Bladder transitional cell carcinoma and BK virus in a young kidney transplant recipient.

Kidney transplant recipients have a heightened risk of developing neoplasms. Immunosuppressive treatments decrease the incidence of transplant rejection but increase the risk of infections, including BK virus (BKV). This infection is acquired in childhood and remains latent in the renal and urinary epithelium. In cases of immunodeficiency, BKV has been implicated as a tumor virus, but the role of BKV in cancer is a controversial topic and is difficult to determine. In the tumor cells, it is possible to detect fragments of the viral genome that could alter the control mechanisms of the cell cycle and DNA repair. We report the case of a kidney transplant recipient who developed BKV nephropathy and carcinoma of the bladder, supporting a possible role for BKV in the oncogenic pathway in this clinical setting, but the role of BKV in cancer remains a controversial topic and difficult to determine.

Clinical-pathological differences and smoking habit depending on gender in a cohort of patients with transitional cell carcinoma of the bladder: retrospective study.

OBJECTIVES: The increased incidence of transitional cell carcinoma (TCC) of the bladder in men is known, generally attributed to greater exposure to the effect carcinogenic products. Although it has been reported that cancer-specific outcome can be particularly adverse in women due to socioeconomic or biological factors, clinical-pathological differences of TCC at the time of diagnosis have not been sufficiently studied. The aim of this study is to analyze whether there are gender-related differences in grade and tumor stage in primary bladder TCC. METHODS: All consecutive primary bladder TCC diagnoses made in our institution between 1990 and 2009 have been included. We retrospectively analyzed age, smoking, symptoms at presentation, tumor grade (WHO 1973), tumor size and number, and TNM stage, comparing men and women. Statistical analysis was conducted using the Mann-Whitney U test as non-parametric test and Chi-squared test to compare frequencies. RESULTS: We analyzed 1196 patients (992 males and 204 females) with a 5:1 ratio. We found significant differences in age (69 years vs. 73 years), smoking (46.5% vs. 11.2%)and muscle-invasive stage (12.1% vs. 18.1%). Correcting by tobacco consumption, never-smoker women have larger and more aggressive tumors with a frequency of muscle-invasive disease three times higher than male never-smokers and equaling to male current-smokers. CONCLUSION: TCC of the bladder is more frequent in males than females. In this series, women are older at the time of diagnosis and most often affected by muscle-invasive disease particularly in never-smokers. We need studies to analyze the potential impact of passive smoking to justify these results.

Diferencias clínico-patológicas y tabaquismo en función del sexo en una cohorte de pacientes con carcinoma de células transicionales de vejiga: un estudio retrospectivo / Clinical-pathological differences and smoking habit depending on gender in a cohort of patients with transitional cell carcinoma of the bladder: retrospective study

OBJETIVO: Es conocida la mayor incidencia de carcinoma de células transicionales (CCT) de vejiga en los varones, generalmente atribuida a una mayor exposición al efecto de los carcinógenos. A pesar de que se ha comunicado que la evolución puede ser especialmente adversa en las mujeres debido a factores socioeconómicos o biológicos, no han sido suficientemente estudiadas las diferencias clínico-patológicas del CCT en el momento del diagnóstico entre el hombre y la mujer. El objetivo de este estudio es analizar las diferencias en la exposición al tabaco, el grado y el estadio tumoral del CCT primario de vejiga en función del sexo.MÉTODOS: Se han incluido todos los diagnósticos consecutivos de CCT primario de vejiga realizados en nuestra institución entre 1990 y 2009. Se analizan, de forma retrospectiva, edad, hábito tabáquico, sintomatología, grado tumoral (OMS 1973), tamaño tumoral, multiplicidad y estadio TNM, comparándolas entre hombres y mujeres. Para el análisis estadístico se empleó la U de Mann-Withney como test no paramétrico y el test de Chi-cuadrado para la comparación de frecuencias.RESULTADOS: Se han analizado 1196 pacientes (992 hombres y 204 mujeres) con una razón observada de 5:1. Se han encontrado diferencias significativas en la edad (69 años vs 73 años), hábito tabáquico (46.5% vs 11.2%) y estadio músculo-infiltrante (12.1% vs 18.1%). Corrigiendo por el hábito tabáquico, las mujeres no fumadoras presentan tumores de mayor tamaño y grado con una frecuencia de enfermedad músculo-infiltrante 3 veces superior a los varones no fumadores e igualando a los fumadores.CONCLUSIÓN: El CCT de vejiga tiene mayor incidencia en los varones. En esta serie, las mujeres tenían una edad más avanzada en el momento del diagnóstico y presentan con más frecuencia enfermedad músculo-infiltrante afectando especialmente a las no fumadoras. Hacen falta estudios dirigidos a analizar el potencial impacto del tabaquismo pasivo que justifiquen estos resultados(AU)

OBJECTIVES: The increased incidence of transitional cell carcinoma (TCC) of the bladder in men is known, generally attributed to greater exposure to the effect carcinogenic products. Although it has been reported that cancer-specific outcome can be particularly adverse in women due to socioeconomic or biological factors, clinical-pathological differences of TCC at the time of diagnosis have not been sufficiently studied. The aim of this study is to analyze whether there are gender-related differences in grade and tumor stage in primary bladder TCC.METHODS: All consecutive primary bladder TCC diagnoses made in our institution between 1990 and 2009 have been included. We retrospectively analyzed age, smoking, symptoms at presentation, tumor grade (WHO 1973), tumor size and number, and TNM stage, comparing men and women. Statistical analysis was conducted using the Mann-Whitney U test as non-parametric test and Chi-squared test to compare frequencies.RESULTS : We analyzed 1196 patients (992 males and 204 females) with a 5:1 ratio. We found significant differences in age (69 years vs. 73 years), smoking (46.5% vs. 11.2%) and muscle-invasive stage (12.1% vs. 18.1%). Correcting by tobacco consumption, never-smoker women have larger and more aggressive tumors with a frequency of muscle-invasive disease three times higher than male never-smokers and equaling to male current-smokers.CONCLUSION: TCC of the bladder is more frequent in males than females. In this series, women are older at the time of diagnosis and most often affected by muscle-invasive disease particularly in never-smokers. We need studies to analyze the potential impact of passive smoking to justify these results(AU)

Molecular analyses of the mitotic checkpoint components hsMAD2, hBUB1 and hBUB3 in human cancer.

During the metaphase-anaphase transition, the spindle checkpoint prevents segregation of chromosomes if the spindle assembly is perturbed. Critical components of this checkpoint are the MAD and BUB families of proteins, which prevent the proteolysis of Pds1 and B cyclins, producing mitotic arrest. In the present study, we first intended to resolve the role of the hsMAD2 gene in human cancer by determining the potential presence of hsMAD2 mutations in 44 primary bladder tumors, 42 soft-tissue sarcomas and 10 hepatocellular carcinomas. The entire coding region of the hsMAD2 gene was analyzed using PCR-SSCP and sequencing. One of the bladder tumor samples showed a point mutation consisting of a transition, ATC-->GTC (Ile-->Val) in codon 190 of hsMAD2. However, no differences were found in the mitotic arrest between cells transfected with mutant and wild-type MAD2 cDNA. We also identified mobility shifts in hsMAD2 in both normal and tumor DNA in 3 bladder tumors, 3 soft-tissue sarcomas and 1 hepatocellular carcinoma, consistent with a polymorphism at codon 143, CCA-->CCG (Pro-->Pro). Another polymorphism was identified in a hepatocellular carcinoma case at codon 22, GAG-->GAA (Glu-->Glu). In addition, a subgroup of 67 primary tumors was analyzed by Southern blot hybridization. No deletion or visible re-arrangements were detected by comparing tumor and normal DNA band signals. Two other important components of the spindle mitotic checkpoint, hBUB1 and hBUB3, were also screened for mutations: hBUB1 in 43 bladder tumors and 9 bladder cell lines and hBUB3 only in the cell lines. Two polymorphisms were found in hBUB1 at positions 144, CAG-->CAA (Gln-->Gln) in 1 primary tumor and 1 bladder cell line, and 913 (ATC-->ATT, Ile-->Ile) in 1 primary tumor. We did not find sequence alterations in hBUB3. These results suggest that mutations of the hsMAD2, hBUB1 and hBUB3 genes are very rare in bladder tumors and that hsMAD2 alterations are also infrequent in soft-tissue sarcomas and hepatocellular carcinomas.

[Incidental diagnosis of renal carcinoma. Impact on prognosis and survival]. / Diagnóstico incidental del carcinoma renal. Influencia sobre el pronóstico y la supervivencia.

A retrospective study was conducted in 206 renal carcinomas (RC) that underwent surgery between 1983 and 1992, evaluating those that were diagnosed incidentally. Among this series, 74 cases (35.9%) were incidental renal carcinomas (IRC). The complementary examination that allowed to reach a diagnosis was ultrasound in 58 (78.4%) patients, computerized axial tomography (CT) in 23 (17.6%) and intravenous urography (IVU) in 3 (4%). An evaluation is made of the main prognostic factors (nuclear differentiation grade and pathological stage) and the survival in these patients. The results obtained allow to conclude that IRC display an earlier pathological stage and lower nuclear differentiation grade than the other RC, the difference being statistically significant (p < 0.05). Also, the probability of survival in IRC-diagnosed patients is higher than in those diagnosed with non-incidental RC, the difference being statistically significant (p < 0.05).