title: Quantification of angiogenesis as an independent predictor of prognosis in invasive bladder carcinomas.
abstract: OBJECTIVE
  To evaluate angiogenesis as a prognostic marker of transitional cell carcinoma of the bladder and to assess its relationship to established variables for survival.
  
  
  METHODS
  Forty-five tumours (two G2T2, seven G3T2 and 36 G3T3) from 36 men and nine women with a mean age of 73 years (range 50-91), who had been followed-up for a median of 37 months (range 1-50), were examined. Vessels were immunohistochemically highlighted using an antibody to the platelet endothelial cell adhesion molecule, CD31. Microvessel density was quantified using a Chalkley point eyepiece graticule.
  
  
  RESULTS
  Univariate analysis of survival showed stage, grade and vascular count were significant indicators of prognosis (P = 0.002, P = 0.007, P = 0.019 respectively). No relationship was observed between stage and grade and vascular count. In a Cox proportional hazard model, adjusted for age and stage, microvessel density not only remained a significant prognostic indicator (P = 0.026) but was as informative as stage in predicting overall survival. A high vascular count conferred a 2.5 increased risk of mortality.
  
  
  CONCLUSIONS
  These findings suggest that assessment of angiogenesis by microvessel quantification is an independent predictor of survival in patients with invasive bladder carcinoma and might be useful in selecting those who would benefit from adjuvant therapy.
authors.affiliation: Department of Urology, Bristol Royal Infirmary, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Dickinson
authors.forename: S B
authors.initials: SB
authors.lastname: Fox
authors.forename: R A
authors.initials: RA
authors.lastname: Persad
authors.forename: J
authors.initials: J
authors.lastname: Hollyer
authors.forename: G N
authors.initials: GN
authors.lastname: Sibley
authors.forename: A L
authors.initials: AL
authors.lastname: Harris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000098:blood supply / Q000235:genetics / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009389:Neovascularization, Pathologic / Q000401:mortality*; D011003:Ploidies; D011379:Prognosis; D012044:Regression Analysis; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000098:blood supply / Q000235:genetics / Q000401:mortality* / Q000473:pathology