Orlando C, Sestini R, Vona G, Pinzani P, Bianchi S, Giacca M, Pazzagli M, Selli C
Department of Clinical Physiopathology, University of Florence, Italy.
J Urol. 1996 Dec;156(6):2089-93.
We used competitive PCR to verify retrospectively the prognostic significance of c-erbB-2 oncogene amplification in transitional cell bladder carcinomas as a predictive index of patient survival with a maximum follow-up of nine years, and to investigate the variations of c-erbB-2 amplification during bladder carcinoma recurrence and/or progression from superficial to more invasive states.
Oncogene amplification was determined by an accurate and sensitive procedure based on competitive PCR. Measurements were performed in DNA extracted from fresh cancers or from formalin-fixed, paraffin-embedded tumor samples.
The overall mean incidence of c-erbB-2 oncogene amplification was 26% (24/92), with a significant relationship with tumor grade (p < 0.0001). We did not find any statistical difference in survival probability between subjects with (20%) or without (30%) oncogene amplification. During tumor progression we observed a limited increase of tumors carrying oncogene amplification (2 of 20) whereas the mean degree of amplification was not affected.
c-erbB-2 amplification seems to be a genetic event related to the degree of bladder tumor differentiation. However the presence and/or the degree of this genetic alteration do not seem predictive of tumor progression, recurrence and survival probability, at least in patients with advanced transitional cell bladder carcinoma. These data seem to indicate that the amplification of c-erbB-2 in bladder carcinoma could be considered as an epiphenomenon, present in a subset of tumors but apparently not related to the clinical outcome.
我们采用竞争性聚合酶链反应（PCR），对移行细胞膀胱癌中c-erbB-2癌基因扩增作为患者生存的预测指标的预后意义进行回顾性验证，最长随访时间为9年，并研究c-erbB-2扩增在膀胱癌复发和/或从浅表状态进展至更浸润状态过程中的变化。
基于竞争性PCR的准确且灵敏的方法来测定癌基因扩增。在从新鲜癌组织或福尔马林固定、石蜡包埋的肿瘤样本中提取的DNA上进行检测。
c-erbB-2癌基因扩增的总体平均发生率为26%（24/92），与肿瘤分级存在显著相关性（p < 0.0001）。我们未发现癌基因扩增组（20%）和无癌基因扩增组（30%）之间在生存概率上有任何统计学差异。在肿瘤进展过程中，我们观察到携带癌基因扩增的肿瘤仅有有限增加（20例中有2例），而扩增的平均程度未受影响。
c-erbB-2扩增似乎是与膀胱肿瘤分化程度相关的一个基因事件。然而，这种基因改变的存在和/或程度似乎并不能预测肿瘤进展、复发及生存概率，至少在晚期移行细胞膀胱癌患者中如此。这些数据似乎表明，膀胱癌中c-erbB-2的扩增可被视为一种附带现象，存在于部分肿瘤中，但显然与临床结局无关。
