[The proliferating nuclear fraction as a prognostic factor in superficial bladder carcinomas]. / Estudio de la fracción proliferativa nuclear como factor pronóstico en los carcinomas de vejiga superficiales.

OBJECTIVE: Low grade, low stage superficial bladder tumors have, in general, a good prognosis; however, some of these tumors progress and behave more aggressively, displaying a high incidence of recurrence and rapid transformation into a higher grade of malignancy with deep invasion of the bladder wall. Numerous studies have been conducted on markers which help to predict this transformation. METHODS: The expression of the anti-proliferating cell nuclear antigen (PCNA) was examined in bladder specimens from 72 patients with superficial transitional cell carcinoma utilizing the PC10 monoclonal antibody. We have compared expression of PCNA with other markers. The cases were divided into three groups: group A comprised patients with good clinical behaviour; group B comprised patients who developed recurrences of the same histological grade and group C comprised patients with superficial TCC who developed muscle wall invasion within 2 years. RESULTS/CONCLUSIONS: Our results demonstrate that the monoclonal antibody PC10 is an excellent marker for the aggressive, low stage and low grade superficial bladder tumours and can distinguish these from those which have a good clinical behaviour.

Superficial bladder cancer: study of the proliferative nuclear fraction as a prognostic factor.

The expression of the anti-proliferating cell nuclear antigen (PCNA) was examined in bladder specimens from 48 patients with superficial transitional carcinoma, with the use of the PC10 monoclonal antibody. In vesical tumours with good clinical behaviour, we found a median PCNA positivity of 7.1% with a range of 5-25%. In vesical tumours with high incidence of recurrence, the median was 36.6% with a range of 15-80%. In vesical tumours with a strong tendency to invasion, the median positivity for PCNA staining was 68% with a range of 40-92%. In conclusion, we believe that using PC10 immunostaining to determine a nuclear proliferative fraction is a quick and simple method of studying the prognosis of patients who have vesical tumours of low grade and low stage.

T-antigen. A prognostic indicator of high recurrence index in transitional carcinoma of the bladder.

Forty biopsies from 36 patients with bladder tumors were tested for T-antigen (TAg) expression on tumor cells on sections untreated or treated with neuraminidase; a 37.5% of tumors showed abnormal expression of TAg either as an aberrant expression, or absence of this antigen after removing sialic acid. These changes were not well correlated with histologic signs of anaplasia or infiltration, nor with other biologic properties of tumor cells such as the expression of blood group antigens (ABH). However, a practical utility of TAg in the study of bladder tumors, is suggested by the analysis of those biopsies with low-grade low-stage tumors, on which the abnormal expression of TAg was more discriminatory than the ABH changes in defining those patients suffering tumors with a particular aggressiveness. Circulating antibody titer was also investigated in 20 patients but all of them displayed titers in the normal range, with independence of the results observed in their corresponding bladder biopsies.