Ribal M J, Alcaraz A, Mengual L, Carrio A, Lopez-Guillermo A, Mallofré C, Palou J, Gelabert A, Villavicencio H
Department of Urology, Fundació Puigvert, C/Cartagena, 340, 08025 Barcelona, Spain.
Eur Urol. 2004 May;45(5):593-9. doi: 10.1016/j.eururo.2003.12.013.
The main prognostic factor generally accepted for tumour progression in T1 transitional cell carcinoma (TCC) of the bladder is histological grade. Despite this fact it is considered inaccurate to make clinical decisions on individuals. It appears that progression from minimally invasive to deeply invasive cancer is concurrent with the acquisition of genomic alterations that increase the malignant potential of cancer cells. The aim of this study is to determine if changes in chromosomes 7, 8, 9 and 17 copy number can be used to predict recurrence and progression in patients with T1 TCC of the urinary bladder.
Thirty-one T1 TCC samples were analyzed for chromosomal alterations by fluorescence in situ hybridization using centromeric probes for chromosomes 7, 8, 9 and 17. Clinical data were collected from the patients' clinical records and correlated with chromosomal studies.
Histological grade was confirmed as a prognostic factor of tumour progression (p=0.01). None of the cytogenetic alterations demonstrated in the studied group could be related to tumour recurrence. The high-polysomies (five or more copies) of chromosomes 8, 9 and 17 showed predictive value (p=0.05, 0.05, 0.03 respectively) for tumour progression since it was observed that patients with high-polysomy of these chromosomes showed more risk of tumour progression towards muscle-invasive disease than those without high-polysomy alteration.
Our findings suggest a possible prognostic significance of highly aneuploid cells (high-polysomies of chromosomes 8, 9 and 17) in tumour progression of T1 TCC bladder tumours. FISH analysis is a reproducible technique for evaluating cytogenetic alterations and could contribute to the assessment of the individual prognosis of T1 transitional cell carcinoma of the bladder.
膀胱T1期移行细胞癌（TCC）肿瘤进展公认的主要预后因素是组织学分级。尽管如此，基于个体情况做出临床决策仍被认为是不准确的。从微浸润癌发展为浸润性癌似乎与获得增加癌细胞恶性潜能的基因组改变同时发生。本研究的目的是确定7号、8号、9号和17号染色体拷贝数的变化是否可用于预测膀胱T1期TCC患者的复发和进展。
使用7号、8号、9号和17号染色体着丝粒探针，通过荧光原位杂交分析31例T1期TCC样本的染色体改变。从患者临床记录中收集临床数据，并与染色体研究结果相关联。
组织学分级被确认为肿瘤进展的预后因素（p = 0.01）。研究组中显示的细胞遗传学改变均与肿瘤复发无关。8号、9号和17号染色体的高多体性（五个或更多拷贝）对肿瘤进展具有预测价值（分别为p = 0.05、0.05、0.03），因为观察到这些染色体高多体性的患者比无高多体性改变的患者发生肿瘤进展至肌层浸润性疾病的风险更高。
我们的研究结果表明高度非整倍体细胞（8号、9号和17号染色体的高多体性）在膀胱T1期TCC肿瘤进展中可能具有预后意义。荧光原位杂交分析是评估细胞遗传学改变的可重复技术，有助于评估膀胱T1期移行细胞癌的个体预后。
