title: Primary adenocarcinoma of the urinary bladder: value of cell cycle biomarkers.
abstract: Primary adenocarcinomas of the urinary bladder are uncommon, and the molecular pathways are currently not well defined. In this study, we assessed the association between biologic markers and clinicopathologic characteristics in a cohort of 21 patients with primary urinary bladder adenocarcinoma. Immunohistochemical staining for cell cycle-specific markers, including p53, p21, p27, Ki-67, and cyclin E, were performed on sections of a tissue microarray construct. The tumors were high grade in 12 (57%) and pT2 or higher in 18 (86%); lymph nodes were involved in 6 cases (29%); and there was pathologic evidence of schistosomiasis in 14 (67%). The best prognostic combination of markers was combined alterations in p27 and Ki-67 and was associated with stage (P = .012), grade (P = .005), DNA ploidy (P = .005), and lymph node involvement (P = .04). Stage, lymph node involvement, combined alterations of p27 and Ki-67, and combined alterations of all 5 biomarkers were associated with increased probability of disease recurrence and cancer-specific mortality (P < .05).
authors.affiliation: Dept. of Pathology, University of Texas Southwestern, 5323 Harry Hines Blvd., Dallas, TX 75390-9110, USA.
authors.forename: Payal
authors.initials: P
authors.lastname: Kapur
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
authors.forename: Ellen
authors.initials: E
authors.lastname: King
authors.forename: Wareef
authors.initials: W
authors.lastname: Kabbani
authors.forename: Anirban P
authors.initials: AP
authors.lastname: Mitra
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mosbah
authors.forename: Hassan
authors.initials: H
authors.lastname: Abol-Enein
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ghoneim
authors.forename: Ramy F
authors.initials: RF
authors.lastname: Youssef
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D015331:Cohort Studies; D019927:Cyclin E / Q000378:metabolism; D050759:Cyclin-Dependent Kinase Inhibitor p21 / Q000378:metabolism; D015653:Cystectomy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000378:metabolism; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D046228:Microarray Analysis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D013194:Staining and Labeling; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; C493956:CDKN1A protein, human; D019927:Cyclin E; D050759:Cyclin-Dependent Kinase Inhibitor p21; D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; C413374:p27 antigen