title: Prognostic value of tumor-associated macrophages count in human non-muscle-invasive bladder cancer treated by BCG immunotherapy.
abstract: OBJECTIVE
  Tumor-associated macrophages can regulate the growth of various cancers positively or negatively. Intravesical bacillus Calmette-Guerin instillation is now the gold standard treatment for bladder carcinoma in situ. The authors investigated the correlation between tumor-associated macrophages infiltrating bladder carcinoma in situ and the response to intravesical bacillus Calmette-Guerin therapy.
  
  
  METHODS
  The authors examined paraffin-embedded tissues from 41 patients with bladder carcinoma in situ who received intravesical bacillus Calmette-Guerin therapy. Tumor-associated macrophages were immunohistochemically stained by anti-CD68 monoclonal antibody.
  
  
  RESULTS
  The median number of tumor-associated macrophages infiltrating among cancer cells and the number in the lamina propria were 4 and 24, respectively. Recurrent carcinoma in situ was found in 4.8% of cases with a lower cancer cell tumor-associated macrophage count but in 47.6% of those with a higher cancer cell tumor-associated macrophage count (less than 4 vs. 4 or greater). Recurrence was found in 31.8% of patients with a lower lamina propria tumor-associated macrophage count but in 21.1% of those with a higher lamina propria tumor-associated macrophage count (less than 25 vs. 25 or greater). The median ratio of tumor-associated macrophages among cancer cells vs. in the lamina propria was 0.2. Recurrence-free survival was significantly better in patients with a lower cancer cell tumor-associated macrophage count (p = .0002). Those with a lower cancer cell-to-lamina propria tumor-associated macrophage ratio had a higher recurrence-free rate (p < .0001). Multivariate analysis revealed that the cancer cell tumor-associated macrophage count and the cancer cell-to-lamina propria tumor-associated macrophage ratio can be prognostic factors for bladder carcinoma in situ.
  
  
  CONCLUSIONS
  The count of tumor-associated macrophages infiltrating the cancer area is useful for predicting the response of bladder carcinoma in situ to intravesical bacillus Calmette-Guerin instillation before treatment initiation. Although on univariate analysis TAMs are associated with other poor prognosticators, on multivariate analysis, TAMs appear only to be associated with MI and VI. TAMs may play a significant role in the biology of tumor progression of endometrial adenocarcinoma, but do not appear to be independent prognostic indicators of patient's survival.
authors: Laboratory of Human and Experimental Pathology, Institute Pasteur of Tunis, Tunis, Tunisia. Faouziaagili@yahoo.fr
authors: Faouzia
authors: F
authors: Ajili
authors: Nadia
authors: N
authors: Kourda
authors: Amine
authors: A
authors: Darouiche
authors: Mouhamed
authors: M
authors: Chebil
authors: Samir
authors: S
authors: Boubaker
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D001500:BCG Vaccine / Q000008:administration & dosage*; D014408:Biomarkers, Tumor / Q000032:analysis; D002278:Carcinoma in Situ / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002452:Cell Count; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D006801:Humans; D007150:Immunohistochemistry; D007167:Immunotherapy / Q000379:methods*; D053208:Kaplan-Meier Estimate; D008264:Macrophages / Q000276:immunology / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D016612:Paraffin Embedding; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D001500:BCG Vaccine; D014408:Biomarkers, Tumor; C067980:CD68 antigen, human; D000097382:CD68 Molecule