title: Prognostic impact of angiogenesis in nonmuscle invasive bladder cancer as defined by microvessel density after immunohistochemical staining for CD34.
abstract: Bladder cancer is the second most common malignancy of the urogenital region. The majority of bladder cancer deaths occur as a consequence of metastatic disease. Microvessel density (MVD), a surrogate marker for angiogenesis, has been shown to be predictive of progression and poor prognosis. The aim of this study was to evaluate the predictive value and prognostic significance of angiogenesis in human non muscle invasive bladder cancer (NMIBC) treated by BCG immunotherapy. The frozen sections of 28 non muscle invasive bladder cancer specimens were stained with CD34 antibody to label the vascular endothelium using the standard streptavidin-biotin immunoperoxidase method. Angiogenic activity was measured using microvessel count determined by the expression of vascular markers CD34.The prognostic significance of tumor stage, grade, loci number, tumor size, age and CD34 expression in determining the risk for recurrence was studied with both univariate and multivariate methods of analysis. According to univariate analysis of the prognostic significance for tumor stage, grade, tumor size, loci number, age and CD34 expression, in patients with NMIBC, the pT1 stage and high grade seem to be associated in a statistically significant manner with higher risk for recurrence (P=0.004, P=0.004, respectively). In the other hand, multivariate Cox regression's analysis showed that microvessel density and multiplicity were independent predictor of recurrence after BCG immunotherapy (p=0.016, p=0.032, respectively). This study provides strong evidence that CD34 MVD is associated with recurrence after BCG immunotherapy. Independent studies, however, will be required on larger cohort to validate these findings.
authors.affiliation: Laboratory of Human and Experimental Pathology, Institute Pasteur of Tunis, Tunisia. Faouziaagili@yahoo.fr
authors.forename: Faouzia
authors.initials: F
authors.lastname: Ajili
authors.forename: Monia
authors.initials: M
authors.lastname: Kacem
authors.forename: Haifa
authors.initials: H
authors.lastname: Tounsi
authors.forename: Amine
authors.initials: A
authors.lastname: Darouiche
authors.forename: Emna
authors.initials: E
authors.lastname: Enayfer
authors.forename: Mouhamed
authors.initials: M
authors.lastname: Chebi
authors.forename: Mouhamed
authors.initials: M
authors.lastname: Manai
authors.forename: Samir
authors.initials: S
authors.lastname: Boubaker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000032:analysis*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D055806:Microvessels / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D001749:Urinary Bladder Neoplasms / Q000098:blood supply* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology
chemical_list: D018952:Antigens, CD34; D000970:Antineoplastic Agents; D001500:BCG Vaccine; D014408:Biomarkers, Tumor