[Prognostic value of E-cadherina, beta catenin, Ki-67 antigen and p53 protein in the superficial bladder tumors]. / Cadherina E, catenina beta, antígeno Ki-67 y proteína p53 en el pronóstico de la recidiva tumoral en los tumores superficiales de vejiga T1.

INTRODUCTION: The natural history of the superficial carcinoma of bladder is characterized by his high rate of recurrence and by the aptitude to progress to higher stages. We are going to investigate the capacity of prediction for tumor recurrence of protein p53, antigen Ki-67, E Cadherin and Beta Catenin MATERIAL AND METHOD: 88 T1 tumors with a median of free time of disease of 36 months. 58% of the serie has received prophylactic treatment with BCG 81 mg. weekly for six weeks. Cut-oof level for For P53 and Ki-67 is 10 % of stained cells. For E Cadherin and Beta Catenin we have established two groups: one with the values 0-4 (negative), and other one with the values 5-8 (positive). RESULTS: Recurrence rate 31%, stage progression 3%. Ki-67 expression is correlated with grade (p .002) and lymphatic permeation (p .028). Multiplicity is correlated with lack( of Cadherin and Catenin's expression. Only Ki-67 expression (p .049) and lack of Beta Catenin expression (p .039) reach statistical significance. In multivariant study only lack of Beta Catenin's expression shows independent recurrence value (p .049; O.R: 2,4-6,9) CONCLUSIONS: The most useful prognmostic markers are Ki-67 and Catenina Beta Only Beta Catenin Beta shows independent value for tumour recurrence. Tumors wich lack expression for Catenin B or Cadherin E have lower recurrence free time.

Cadherina E, Catenina Beta, Antígeno Ki-67 y proteína p53 en el pronóstico de la recidiva tumoral en los tumores superficiales de vejiga T1 / Prognostic value of E-Cadherina, Beta Catenin, K1, Ki-67 antigen and p53 protein in the superficial bladder tumors

Introducción: La historia natural del carcinoma superficial de vejiga (CSV) se caracteriza por su alta tasa de recidivas y por la capacidad de progresar a estadios infiltrantes. Vamos a investigar la capacidad de predicción de recidiva tumoral de la proteína p53, el antígeno Ki-67 y las moléculas de adhesión celular Cadherina E y Catenina Beta Material y método: 88 tumores T1 con una mediana de tiempo libre de enfermedad de 36 meses. Han recibido tratamiento profiláctico con BCG 81 mg. semanal durante seis semanas el 58% de la serie. Para p53 y Ki-67 se estableció el nivel de 10% de células teñidas para considerar positivo el tumor. Para Cadherina E y Catenina se han establecido dos grupos: uno con los valores 0-4 (negativo), y otro con los valores 5-8 (positivo). Resultados: Han recidivado el 31% de los tumores y progresado a estadio infiltrante el 3% La expresión de Ki-67 se correlaciona con grado (p ,002) y permeación linfática (p ,028). La multiplicidad tumoral con la falta de expresión de Cadherina E y Catenina Beta. Sólo la expresión de Ki-67 (p .049) y la de Catenina Beta (p .039) alcanzan significación estadística. En el estudio multivariante sólo la falta de expresión de Catenina Beta muestra tener valor pronóstico independiente para recidiva (p .049; O.R : 2,4-6,9) Conclusiones: Los marcadores más útiles son Ki-67 y Catenina Beta. Sólo la Catenina Beta muestra un valor independiente para recidiva tumoral. Los tumores que no expresan Catenina Beta o Cadherina E tienen un menor tiempo libre de recidiva

Introduction: The natural history of the superficial carcinoma of bladder is characterized by his high rate of recurrence and by the aptitude to progress to higher stages. We are going to investigate the capacity of prediction for tumor recurrence of protein p53, antigen Ki-67, E Cadherin and Beta Catenin Material and method: 88 T1 tumors with a median of free time of disease of 36 months. 58% of the serie has received prophylactic treatment with BCG 81 mg. weekly for six weeks. Cut-oof level for For P53 and Ki-67 is 10 % of stained cells. For E Cadherin and Beta Catenin we have established two groups: one with the values 0-4 (negative), and other one with the values 5-8 (positive). Results: Recurrence rate 31 %, stage progression 3 %. Ki-67 expression is correlated with grade (p .002) and lymphatic permeation (p .028). Multiplicity is correlated with lack( of Cadherin and Catenin´s expression. Only Ki-67 expression (p .049) and lack of Beta Catenin expression (p .039) reach statistical significance. In multivariant study only lack of Beta Catenin’s expression shows independent recurrence value (p .049; O.R: 2,4-6,9) Conclusions: The most useful prognmostic markers are Ki-67 and Catenina Beta Only Beta Catenin Beta shows independent value for tumour recurrence. Tumors wich lack expression for Catenin B or Cadherin E have lower recurrence free time

Determinación de ploidía de ADN mediante citometría de flujo, índice Ki-67 y sobreexpresión de proteína p53 en 121 carcinomas superficiales de vejiga T1. Estudio retrospectivo correlación con las variables clásicas / Flow cytometry-DNA ploidy, Ki67 label and overexpression of P53 protein in 121 T1 superficial bladder cancer. Retrospective study. 1st Part: Corelation with classic variables

OBJETIVO: Observar la correlación entre el índice Ki-67, la expresión de proteína p53 y la ploidía de ADN mediante citometría de flujo con las variables clásicas (grado, permeación linfática, volumen tumoral, multiplicidad, primario).MATERIAL Y MÉTODO: 121 carcinomas vesicales T1. Nivel de corte para Ki-67 y p53 del 10 por ciento. Se considera aneuploide cuando el tumor tiene un índice de ADN distinto de 1 ó más del 20 por ciento de la población en fase G2-M.RESULTADOS: Se aprecia una correlación estadísticamente significativa entre las tres técnicas y las variables grado y permeación linfática, así como de las tres técnicas entre sí. El índice Ki-67 y la expresión de proteína p53 distingue entre G1, G2 frente a G3 y Lx, L0 frente a L1. Se aprecia también relación entre volumen tumoral y positividad para p53.CONCLUSIONES: La aneuploidía y la positividad para Ki-67 y p53 aumenta conforme aumenta el grado y la permeación linfática. (AU)

[DNA ploidy determination with flow cytometry, Ki-67 index, and overexpression of p53 protein in 121 T1 superficial bladder carcinoma. Retrospective study. Correlation with classic variables]. / Determinación de ploidía de ADN mediante citometría de flujo, índice Ki-67 y sobreexpresión de proteína P53 en 121 carcinomas superficiales de vejiga T1. Estudio retrospectivo. Correlación con las variables clásicas.

OBJECTIVE: Observe the correlation between Ki-67 label index, p53 expression and flow cytometry-DNA ploidy with the classic variables (grade, lymphatic permeation, multiplicity, volume, primary). MATERIAL AND METHOD: 121 superficial bladder tumors T1. 10% Cut-off level for Ki-67 and p53. Aneuploidy is defined as a tumor with DNA index different of 1 or more than 20% in G2-M phase. RESULTS: Statistical correlation with grade and lymphatic permeation. Ki-67 label index and p53 expression can distinguish between G1, G2 vs G3 and Lx, L0 vs. L1. The volume correlates with positivity to p53. CONCLUSIONS: Aneuploidy and positivity to Ki-67 and p53 increase with grade and lymphatic permeation.

[The prevention of stage-T1 superficial bladder tumors with 27 mg. of BCG weekly over 6 weeks]. / Profilaxis de los tumores superficiales de vejiga estadio T1 con 27 mg. de BCG semanal durante seis semanas.

OBJECTIVE: To evaluate the utility of prophylactic treatment of stage T1 superficial tumors of the bladder with 27 mg BCG weekly for 6 weeks and to compare the results reported in the literature. METHODS: BCG instillations were offered to 235 patients and was accepted by 111 (group A) and refused by 124 (group B). Three weeks thereafter, intravesical instillation of 27 mg BCG was administered for 6 weeks. The patients were controlled regularly according to the standard control procedures utilized in our setting. RESULTS: 39% of the patients in group A showed recurrence versus 71.7% of those in group B (p < 0.001). No differences in progression of tumor stage was observed; 6.3% for group A and 10.9% for group B. By grade, significant differences were found in the number of recurrence in those with G1 (28.5% vs 69%; p < 0.001) and G2 (47% vs 72%; p < 0.01) tumors, but not for G3 (53% vs 77%; p = n.s.). No differences were found in the number of progressions. For those with G2 and G3, the results were not as good as those reported in the literature. The incidence of toxicity was 33%. CONCLUSIONS: The results achieved in patients with G2 and especially G3 tumors were not as good as those reported in the literature, therefore we do not recommend this approach. For those with G1 tumors and assuming a toxicity rate of 33%, the results are similar to those reported elsewhere using higher doses, and therefore this approach could be utilized.

[The prognostic factors in T1 superficial bladder carcinoma. Our experience]. / Factores pronósticos en el carcinoma superficial de vejiga T1. Nuestra experiencia.

OBJECTIVE: To identify the prognostic factors for recurrence and disease progression in T1 superficial carcinoma of the bladder for prophylactic therapeutic planning. METHODS: Of 309 patients with superficial carcinoma of the bladder that had only undergone TUR, we selected 196 patients that met the following requirements: T1 tumor, one year minimum follow-up (except for recurrence), TUR complete on gross examination. The changes observed with recurrence (presence of a tumor regardless of grade or stage) and disease progression (higher tumor stage and therefore infiltrating) in the following parameters were analyzed: tumor grade, node involvement, volume resected, number of tumors, primary or recurrent and age. RESULTS: 141 (72%) showed recurrence and 23 disease progression (11.7%) at two-years' mean follow-up. The resected tumor volume was found to be a prognostic factor for recurrence by univariate (0.010) and multivariate analysis (0.039). Tumor grade (0.0005) and node involvement (0.040) were prognostic factors for disease progression by univariate analysis and tumor grade (0.006) by multivariate analysis. CONCLUSIONS: Resected tumor volume, node involvement and tumor grade were found to be prognostic factors. The incidence of disease progression in this series falls within the lower ranges reported in the literature.