Evaluation of polysialic acid in the diagnosis of Wilms' tumor. A comparative study on urinary tract tumors and non-neuroendocrine tumors.

The polysialic acid moiety of the neural cell adhesion molecule has been shown to represent an onco-developmental antigen which can be detected in both embryonic human kidney and Wilms' tumor but not in normal adult human kidney. In the present comparative study, Wilms' tumors, clear cell (bone-metastasizing) sarcomas of kidney, cystic nephromas, renal cell carcinomas, transitional cell carcinomas and papillomas of the renal pelvis, ureter and urinary bladder (as well normal transitional epithelium from these regions). Ewing sarcomas, hepatoblastomas, rhabdomyosarcomas, and carcinomas of the stomach, colon, exocrine pancreas, lung, and esophagus, were investigated immunohistochemically for the presence of polysialic acid. In addition, immunoblot analysis was performed in selected tumors. With the exception of Wilms' tumor, none of the tumors investigated was positive for polysialic acid. In Wilms' tumor, blastemal cells and all epithelial components were positive but no immunostaining was observed in the stroma. These observations emphasize the potential value of a monoclonal anti-polysialic acid antibody in identifying blastemal metanephric cells and their epithelial differentiatives in Wilms' tumor.

Intermediate filament proteins as tissue specific markers in normal and malignant urological tissues.

Immunocytochemical techniques have become valuable tools in many fields of clinical pathology and medical research. Especially the development of highly specific (monoclonal) antibodies to a large variety of tissue antigens has in recent years led to the establishment of sensitive tissue markers. One of the most promising types of tissue specific markers so far is represented by the intermediate filament proteins. Since the findings of this rapidly expanding field are also being applied in urology, we have reviewed the current data in order to describe the new insights in tumor biology and histogenesis, as well as their application in diagnostic pathology.

Flow cytometry in urologic oncology.

Flow cytometers have proved to be useful research tools in cellular biology. By using these devices, rapid and objective measurements of a variety of cellular parameters can be made on a cell-by-cell basis. The application of flow cytometers to the study of urologic neoplasms is at present very preliminary. The available literature on the flow cytometric study of urologic tumors is presented and discussed.

Tumour angiogenesis factor in urological cancers.

The presence of a tumour angiogenesis factor (TAF) was investigated by bioassay and radioimmunoassay (RIA) in tissue and urine from patients with a variety of urological cancers. TAF was present in the majority of tumours studied by both methods and absent from controls. Our results suggest that RIA of urine for TAF may be applicable as a screening test for bladder cancer.

Copper and zinc levels in normal and malignant tissues.

The copper and zinc levels in 53 malignant and 47 normal human tissue samples were measured. In the malignant tissues, the mean copper concentration was 46% higher (P less than 0.001) than in the normal ones. Analysis of the individual organs showed this increment to be statistically significant in malignancies of the large bowel, stomach, urinary bladder and female reproductive organs, while in cancer of the breast, kidney and testis, the increase in copper level was not significant. The mean zinc concentration in the malignant tissues was not significantly different from that in the corresponding normal tissue specimens (-11%; P less than 0.2). In breast cancer, however, tissue zinc levels were increased by 72% (P less than 0.01), and decreased markedly in carcinoma of the kidney (-73%). A hypothesis for the possible mechanism involving elevated tissue copper levels in biological damage (previously caused by free radicals) which may be responsible for the malignant process, is presented and discussed.

The secretory immunoglobulin system in urothelial neoplasia.

The role of the secretory immunoglobulin system in urinary tract neoplasia has been investigated by staining formalin-fixed, paraffin-wax embedded sections of normal and abnormal urinary tract epithelium for secretory component (SC), IgA and J (joining) chain. Normal mucosa contains IgA with J chain and SC as a thin superficial layer on surface umbrella cells and in small amounts in the cytoplasm of intermediate cells. Inflamed mucosa is infiltrated by many IgA and J chain positive plasma cells in the lamina propria and there is IgA, SC and J chain in the cytoplasm of the second layer of the epithelium as much as in surface umbrella cells. Epithelium with moderate to severe dysplasia and invasive transitional cell carcinoma is almost always negative, containing only occasional cells with cytoplasmic IgA, J chain and SC, whilst surface staining is entirely absent.

Steroid receptors in urological malignancies.

Within urological practice, three important types of cancer seem to be under endocrine influence or develop in endocrine-dependent organs: prostate cancer, hypernephroma and testicular tumors. Endocrine therapy is not used in testicular cancer, its value in renal cell carcinoma is limited, whereas it is a dominant form of therapy for prostate cancer. There seems to be a definite relation between androgen receptor content in primary prostatic carcinoma and response to hormonal manipulations. The presence of estrogen receptors is not well documented and probably the major effect of estrogen therapy is indirect, being exerted via the hypothalamo-pituitary axis. Progestin receptors are present in hyperplastic prostate as well as in prostate cancer and may indicate cases sensitive to progestin therapy. The assay method still needs considerable refinement before it can be introduced into clinical practice.