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ABSTRACT
Year : 2016  |  Volume : 8  |  Issue : 5  |  Page : 6-7  

Urothelial Tumor


Date of Web Publication18-Dec-2015

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How to cite this article:
. Urothelial Tumor. Urol Ann 2016;8, Suppl S1:6-7

How to cite this URL:
. Urothelial Tumor. Urol Ann [serial online] 2016 [cited 2020 May 27];8, Suppl S1:6-7. Available from: http://www.urologyannals.com/text.asp?2016/8/5/6/172178

Grade concordance of urothelial tumors

Ashraf J. Abusamra, J. Izawa, M. Abdelhady, B. Chew, S. Pautler, J. Chin


Department of Urology, London Health Sciences Centers, University of Western Ontario, London, Ontario, Canada

Introduction: Urothelial cancer is thought to involve the entire urothelium as a multifocal field change. Predicting the grade of concurrent or future urothelial tumors could change the invasiveness of their work up and treatment and the frequency of follow up. We studied the grade concordance between the urothelial tumors of the ureter and renal pelvis with those occurring in the urinary bladder.

Methods: The charts of patients who underwent nephroureterectomy for an upper tract urothelial tumor in our institution between 1996 and 2004 were reviewed.

Results: A total of 100 patients underwent 101 nephroureterectomies with a mean follow up of 55 months. Of these, 53 patients (53%) had never been diagnosed with a bladder tumor, neither before, nor after nephroureterectomy. Twenty-five patients (25%) had a history of bladder tumors prior to nephroureterectomy, and the bladder urothelial cancer grade correlated with the grade of the upper tract tumor in 19 cases. Twenty-eight patients (28%) developed bladder cancer during their follow up post nephroureterectomy, and in those the grade concordance occurred in 19 cases. Overall, the concordance rate between upper tract urothelial tumor and bladder tumor grade was 72%.

Conclusion: This is, to our knowledge, the first analysis of grade concordance of urothelial tumors. This study shows that the concordance of urothelial tumors in the upper and lower urinary tracts is present in 72% of cases. This knowledge can have a significant impact on the therapeutic and follow up plans for urothelial tumors.

Presented at the: 18 th Saudi Urological Conference

King Abdulaziz University Hospital

20-23 February 2006 (21-24 Muharram 1427)

Could we improve the biopsy quality of the upper urinary tract transitional carcinoma (UUT-TCC)? (evaluation of a new forceps)

Olivier Traxer, S. Al-Qahtani, S. Gil-Diez, M. Sibony


Department of Urology, Tenon Hospital, Pierre and Marie CURIE University, Paris, France

Objective: We aim to evaluate the biopsy quality for the upper tract urothelial tumors with new biopsy forceps (Bigopsy Cook Medical) in comparing with classic biopsy forceps (Piranha Boston Scientific).

Methods: Fifteen patients with upper tract urothelial tumors were been treated by conservative treatment using Flexible-Ureterorenoscopy. The histopathology specimens had been obtained by the (Piranha Boston Scientific) and by the (Bigopsy Cook Medical). All the specimens were been analyzed blindly by a single pathologist to determine the best specimen of each patient.

Results: From our date the tumor location was found to be in renal pelvis (8), renal pelvis and upper calyx (2), middle calyx (1), lower and middle calyx (1), lower and upper calyx (1), upper third ureter (1), middle third ureter (1). One patient with no valid biopsies whether obtained by the classic or the new forceps. Among these 14 patients, all of the histopathology results of the biopsies performed by the new forceps were better in 9 patients (60%) or equal in 5 patients (33.3%) comparing to the classic especially for the stage of the tumor.

Summary and Conclusion: Out study demonstrates the advantage of this new forceps. We strongly recommend it for the evaluation of the (UUT-TCC) especially in case of conservative treatment or in case of taking biopsy of any radiological suspected lesions.

Presented at the: 22 nd Saudi Urological Conference

King Faisal Specialist Hospital and Research Centre

15-18 March 2010

Epigenomic profiling of micro RNA in urothelial cel carcinoma

Hani Choudhry 1,2,3 , James Catto 1,2,3

1 Department of Urology, University of Oxford, Oxford, United Kingdom, 2 King Abdulaziz University, Jeddah, Saudi Arabia, 3 University of Sheffield, South Yorkshire, United Kingdom

Introduction: MicroRNAs (miRNAs) are short non-coding RNA molecules that negatively regulate gene expression. Aberrant miRNA expression appears common in various tumors and we have recently profiled the expression of miRNA in UCC. We reported differential expression of numerous miRNAs located within proximity of CpG islands. Altered hypermethylation of miRNA promoters is described in several tumors. In this study, we systematically investigate epigenetic regulation of miRNA in UCC.

Methods: We profiled the expression of 802 miRNAs in 4 urothelial cell lines before and after epigenetic drug treatment (5-Azacytidine) using microarryas. Altered miRNA expression was confirmed using QrtPCR. The CpG islands of selected miRNA were then bisulphate sequenced to define the methylation status of individual CpG dinucleotides. Identified microRNA were then analyzed for functional significance using microRNA knock down in human urothelial cells and subsequent proliferation assays. We then profiled methylation of the selected promoter regions in a large UCC cohort.

Results: 5-Azacytidine treatment altered the expression of several microRNAs as determined by both microarray and QrtPCR (r=0.65 to −0.9, p<0.0001). Bisulphate sequencing revealed tumor specific methylation of miR-9-1, miR-152 and miR-1224-5p and tissue specific methylation of miR-200b and miR-34a. Methyl specific PCR revealed frequent methylation of these miRNAs in UCC and various associations with phenotype in patient cohort.

Conclusion: We found silencing of various miRNAs in UCC and specifically, silencing of miR-152 and miR-1224-5p may contribute to disease pathogenesis. These represent potential therapeutic targets or predictive biomarkers, and the implications of their silencing require further evaluation.

Presented at the: 22 nd Saudi Urological Conference

King Faisal Specialist Hospital and Research Centre

15-18 March 2010

High molecular weight cystokeratin and cytokeratin-20 expression as a strong predictor for recurrence in low grade superficial papillary urothelial neoplasms

Mahmoud Sherief, Gamal Abdel-Aty, Manal M. Sami


Department of Urology, Faculty of Medicine, Suez-Canal University Hospitals, Ismaillia, Egypt

Objectives: It has not been possible to identify those low grades superficial papillary urothelial neoplasms (LGSPUN) that will recur based on conventional histopathologic assessment. In addition the classical clinic pathological factors, several biological prognostic markers and being investigated in an attempt to clarify the clinical outcome of patients with LGSPUN. Among those prognostic markers is the immunohistochemical expression of cytokeratin 20 (CK 20) and high molecular weight cytokeratin (HMWCK). This study aimed to determine the frequency of immunohistochemical expression of HMWCK and CK 20 in LGSPUN and to investigate if they could have any association with the grade or stage of these neoplasms and whether they could have a prognostic role for prediction of their recurrence.

Patients and Methods: 51 patients fulfilled our inclusion criteria with LGSPUN of the bladder after standard transurethral resection of the tumor (TURT). The follow up protocol was cystoscopy every 3 months for the first 2 years, every 6 months from the 3 rd to 5 th years, and then annually specimens were processed for routine diagnostic histopathology including histological type, grade and stage. Only LGSPUN cases were included in the study. Sections immunostained for CK 20 and for HMWCK with mouse monoclonal antibodies Keratin, 20 Ab-1 and Keratin, HMW Ab-3, respectively, then were compared with respect to the presence of normal or abnormal immunohistochemical expression of HMWCK or CK 20.

Results: According to the most recent grading system is the World Health Organization/International Society of Urologic Pathology (WHO/ISUP) 2004 grading system, 16% of those patients were papillary Urothelial neoplasm (Transitional Cell) of low malignant potential (PUNLMP) and 84% low grade papillary urethelial carcinoma (LGPUC), 46% of cases were pTa and 54% were pT1. Twelve cases showed recurrence, all of them were pT1 LGPUC. 16 tumors (32%) showed normal staining pattern of HMWCK expression. 16% showed normal staining pattern of CK 20 expression. 12% showed double normal staining of HMWCK and CK 20. No statistically significant relation was found between the normal immunohistochemical expression of HMWCK and CK 20 on one hand and the grade or stage of LGSPUN on the other hand. However, no recurrence was observed in LGSPUN showing normal expression of CK 20 or in cases showing double normal expression of CK 20 and HMWCK. Normal immunohistochemical expression of HMWCK could not alone predict tumor non-recurrence in LGSPUN.

Conclusion: Normal immunohistochemical expression of CK 20 with or without normal expression of HMWCK could identify a subset of LGSPUN with markedly lower tendency for recurrence and might spare some of the regular cystoscopic examination which is associated with a risk of morbidity and patient incompliance.

Presented at the: 22 nd Saudi Urological Conference

King Faisal Specialist Hospital and Research Centre

15-18 March 2010




 

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