Proliferative activity is the most significant predictor of recurrence in noninvasive papillary urothelial neoplasms of low malignant potential and grade 1 papillary carcinomas of the bladder

✍ Scribed by Achille Pich; Luigi Chiusa; Andrea Formiconi; Diego Galliano; Paola Bortolin; Alberto Comino; Roberto Navone

• Publisher: John Wiley and Sons
• Year: 2002
• Tongue: English
• Weight: 83 KB
• Volume: 95
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/cncr.10733

✦ Synopsis

Background:

Recurrence of transitional cell carcinoma of the bladder cannot be predicted accurately by traditional criteria alone. this study examined the value of cell proliferative activity, morphometry, and expression of p53, c-erbb-2, and bcl-2 oncogenes in predicting recurrence of superficial papillary urothelial neoplasms of low malignant potential (lmp) and grade 1 (g1) papillary carcinomas of the bladder.

Methods:

Sixty-two patients (mean age, 62 years) with newly diagnosed superficial pta bladder tumors (19 lmp, and 43 g1) were analyzed retrospectively. all patients underwent transurethral resection (tur). median follow-up was 69 months. serial sections from formalin-fixed, paraffin-embedded material at initial tur were stained with monoclonal antibodies (moabs) do7, cb11, and bcl-2-124. cell proliferation was assessed by mib-1 moab, the quantity of argyrophilic nucleolar organizer region-associated proteins (agnors), and mitotic count.

Results:

Of the 62 patients, 42 (67.7%) had one or more recurrences. recurrence rates were higher in mib-1 (p < 0.0001) and p53 immunopositive cases (p = 0.02), when the mitotic count was greater than 5 (p = 0.004), and in g1 carcinomas (p = 0.04). in univariate analysis, the disease-free period was shorter for mib-1 (p < 0.0001) and p53 immunopositive (p = 0.0001) cases, for cases with high agnor quantity (p = 0.04), mitotic count greater than 5 (p = 0.01), and in g1 carcinomas (p = 0.002). in multivariate analysis, only mib-1 immunoreactivity retained independent prognostic significance.

Conclusions:

Despite the small cohort, the results confirm the prognostic value of cell proliferation and p53 expression in patients with bladder neoplasms. the results also indicate that mib-1 immunopositivity is the most significant predictor of recurrence and disease-free survival in superficial lmp and g1 papillary bladder carcinomas.