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2.
Adv Anat Pathol ; 28(4): 179-195, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34128483

RESUMO

The Genitourinary Pathology Society (GUPS) undertook a critical review of the recent advances in bladder neoplasia with a focus on issues relevant to the practicing surgical pathologist for the understanding and effective reporting of bladder cancer, emphasizing particularly on the newly accumulated evidence post-2016 World Health Organization (WHO) classification. The work is presented in 2 manuscripts. Here, in the first, we revisit the nomenclature and classification system used for grading flat and papillary urothelial lesions centering on clinical relevance, and on dilemmas related to application in routine reporting. As patients of noninvasive bladder cancer frequently undergo cystoscopy and biopsy in their typically prolonged clinical course and for surveillance of disease, we discuss morphologies presented in these scenarios which may not have readily applicable diagnostic terms in the WHO classification. The topic of inverted patterns in urothelial neoplasia, particularly when prominent or exclusive, and beyond inverted papilloma has not been addressed formally in the WHO classification. Herein we provide a through review and suggest guidelines for when and how to report such lesions. In promulgating these GUPS recommendations, we aim to provide clarity on the clinical application of these not so uncommon diagnostically challenging situations encountered in routine practice, while also importantly advocating consistent terminology which would inform future work.


Assuntos
Carcinoma Papilar/patologia , Carcinoma de Células de Transição/patologia , Neoplasias Urológicas/patologia , Humanos , Gradação de Tumores , Urotélio/patologia
3.
Adv Anat Pathol ; 28(4): 196-208, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34128484

RESUMO

The Genitourinary Pathology Society (GUPS) undertook a critical review of the recent advances in bladder cancer focusing on important topics of high interest for the practicing surgical pathologist and urologist. This review represents the second of 2 manuscripts ensuing from this effort. Herein, we address the effective reporting of bladder cancer, focusing particularly on newly published data since the last 2016 World Health Organization (WHO) classification. In addition, this review focuses on the importance of reporting bladder cancer with divergent differentiation and variant (subtypes of urothelial carcinoma) histologies and the potential impact on patient care. We provide new recommendations for reporting pT1 staging in diagnostic pathology. Furthermore, we explore molecular evolution and classification, emphasizing aspects that impact the understanding of important concepts relevant to reporting and management of patients.


Assuntos
Carcinoma de Células de Transição/patologia , Imunoterapia , Neoplasias Urológicas/patologia , Biomarcadores Tumorais/metabolismo , Carcinoma de Células de Transição/tratamento farmacológico , Carcinoma de Células de Transição/metabolismo , Humanos , Estadiamento de Neoplasias , Neoplasias Urológicas/tratamento farmacológico , Neoplasias Urológicas/metabolismo
4.
Virchows Arch ; 477(1): 111-120, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31950242

RESUMO

We report on the clinicopathologic features of 115 cases of high-grade urothelial carcinoma of the upper urinary tract with variant histology present in 39 (34%). Variant histology was typically seen in high pathological stage (pT2-pT4) (82%, 32 cases) patients with lower survival rate (70%, 27 cases, median survival 31 months) and consisted in urothelial with one (23%), two (3%), and three or more variants (3%); 4% of cases presented with pure variant histology. Squamous divergent differentiation was the most common variant (7%) followed by sarcomatoid (6%) and glandular (4%), followed by 3% each of micropapillary, diffuse-plasmacytoid, inverted growth, clear cell glycogenic, or lipid-rich. The pseudo-angiosarcomatous variant is seen in 2%, and 1% each of nested, giant-cell, lymphoepithelioma-like, small-cell, trophoblastic, rhabdoid, microcystic, lymphoid-rich stroma, or myxoid stroma/chordoid completed the study series. Loss of mismatch repair protein expression was identified in one case of upper urinary tract carcinoma with inverted growth variant (3.6%). Variant histology was associated to pathological stage (p = 0.007) and survival status (p = 0.039). The univariate survival analysis identified variant histology as a feature of lower recurrence-free survival (p = 0.046). Our findings suggest that variant histology is a feature of aggressiveness in urothelial carcinoma of the upper urinary tract worth it to be reported.


Assuntos
Carcinoma de Células de Transição/patologia , Neoplasias da Bexiga Urinária/patologia , Neoplasias Urológicas/patologia , Urotélio/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistema Urinário/metabolismo , Sistema Urinário/patologia
5.
Expert Rev Mol Diagn ; 20(2): 231-243, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31795775

RESUMO

Introduction: Bladder cancer detection typically requires unpleasant and costly cystoscopy, a procedure potentially harmful and often accompanied by variable adverse effects. The use of urine analysis as a noninvasive method is of great scientific interest since it is enriched in tumor-related proteins, DNA and RNA which can provide a molecular landscape with multiple alterations identified in bladder cancer.Areas covered: Current sensitivity, specificity and diagnostic accuracy of FDA approved urine-based assays are still suboptimal with none of them routinely used by clinics. The recent introduction of RNA/DNA based bladder cancer tests, some of them commercially available, establishes a promising new horizon of clinical applicability.Expert opinion: There is growing evidence toward the use of minimally invasive 'liquid biopsies' to identify biomarkers in urothelial malignancy. Urine has been identified as an optimal noninvasive source of proteins, DNA and RNA; therefore, it has been identified as a type of liquid biopsy likely to soon be routine clinical practice. Cell-free proteins and peptides, exosomes, cell-free DNA, methylated DNA and DNA mutations, circulating tumor cells, miRNA, lncRNA, rtRNA and mRNAs, have been assessed in urine specimens. However, lack of well-designed multicenter clinical studies remain as important limitation, and therefore, precludes their use in clinical practice.


Assuntos
Biomarcadores Tumorais , Biópsia Líquida/métodos , Urinálise/métodos , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/urina , Ácidos Nucleicos Livres , DNA de Neoplasias , Gerenciamento Clínico , Suscetibilidade a Doenças , Humanos , Biópsia Líquida/normas , Técnicas de Diagnóstico Molecular , Células Neoplásicas Circulantes , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Urinálise/normas , Neoplasias da Bexiga Urinária/etiologia
6.
Virchows Arch ; 475(6): 735-744, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31588959

RESUMO

Focal or non-focal/extensive extraprostatic extension of prostate carcinoma is an important pathologic prognostic parameter to be reported after radical prostatectomy. Currently, there is no agreement on how to measure and what are the best cutoff points to be used in practice. We hypothesized that digital microscopy would potentially provide more objective measurements of extraprostatic extension, thus better defining its clinical significance. To further our knowledge on digital prostate pathology, we evaluated the status of extraprostatic extension in 107 consecutive laparoscopic radical prostatectomy samples, using digital and conventional light microscopy. Mean linear and radial measurements of extraprostatic extension by digital microscopy significantly correlated to pT status (p = 0.022 and p = 0.050, respectively) but only radial measurements correlated to biochemical recurrence (p = 0.042) and grade groups (p = 0.022). None of the measurements, whether conventional or digital, were associated with lymph node status. Receiving operating characteristic analysis showed a potential cutoff point to assess linear measurements by conventional (< vs. > 24.21 mm) or digital microscopy (< vs. > 15 mm) or by radial measurement (< vs. > 1.6 mm). Finally, we observed an association between the number of paraffin blocks bearing EPE with pT (p = 0.041) status (digital microscopy), and linear measurements by conventional (p = 0.044) or digital microscopy (p = 0.045) with lymph node status. Reporting EPE measurements by digital microscopy, both linear and radial, and the number of paraffin blocks with EPE, might provide additional prognostic features after radical prostatectomy.


Assuntos
Invasividade Neoplásica/patologia , Recidiva Local de Neoplasia/patologia , Próstata/patologia , Neoplasias da Próstata/patologia , Idoso , Intervalo Livre de Doença , Humanos , Masculino , Microscopia/métodos , Pessoa de Meia-Idade , Invasividade Neoplásica/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Prognóstico , Antígeno Prostático Específico/metabolismo , Prostatectomia/métodos , Neoplasias da Próstata/diagnóstico
7.
Histopathology ; 74(1): 77-96, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30565299

RESUMO

Pathological evaluation of bladder cancer typically reveals great tumour heterogeneity, and therefore the common observation of urothelial carcinoma exhibiting a wide variety of histopathological patterns is not surprising. Some of these patterns are so distinctive that they have been recognised as specific variants of urothelial carcinoma. Classifications have recently been revised in the 2016 World Health Organisation (WHO) classification of tumours of the urinary system and male genital organs. The current WHO classifications clarify terminological issues and provide better definition criteria, but also incorporate some new entities. Many of these variants have important prognostic or therapeutic implications worth knowing by the urologist and oncologist, but also represent diagnostic challenges in daily pathology practice. This review will discuss the features of variants of urothelial carcinoma in the context of our current clinical practice. Histological variations and new entities of bladder cancer not included in the current WHO classification of urothelial tumours will be briefly discussed.


Assuntos
Carcinoma de Células de Transição/patologia , Neoplasias da Bexiga Urinária/patologia , Carcinoma de Células de Transição/classificação , Humanos , Neoplasias da Bexiga Urinária/classificação , Neoplasias Urológicas/patologia , Urotélio/patologia
8.
Minerva Urol Nefrol ; 71(4): 421-425, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30421592

RESUMO

Primary penile cancer is a rare malignant disease. In most cases, it presents as a clinically obvious lesion leading to early diagnosis in most patients. However, even in developed Countries, it carries a significant social stigma leading to diagnosis at locally advanced stages in a non-negligible proportion of patients. Yet, bulky penile lesions are becoming extremely rare in current clinical practice. We present a case of a patient with a giant primary penile cancer managed with radical penectomy, bilateral inguinal lymphadenectomy and perineal urethrostomy, who experienced disease recurrence six months after surgery and died with metastatic disease after denial of further treatment. The management of our case was challenging due to the extremely late diagnosis, the huge dimensions and the infiltrative nature of the tumor; however, from a histopathological perspective, the cancer itself did not display any microscopic peculiarity. Our case highlights that such bulky penile tumors can still occur in current urologic practice and require complex salvage surgical interventions in the context of a multidisciplinary setting.


Assuntos
Neoplasias Penianas/cirurgia , Evolução Fatal , Humanos , Excisão de Linfonodo , Linfonodos/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias Penianas/diagnóstico por imagem , Neoplasias Penianas/patologia , Tomografia Computadorizada por Raios X
9.
Semin Diagn Pathol ; 35(4): 218-227, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29576423

RESUMO

Intravesical immunotherapy, chemotherapy, and neoadjuvant systemic chemotherapy are among the most frequent therapeutic procedures to treat malignancies of the urinary bladder. These treatment modalities produce reactive morphologic changes in the urothelium that can mimic urothelial carcinoma in situ, urothelial dysplasia or true invasive urothelial neoplasia. Mitomycin C used after transurethral resection of bladder tumor to reduce recurrences, BCG intravesical immunotherapy to treat high risk non-muscle invasive bladder cancer and urothelial carcinoma in situ, and platinum-based systemic chemotherapy to improve post-cystectomy disease-specific survival some of the causes of therapy related atypia in urinary bladder. In addition, a number of systemic drugs in use to treat other systemic diseases, such as cyclophosphamide used to treat certain auto-immune disorders or hematologic malignancies, or the anesthetics ketamine increasingly used as illegal recreational drug, may produce similarly relevant atypical changes in the urothelium, and therefore, need to be differentiated from intraepithelial neoplasia. Immunohistochemical approach to reactive urothelium from CIS using CK20, p53, and CD44 may also be of utility in the pos-therapy scenario.


Assuntos
Biomarcadores Tumorais/análise , Carcinoma in Situ/patologia , Carcinoma de Células de Transição/patologia , Neoplasias da Bexiga Urinária/patologia , Carcinoma in Situ/terapia , Carcinoma de Células de Transição/terapia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Doença Iatrogênica , Imuno-Histoquímica , Imunoterapia/efeitos adversos , Terapia Neoadjuvante/efeitos adversos , Radioterapia/efeitos adversos , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/terapia , Urotélio
10.
Virchows Arch ; 472(3): 451-460, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29453523

RESUMO

Positive surgical margin (PSM) extension reported as focal or non-focal/extensive is an important pathologic prognostic parameter after radical prostatectomy. Likewise, there is limited or no agreement on how to measure and what the best cut-off points to be used in practice are. We hypothesized that digital microscopy (DM) would potentially provide a more objective way to measure PSM and better define its clinical significance. To further our knowledge, we have evaluated PSM status in 107 laparoscopic radical prostatectomies using digital and conventional light microscopy (LM). DM evaluation detected three additional PSM cases, but no differences were seen (LM vs DM; p = 0.220). Mean linear measurement correlated to biochemical recurrence (BR) (LM, p = 0.002; DM, p = 0.001). ROC analysis identified a cut-off point to assess linear measurement by LM (3.5 mm) or DM (3.2 mm), but only digital measurement was significant for BR-free survival. Our study also evaluated a cut-off ≤ 3 mm that was associated to BR using LM (p = 0.023) or DM (p = 0.001). Finally, the number of paraffin blocks bearing PSM correlated with BR (p < 0.001) status with either LM or DM. In conclusion, DM produces similar data than LM but shows more accurate measurements. Reporting of PSM with score of ≤ 3 vs. > 3 mm linear extent using LM (3.2 mm if digital microscopy is applied) might represent an important prognostic feature after radical prostatectomy. Alternatively, reporting the number of blocks with PSM 1 vs. 2 or more might also provide important prognostic data in practice.


Assuntos
Margens de Excisão , Próstata/diagnóstico por imagem , Prostatectomia , Neoplasias da Próstata/diagnóstico por imagem , Idoso , Intervalo Livre de Doença , Humanos , Masculino , Microscopia/métodos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Antígeno Prostático Específico/metabolismo , Prostatectomia/métodos
11.
Future Oncol ; 14(3): 277-290, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29345160

RESUMO

Environmental factors that play a role in the urothelial carcinogenesis have been well characterized. Current research is continuously exploring potential heritable forms of bladder cancer. Lynch syndrome is a well-known inheritable disease that increases the risk for a variety of cancers, including urothelial carcinomas. Screening of patients with known Lynch syndrome is important to evaluate for development of new primary tumors. Further study may provide more information on what level of follow-up each patient needs. Recent data suggest that mismatch repair mutations confer a greater risk for urothelial cancer. Additional large patient series as well as advancement of molecular testing may provide triage for Lynch syndrome patients in regards to the frequency and type of screening best suited for individual patient.


Assuntos
Estudos de Associação Genética , Predisposição Genética para Doença , Neoplasias da Bexiga Urinária/genética , Biomarcadores Tumorais/genética , Neoplasias Colorretais Hereditárias sem Polipose/diagnóstico , Neoplasias Colorretais Hereditárias sem Polipose/epidemiologia , Neoplasias Colorretais Hereditárias sem Polipose/genética , Detecção Precoce de Câncer , Humanos , Programas de Rastreamento , Instabilidade de Microssatélites , Síndromes Neoplásicas Hereditárias/diagnóstico , Síndromes Neoplásicas Hereditárias/epidemiologia , Síndromes Neoplásicas Hereditárias/genética , Vigilância da População , Prognóstico , Fatores de Risco , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/epidemiologia
13.
Nat Rev Urol ; 14(10): 620-629, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28813037

RESUMO

Radical cystoprostatectomy (RCP) followed by bilateral pelvic lymphadenectomy and urinary diversion remains the gold-standard therapy for men with localized muscle-invasive bladder cancer (MIBC). Prostate cancer might be incidentally detected at the time of RCP with a reported prevalence of 24-51%. Typically, these patients are considered to have clinically insignificant disease, but data from emerging series challenge this assumption and suggest that some of these tumours might be aggressive, or somehow increase the aggressiveness of the associated MIBC, and can negatively influence the patient's overall survival outcomes. Furthermore, the potential use of prostate-sparing cystectomy in patients with less-aggressive MIBC might lead to newly diagnosed incidental cases of prostate cancer, with characteristics suggestive of clinically significant disease, requiring a specific, separate workup. The development of evidence-based, validated protocols to define the necessary steps for diagnosis of prostate cancer in these patients, including the role of serum PSA testing, digital rectal examination, the role of imaging methods and the indication and type of biopsy protocol, is of major importance to the multidisciplinary management of patients with urological cancer. Finally, the retrospective nature of the available data account for much of the variability in the prevalence of coexisting bladder and prostate cancer and emphasizes the need for randomized trials in this controversial area of urological oncology.


Assuntos
Neoplasias da Próstata/complicações , Neoplasias da Próstata/terapia , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/terapia , Cistectomia , Humanos , Masculino , Prostatectomia , Neoplasias da Próstata/patologia , Neoplasias da Bexiga Urinária/patologia
14.
Virchows Arch ; 470(6): 703-709, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28455741

RESUMO

In this report, we summarized the clinicopathologic features of ten cases of lymphoepithelioma-like carcinoma (LELC) of the upper urinary tract (ureter n = 6; renal pelvis n = 4), a rare variant of urothelial cancer characterized by a malignant epithelial component densely infiltrated by lymphoid cells. The initial diagnosis was made on radical nephrectomy in five cases, nephroureterectomy in three cases, and ureterectomy in two others. Four patients had pathologic stage T1 (n = 2) or T2 (n = 2) tumors, and six patients had stage pT3 disease. Microscopically, all tumors contained pure (n = 3) or predominant (n = 7) LELC, which composed 60 to 80% of the entire tumor. Non-LELC tumor component was adenocarcinoma (n = 2), spindle cell carcinoma (n = 1), or high-grade conventional urothelial carcinoma (n = 4). The LELC component was characterized by indistinct cytoplasmic borders and a syncytial growth pattern. Immunohistochemical staining showed LELC to be positive for cytokeratin AE1/AE3, CK7, CK34ßE12 (rare cells), CK5/6 (rare cells), and CK20 (rare cells); rare cells were p40 positive. GATA 3 was positive in all cases in a variable proportion of cells (20-80%). Lymphoid markers showed a polyclonal proliferation of predominant T cells admixed with B cells. In situ hybridization for the HPV genome was negative in all ten cases. Survival analysis showed no differences between LELC and conventional upper urinary tract urothelial carcinoma, pT classification being the only significant prognostic parameter. Morphologic recognition and distinction from other (non-)neoplastic lesions with prominent lymphoid stroma are critical for its clinical management.


Assuntos
Carcinoma/patologia , Neoplasias Renais/patologia , Neoplasias Ureterais/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma/mortalidade , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Neoplasias Renais/mortalidade , Masculino , Pessoa de Meia-Idade , Neoplasias Ureterais/mortalidade
15.
Expert Opin Ther Targets ; 21(4): 401-414, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28281901

RESUMO

INTRODUCTION: Despite more than 30 years of research on p53 resulting in >50,000 publications, we are now beginning to figure out the complexity of the p53 pathway, gene ontology and conformational structure of the molecule. Recent years brought great advances in p53 related drugs and the potencial ways in which p53 is inactivated in cancer. Areas covered: We searched for related publications on Pubmed and ClinicalTrial.gov using the following keywords 'p53, Tp53, p53 and bladder cancer, p53 and therapeutic target'. Relevant articles improved the understanding on p53 pathways and their potential as candidate to targeted therapy in bladder cancer. Expert opinion: Novel strategies developed to restore the function of mutants with chemical chaperones or by using compounds to improved pharmacokinetic properties are in development with potential to be applied in the oncology clinic. Other strategies targeting aberrantly overexpressed p53 regulators with wild-type p53 are also an active area of research. In particular, studies inhibiting the interaction of p53 with its negative regulators MDMX and MDM2 are an important field in drug discovery. Small molecules for inhibition of MDM2 are now in clinical trials process. However, personalized anticancer therapy might eventually advance through analyses of p53 status in cancer patients.


Assuntos
Antineoplásicos/farmacologia , Proteína Supressora de Tumor p53/metabolismo , Neoplasias da Bexiga Urinária/tratamento farmacológico , Animais , Proteínas de Ciclo Celular , Desenho de Fármacos , Humanos , Chaperonas Moleculares/farmacologia , Terapia de Alvo Molecular , Proteínas Nucleares/metabolismo , Proteínas Proto-Oncogênicas/metabolismo , Proteínas Proto-Oncogênicas c-mdm2/antagonistas & inibidores , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Proteína Supressora de Tumor p53/genética , Neoplasias da Bexiga Urinária/genética , Neoplasias da Bexiga Urinária/patologia
16.
Histopathology ; 70(1): 10-25, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27960233

RESUMO

A handful of therapeutic procedures are used to treat malignancies of the urinary tract, most frequently intravesical immunotherapy or chemotherapy, but also neoadjuvant systemic chemotherapy. These treatment modalities produce morphological changes in the urothelium that can be mistaken for carcinoma; in particular, these therapies frequently mimic urothelial carcinoma in situ (CIS) urothelial dysplasia or true invasive neoplasia. Drugs such as mitomycin C used after transurethral resection of bladder tumour to reduce recurrences, bacillus Calmette-Guérin (BCG) intravesical immunotherapy to treat high-risk non-muscle-invasive bladder cancer and urothelial CIS and platin-based systemic chemotherapy to improve postcystectomy disease-specific survival are examples of therapy-related atypia seen in the urinary tract. To complicate the pathologist's life, a number of systemic drugs in use to treat other diseases, such cyclophosphamide, used to treat some autoimmune disorders or certain haematological malignancies or, in the case of anaesthetics, ketamine, used increasingly as an illegal recreational drug, may produce similarly relevant atypical changes in the urothelium, and therefore need to be differentiated from intraepithelial neoplasia. Other less frequent procedures, such as photodynamic and laser therapy or the newer gene therapy to treat urothelial neoplasia, remain experimental. An immunohistochemical approach to reactive urothelium versus carcinoma in situ using p53, cytokeratin 20 and CD44 is also valid in the post-therapy setting. The pathologist should be aware of these novelties, as he or she plays a crucial role in evaluating treatment efficacy, but at the same time needs to avoid misdiagnosing secondary atypia as intraepithelial neoplasia.


Assuntos
Doença Iatrogênica , Doenças Urológicas/diagnóstico , Doenças Urológicas/etiologia , Antineoplásicos/efeitos adversos , Humanos , Neoplasias Urológicas/diagnóstico , Neoplasias Urológicas/terapia
18.
Biomark Med ; 10(3): 243-53, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26861974

RESUMO

AIM: To assess the diagnostic performance of FGFR3 and Cyclin D3 urinary protein levels in detecting bladder cancer recurrence. PATIENTS & METHODS: Urine of 321 patients in follow-up for bladder cancer and 150 non-neoplastic urine controls was included. Cytology, cystoscopy and FGFR3 and Cyclin D3 expression by western blot were performed. RESULTS: One hundred ten (34.3%) patients had evidence of tumor recurrence. The sensitivity and specificity of cytology/cystoscopy was 80 and 84%, and for FGFR3/Cyclin D3 was of 73 and 90%. CONCLUSION: Combined urinary FGFR3/Cyclin D3 expression shows improved detection rates for bladder cancer recurrence with high specificity and sensitivity, and within the same range of detection shown by cystoscopy, therefore supporting its potential use as noninvasive diagnostic biomarker for bladder cancer recurrence.


Assuntos
Biomarcadores Tumorais/urina , Ciclina D3/urina , Recidiva Local de Neoplasia/urina , Receptor Tipo 3 de Fator de Crescimento de Fibroblastos/urina , Neoplasias da Bexiga Urinária/urina , Adulto , Idoso , Idoso de 80 Anos ou mais , Western Blotting , Células HEK293 , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Curva ROC
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