Expression of beta-human chorionic gonadotropin (ß-hCG) in non-trophoblastic elements of transitional cell carcinoma of the bladder: possible relationship with the prognosis

RESUMO

Transitional cell carcinoma (TCC) of the bladder is a neoplasm with variability in its clinical behavior. Although there are several studies correlating stage and ABO isoantigen expression with invasiveness, there is no single predictor factor to assess the potential invasiveness, especially in the low grade, non-invasive TCC. In the present study we evaluated the correlation of histological gradeplus stage and the expression of beta human chorionic gonadotropin (ß-hCG); in 100 cases of TCC, with the clinical behavior. These features were correlated with tumor progression in patients with at least two years of follow up. We observed more aggressiveness in G4 group (high grade and invasive) (93 per cents had tumor progression) when comapared to G1 group (low grade and superficial) (11 per cents had tumor progression). However in 25.5 per cents of the TCC cases (groups G2: low grade and invasive and G3: high grade and superficial) the clincial behavior was intermediate, showing some limitation in using grading and staging only, as predictive factor. There was an expression of ß-hCG in 21.4 per cents of the cases in up to 25 per cents of the tumor cells without any trophoblastic morphology. These ß-hCG producing TCC had a strong correlation with aggressiveness: 39.1 per cents and 12.8 per cents of the TCC expressed ß-hCG with and without tumor progression, respectively