Microvessel density at presentation predicts subsequent muscle invasion in superficial bladder cancer.
OBJECTIVE
The purpose of this study was to determine whether angiogenesis, as measured by microvessel density (MVD), at presentation is related to subsequent progression of superficial bladder cancer (SBC).


METHODS
Archived primary bladder tumors from 180 patients were stained with a monoclonal antibody against cluster determinant 34 to label vessels. Image analysis was used to count MVD in 30 randomly selected areas in each case.


RESULTS
Of the 170 patients evaluated, 37 progressed to muscle invasive disease. A strong association was found between the intensity of angiogenesis and clinical stage, pT1 tumors having a higher MVD than pTa disease. The median MVD was significantly higher at presentation in those patients that subsequently developed progressive SBC than in those that did not progress (P < 0.0001). pT1 (P = 0.001), grade 3 disease (P = 0.002), and MVD (P = 0.008) were found to predict subsequent disease progression on univariable analysis. Both MVD (P = 0.007) and pT1 disease (P = 0.044) remained significant predictive factors for subsequent disease progression on multivariable analysis.


CONCLUSIONS
MVD in SBC at presentation is significantly higher in those cases that subsequently progress to muscle invasive disease.
Goddard
Jonathan C
JC
Departments of Urology, University Hospitals of Leicester National Health Service Trust, Leicester LE5 4PW, United Kingdom. jonathan@jcgoddard.freeserve.co.uk
Sutton
Christopher D
CD
Furness
Peter N
PN
O'Byrne
Kenneth J
KJ
Kockelbergh
Roger C
RC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D045744:Cell Line, Tumor; D018450:Disease Progression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D015999:Multivariate Analysis; D009132:Muscles / Q000378:metabolism*; D009361:Neoplasm Invasiveness; D009389:Neovascularization, Pathologic; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000098:blood supply* / Q000473:pathology*