ABSTRACT
Survivin and vascular endothelial growth factor (VEGF) are newly discovered tumor markers closely correlated with bladder cancer. We analyzed the expression of survivin and VEGF in paraffin-embedded tumor tissues from 78 patients with bladder transitional cell carcinoma (BTCC) using an immunohistochemistry method. Normal bladder mucosae from 10 non-BTCC cases were also included as a control group. All patients were closely followed up for tumor recurrence after undergoing transurethral resection of bladder tumor procedures. The positive expression rates of survivin and VEGF in superficial BTCC were 66.7% (52/78) and 69.2% (54/78), respectively, which were significantly higher than those in the control group, 0% (0/10). A positive correlation was found between survivin and VEGF expression (r = 0.283, P < 0.01). Thirty-two of 78 patients (41.0%) displayed recurrence during follow-up (median: 47; range: 7-62 months). The tumor recurrence rate in survivin(+) patients was 53.8% (28/52), which was significantly higher than that in survivin(-) patients [15.4% (4/26); P < 0.05]. The recurrence rate in VEGF(+)/ VEGF(-) patients was 50.0% (27/54) and 20.8% (5/24), respectively (P < 0.05). The sensitivity for predicting the relapse of superficial BTCC was 87.5% in the survivin(+) group, 84.4% in the VEGF(+) group, and 78.1% in the survivin(+)/VEGF(+) group, and the specificity was 47.8, 41.3, and 65.2%, respectively. Survivin and VEGF interact and jointly regulate the biological behavior of bladder cancer. Our results suggest that overexpression of survivin and VEGF accompany a higher risk of BTCC recurrence, making survivin and VEGF biomarkers for predicting the relapse of bladder cancer.
Subject(s)
Carcinoma, Transitional Cell/metabolism , Carcinoma, Transitional Cell/pathology , Inhibitor of Apoptosis Proteins/metabolism , Urinary Bladder Neoplasms/metabolism , Urinary Bladder Neoplasms/pathology , Vascular Endothelial Growth Factor A/metabolism , Adult , Aged , Aged, 80 and over , Carcinoma, Transitional Cell/diagnosis , Female , Gene Expression , Humans , Immunohistochemistry , Inhibitor of Apoptosis Proteins/genetics , Male , Middle Aged , Neoplasm Grading , Neoplasm Staging , Prognosis , Recurrence , Sensitivity and Specificity , Survivin , Urinary Bladder Neoplasms/diagnosis , Vascular Endothelial Growth Factor A/genetics , Young AdultABSTRACT
The present survey aimed to assess the prevalence and nature of physical disabilities among medical school graduates and to investigate the academic performance of these new physicians with disabilities. A questionnaire was sent to the deans of student affairs of each of the then existing 128 United States and Puerto Rican medical schools, addressing the profiles of students with physical disabilities in the 1987 through 1990 graduating classes. Seventy-seven (60%) United States and Puerto Rican medical schools responded to the questionnaire, of which 67 were able to complete it. A total of 67 students with physical disabilities (40 males and 27 females) were reported. Three of the 67 students were excluded from the study because their conditions did not match our definition of physical disability. The remaining 64 students (38 males and 26 females), ranging from 0 to 10 per school, comprised 0.19% of the 33,138 students who graduated from the 67 medical schools during these 4 academic yr. The disabilities represented by the 64 students encompassed a wide spectrum of etiologies, including neurologic (39%), musculoskeletal (20%), medical-surgical (13%), visual (13%), and auditory (9%) problems. The majority of students with disabilities had above average (36%) to average (48%) academic standings. The actual prevalence of medical students with disabilities might be higher than reported because of the underreporting of the less noticeable types of disabilities.