Association between atherosclerosis and urothelial tumors of the renal pelvis.

OBJECTIVES

An association between the prevalence of general and local atherosclerosis and various types of cancer has previously been reported. The present study therefore aimed to morphometrically compare atherosclerotic changes in kidneys with urothelial carcinomas of the renal pelvis and tumor-negative renal tissue.

MATERIALS AND METHODS

The intima-to-media ratio (IMR), which is the most sensitive marker for the degree of atherosclerosis, was evaluated in arteries (n = 492) of non-invasive papillary urothelial carcinoma (n = 128), invasive urothelial carcinoma (n = 168) and tumor-negative renal specimens (n = 196).

RESULTS

IMR was significantly higher and more often exceeded 1 in invasive and non-invasive urothelial carcinomas than in tumor-negative specimens. Furthermore, in invasive urothelial carcinomas IMR was significantly higher in immediately peritumorous arteries than in more distant arteries. Moreover, IMR correlated weakly with age and renal parenchymal inflammation but not with peritumorous inflammation, coronary heart disease (CHD) or gender.

CONCLUSION

Local atherosclerosis was more pronounced in tumor-positive than in tumor-negative renal specimens. IMR > 1 was significantly associated with urothelial tumors and the overall odds of having a urothelial tumor were significantly greater for patients with an IMR > 1 than for patients with an IMR < or = 1, supporting the view that patients with local atherosclerotic lesions are at elevated risk for urothelial carcinoma of the renal pelvis.