hormonal stimulation and can interact with neighboring cells to produce exosomes and transmit intercellular biological signals.…”