Molecular determination of perivesical and lymph node metastasis after radical cystectomy for urothelial carcinoma of the bladder.
Molecular determination of perivesical and lymph node metastasis after radical cystectomy for urothelial carcinoma of the bladder.
复制标题
膀胱尿路上皮癌根治性膀胱切除术后膀胱周围和淋巴结转移的分子测定。
DOI：
--
复制
发表时间：
2001
影响因子：
11.5
通讯作者：
D. Theodorescu
中科院分区：
文献类型：
--
作者：
M. Seraj;A. Thomas;J. Chin;D. Theodorescu
PURPOSE
Current methods used to determine the pathological stage of the primary tumor and associated lymphatics after radical cystectomy are tedious, costly, and may lack the sensitivity afforded by molecular approaches such as reverse transcription-PCR (RT-PCR) for markers specific for urothelial tissue such as the uroplakin II (UPII) gene. Thus, we sought to evaluate an objective and sensitive molecular approach for the assessment of perivesical extension and lymph node status after radical cystectomy, based on the detection of UPII expression using RT-PCR and compare this assay to standard clinical and pathological examination.
EXPERIMENTAL DESIGN
From November 1999 to September 2000, 27 patients with clinical T(a)-T(3)N(0)M(0) urothelial bladder cancer underwent radical cystectomy, 19 (70%) of which also had pelvic lymphadenectomy. At the completion of cystectomy, systematic biopsies of the external surface of the bladder specimen as well as from the largest palpable lymph node found at lymphadenectomy were obtained for molecular analysis. RT-PCR analysis for UPII mRNA was carried out on these biopsy specimens, and results were compared with data obtained from conventional pathological examination.
RESULTS
Pathologically organ-confined tumors had a 42% (5 of 12) incidence of positive signals in the perivesical tissues and 17% (1 of 7) in the lymph nodes. Corresponding percentages for pT(3a)N(0) and pT(3b)-T(4)N(0) lesions were 67% (4 of 6)/25% (1 of 4) and 67% (4 of 6)/33% (2 of 6), respectively. Overall, pathologically node-negative cancers had a perivesical positivity rate of 54% (13 of 24) and a lymph node positivity rate of 25% (4 of 16). All patients with pathologically positive nodes had positive UPII signals in the lymph node sample.
CONCLUSIONS
This molecular assay aimed at assessing perivesical extension and lymph node status after radical cystectomy appears to identify patients that may harbor residual disease not appreciated by conventional histology. Larger studies with 5-7-year follow-up will be required to determine the prognostic significance of such molecular information.
影响因子：
11.2
作者：
Ren-Long Wu;Iman Osman;Xueling Wu;Ming-Lan Lu;Zuo-Feng Zhang;F. Liang;R. Hamza;Howard I. Scher;Carlos Cordon-Cardo;T-T. Sun
通讯作者：
Ren-Long Wu;Iman Osman;Xueling Wu;Ming-Lan Lu;Zuo-Feng Zhang;F. Liang;R. Hamza;Howard I. Scher;Carlos Cordon-Cardo;T-T. Sun
影响因子：
6.6
作者：
Li, SM;Zhang, ZT;Wu, XR
通讯作者：
Wu, XR
影响因子：
45.3
作者：
Saxman, SB;Propert, KJ;Trump, D
通讯作者：
Trump, D