The expression of thymidine phosphorylase is a prognostic predictor for the intravesical recurrence of superficial bladder cancer.
BACKGROUND
Thymidine phosphorylase (TP), also known as platelet-derived endothelial cell growth factor, has been implicated in the angiogenesis of bladder cancer. The aim of this study is to investigate the association between TP expression and the clinicopathologic findings, and the prognostic value.


METHODS
TP immunohistochemical staining was performed in specimens from 71 patients (50 men and 21 women) with superficial bladder cancer (pTa or pT1). Thirty-nine patients had received intravesical instillation of tetrahydropyranyladriamycin (THP) after transurethral resection (TUR) and the other 32 had not. For immunohistochemistry, paraffin-embedded specimens were stained with mouse monoclonal antibody against TP. When more than 10% of tumor cells were positively stained, staining was defined as positive. The correlations between TP immunostaining and clinicopathological features were analyzed. Multivariate analysis, using the Cox proportional hazard model, was performed to determine the risk factors for intravesical recurrence.


RESULTS
Specimens from 29 of the 71 patients (19 men and 10 women) were positive for TP. The expression of TP was not correlated with age, sex, histological grade, multiplicity, or morphology. Also, TP expression was not associated with whether the cases were primary or recurrent. Multivariate analysis demonstrated that the decreased expression of TP and the use of THP instillation could be independent predictors of a higher rate of intravesical recurrence-free bladder cancer.


CONCLUSIONS
The present study suggests that immunohistochemical TP staining is useful for predicting the intravesical recurrence of superficial bladder cancer after Transurethral resection of bladder tumor (TUR-Bt).
Nonomura
Norio
N
Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita 565-0871, Japan. nono@uro.med.osaka-u.ac.jp
Nakai
Yasutomo
Y
Nakayama
Masashi
M
Inoue
Hitoshi
H
Nishimura
Kazuo
K
Hatanaka
Eijirou
E
Arima
Ryouichi
R
Kishimoto
Tomomi
T
Miki
Tsuneharu
T
Kuroda
Hideya
H
Okuyama
Akihiko
A
D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology / Q000517:prevention & control; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011315:Preventive Medicine / Q000379:methods; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D013939:Thymidine Phosphorylase / Q000378:metabolism*; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D004317:Doxorubicin; C027260:pirarubicin; D013939:Thymidine Phosphorylase