Adenocarcinoma of the Urinary Bladder: Value of Cell Cycle Biomarkers
E King, R Youssef, W Kabbani, A Mosbah, H Abol-Enein, M Ghoniem, Y Lotan, P Kapur. UT Southwestern Medical Center, Dallas, TX; Urology & Nephrology Center Mansoura University, Mansoura, Egypt
Background: Primary adenocarcinomas of the urinary bladder are uncommon, accounting for 0.5 to 2% of all bladder malignancies. Currently, molecular pathways for adenocarcinoma of the bladder are not well defined. We assessed the association between biological markers and clinico-pathologic characteristics of bladder adenocarcinoma.
Design: Immunohistochemical staining for p53, p21, p27, and cyclin E were performed on sections of a tissue microarray construct of bladder adenocarcinoma specimens from 21 patients who underwent radical cystectomy between 1997 and 2003. Altered immunohistochemical expression was defined as p53 ≥10%, p21 <10%, p27 <30%, and cyclin E <30% nuclear reactivity.
Results: The 21 patients included 16 males and 5 females, with mean age of 49±8 y (range 35-72 years). Of these patients, 14 (67 %) had history of schistosomiasis, 12 (57 %) were high grade, 18 (86%) were ≥ pT2, and 6 (27 %) had positive lymph nodes. Recurrence occurred in 6 (29%) patients during 4.8±1.3 year follow up. Each biomarker was altered in at least 60% of cases. P27 and p21 were associated with grade, pathological T stage, and lymph node involvement (P < 0.05). The incremental number of altered biomarkers was associated with lymph node involvement as well as lymphovascular invasion (P < 0.05).
Conclusions: Assessment of cell cycle regulatory markers in adenocarcioma of the bladder may improve our knowledge about the biological behavior of this rare but dangerous disease. P27 and p21 are the most promising markers. Their combination can predict higher stage and grade as well as lymph node involvement. Combination of biomarkers can improve prediction of prognosis and may identify patients who will benefit from multimodal therapy.
Category: Genitourinary (including renal tumors)
Tuesday, March 23, 2010 1:00 PM
Poster Session IV # 89, Tuesday Afternoon