Soluble form of carbonic anhydrase IX (CAIX) in transitional cell carcinoma of urinary tract.

We investigated the expression of cell-associated CAIX protein in histological sections of the transitional cell carcinoma (TCC) of the urinary tract and of the soluble form of CAIX (s-CAIX) shed by the tumor into the serum and urine of TCC patients. A total of 23 patients with histologically confirmed TCC or squamous cell carcinoma (SCC) were enrolled in the pilot study. Sixteen healthy individuals served as controls. Membrane-bound CAIX was present in the tumor cells near the endoluminal surface. Necrosis was observed in only 4 samples. Using Western blots, s-CAIX concentrated from urine was visualized as a double band at 50 and 54 kDa. In most cases, the presence of s-CAIX in the urine correlated with CAIX expression in the tumor. On the other hand, s-CAIX did not exceed the normal level in the serum of TCC patients. Urine from patients with TCC of the urinary bladder and renal pelvis contained s-CAIX, allowing the detection of tumors in approximately 70% of the patients. Moreover, two additional patients with suspected, but unconfirmed bladder tumor, with s-CAIX detected in urine, developed tumors identified as TCC within six months. We suggest that after a simple, rapid and sensitive test, monitoring s-CAIX levels in urine will be developed, it may be useful for early detection of relapse in patients following transurethral tumor resection.

Soluble form of carbonic anhydrase IX (CA IX) in the serum and urine of renal carcinoma patients.

Tumour-associated protein carbonic anhydrase IX (CA IX) has two major forms. One is a cell-associated, transmembrane protein seen on Western blots as a twin band of 54/58 kDa, expressed in gastric mucosa and in several types of cancer. The other is a soluble protein s-CA IX of 50/54 kDa, which is released into the culture medium or into the body fluids, most likely by proteolytic cleavage of the extracellular part from transmembrane and intracellular sequences. While TC media of CA IX-positive tumour cell lines or short-term cultures of tumour explants contain a relatively high concentration of s-CA IX (20-50 ng ml(-1)), the level of this antigen in blood serum and urine of renal clear cell carcinoma patients is about 1000 x lower. The concentration of CA IX in the blood and in urine varies within wide limits and there is no obvious correlation with tumour size. After nephrectomy, s-CA IX is cleared from the blood within a few days. Only an extremely low concentration of CA IX was detectable in the sera and in urine of control individuals.

Immunotherapy of superficial bladder tumors: preliminary results with ImmuCyst--BCG Connaught, Toronto.

A clinical study has been started in 1991 with ImmuCyst (BCG Connaught) as a secondary prophylaxis in urothelial superficial bladder tumors (SBT) patients. Till now 31 patient have been entered into the trial and the results seem to be promising. Only 2 patients were excluded from the study. Side-effects did not extend in average the data quoted in literature and were easily managed. There were 4 recurrences confirmed by cystoscopy. Urinary infection was treated in 7 cases with current chemotherapeutic drugs.

[Ultrasonography in urologic ambulatory care]. / Prínos ultrasonografie pro práci lékare na urologické ambulanci.

Ultrasonography holds an important place in urological diagnostics. The number of urological departments which have their own apparatus is increasing. So far, however, the opportunity of ultrasonic examination in routine practice of the urologist in out-patient departments is not common, despite the fact that it would be a great asset. In order to make maximum use of ultrasonographic equipment in the urological out-patient department is important to know also some potential negative aspects. Therefore the authors present their experience and compare it with data in the professional literature. The authors demonstrate on examples the impact of ultrasonography on diagnostic algorithms of some urological diseases.

[Pseudotumor of the left epigastrium]. / Pseudotumor levého nadbrisku.

The authors describe the case of a patient with an accessory spleen located between the spleen and upper pole of the left kidney. A repeated sonographic examination suggested a suspicion for a kidney tumour, shape anomaly of the spleen, accessory spleen or kidney, but did not exclude even benign tumour in retroperitoneum. Computer tomography proved a formation between the upper pole of the kidney and the spleen, whose density characteristic after a rapid intravenous injection of 60% Verografin at the amount of 1 ml per kg body weight was the same as that of the spleen. Only angiographic examination revealed that the case is an accessory spleen and not a tumour.