Dr Rejwana Nahar, Assistant Professor, Department of Pathology, Mugda Medical College, Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2024 Apr;33(2):461-465.
Urothelial carcinoma (UC) is the most common malignancy of urinary bladder. It is the 9th leading cause of death worldwide and second most common genitourinary malignancy among male. Incidence is increasing in developing countries like Bangladesh. About 80% of patients are found between 50 to 80 years of age. It is 3-4 times more common in male than in female. Determination of therapeutic strategy and prediction of progression of urothelial carcinoma is a major clinical challenge. Treatment of urothelial carcinoma still now mostly depends on pathological stages. Amplification or genomic alteration of Cyclin D1 (a proto-oncogene) may cause protein overexpression which is frequently realized as a clonal pathology in various human neoplasms including bladder cancer. Evaluation of Cyclin D1 expression is promising for guiding therapeutic strategies, risk stratification and prediction of tumor progression. The aim of the study was to determine the expression of Cyclin D1 in urothelial carcinoma of urinary bladder and its association with tumour grade. This cross-sectional observational study was conducted in Department of Pathology, Dhaka Medical College, Dhaka, Bangladesh from July 2019 to June 2021. Histomorphologically diagnosed 51 urothelial carcinomas were included. Sections were stained with hematoxylin and eosin. Immunostaining with Cyclin D1 antibody was also done. Relevant information was collected and recorded in a predesigned data sheet. Statistical analysis was carried out as required. Mean age ±SD was 57.8±10.55 years. Male female ratio was 4.6:1. In this study 39(76.5%) patients were smoker. Regarding clinical presentations 36(70.6%) patients presented with painless hematuria alone. Lateral wall (64.7%) was the most frequent tumor location. Among 51 cases, 38(74.5%) cases were high grade urothelial carcinoma (HGUC) and 13(25.5%) cases were low grade urothelial carcinoma (LGUC). Considering Cyclin D1 expression, most of the LGUC cases showed high level of expression by both percentage (84.6%) and intensity (84.6%). Most of the HGUC cases showed low level of expression by both percentage (63.2%) and intensity (60.5%). Cyclin D1 showed significant inverse association with HGUC (p<0.05). In urothelial carcinoma of urinary bladder, Cyclin D1 expression was decreased with increasing grade of the tumor. Cyclin D1 expression was inversely associated with tumour grade.
尿路上皮癌（UC）是最常见的膀胱癌恶性肿瘤。它是全球第 9 大死亡原因，也是男性中第二常见的泌尿生殖系统恶性肿瘤。在孟加拉国等发展中国家，发病率正在上升。约 80%的患者年龄在 50 至 80 岁之间。男性发病率是女性的 3-4 倍。治疗策略的确定和尿路上皮癌的进展预测是一个主要的临床挑战。目前，治疗尿路上皮癌主要还是依赖于病理分期。细胞周期蛋白 D1（原癌基因）的扩增或基因组改变可能导致蛋白过表达，这在包括膀胱癌在内的各种人类肿瘤中经常表现为克隆性病理学。评估细胞周期蛋白 D1 的表达有望指导治疗策略、风险分层和肿瘤进展预测。本研究旨在确定 Cyclin D1 在膀胱癌中的表达及其与肿瘤分级的关系。这项横断面观察性研究在 2019 年 7 月至 2021 年 6 月期间在孟加拉国达卡医学院病理学系进行。共纳入 51 例经组织形态学诊断的尿路上皮癌。对组织进行了苏木精和伊红染色。还进行了 Cyclin D1 抗体的免疫染色。收集并记录了相关信息。进行了所需的统计分析。平均年龄为 57.8±10.55 岁。男女比例为 4.6:1。在这项研究中，39 名（76.5%）患者为吸烟者。就临床表现而言，36 名（70.6%）患者仅表现为无痛性血尿。侧壁（64.7%）是最常见的肿瘤位置。在 51 例病例中，38 例（74.5%）为高级别尿路上皮癌（HGUC），13 例（25.5%）为低级别尿路上皮癌（LGUC）。考虑到 Cyclin D1 的表达，LGUC 病例中，无论是百分比（84.6%）还是强度（84.6%），大多数都表现出高水平的表达。HGUC 病例中，无论是百分比（63.2%）还是强度（60.5%），大多数都表现出低水平的表达。Cyclin D1 与 HGUC 呈显著负相关（p<0.05）。在膀胱癌中，随着肿瘤分级的增加，Cyclin D1 的表达降低。Cyclin D1 的表达与肿瘤分级呈负相关。
