A Clinicopathological Study of Urinary Bladder Neoplasms in Patients at Three Centers in Khartoum, Sudan

OBJECTIVES: To present the histopathological pattern of urinary bladder neoplasms using the WHO/ISUP classification system and relate it to the outcome.METHODS: This study was conducted in the period from January 2004 through December 2005 at three centres in Khartoum, Sudan. One hundred and six patients with urinary bladder neoplasms were included in the study.RESULTS: The commonest affected age group was 60-80 years with male to female ratio 4.6:1. Urothelial neoplasms were found in 72 (67.9%), Squamous cell carcinoma (SCC) in 26 (24.5%), urothelial neoplasms with Squamous differentiation in 3 (2.8%), and other types in 5 (4.7%) of thepatients. There were 43.4% of the urothelial neoplasms graded as papillary carcinoma of high grade, 52.6% papillary carcinoma of low grade, 1.3% papillary neoplasm of low malignant potential, 1.3% papilloma, and 1.3% was graded as flat neoplasm. Of the SCCs, twelve (42.9%)were poorly differentiated SCCs, nine (32.1%) moderately differentiated, and seven (25%) cases were well differentiated SCCs. Follow-up information was available in 32 patients. At last followup, fifteen (46.9%) patients were dead of the disease, twelve (35.5%) were alive with no evidence of disease, four (12.5%) were alive with disease, and one (3.1%) was alive and terminally ill. CONCLUSION: Histological grade (P: 0.006), and muscle invasion (P: 0.002) were significantly associated with survival. A subset of the cases could not be assessed for muscle invasion due toinadequate sampling; we thus recommend proper trans-urethral bladder biopsy (TUBP) sampling.Key words: Urinary bladder neoplasm; Papillary carcinoma; Squamous cell carcinoma; WHO/ISUP classification system

Pattern and Risk Factors of Urinary Bladder Neoplasms in Sudanese patients in Khartoum State, Sudan

Background: Urinary bladder neoplasm (UBN) is associated with high morbidity and mortality rate. It poses biologic and clinical challenges. Objectives: To evaluate the pattern as regards frequency, age, sex, occupation, local geographical distribution, clinical presentations and risk factors of UBN in Sudanese patients in Khartoum State. Patients and Methods: This study was conducted in the period from January 2004 through December 2005 at three centres in Khartoum State. One hundred and six patients with urinary bladder neoplasms were included in the study. Results: The commonest affected age group was 60-80 years with male to female ratio 4.6:1. Urinary bladder neoplasms have some ethno-geographic variations in Sudan. The majority of these patients were from the Northern and Western regions. Conclusion: There is significant relationship between urinary schistosomal infestation and the development of squamous cell carcinoma of the urinary bladder among Sudanese patients. Keywords: Urinary Bladder, Transitional Cell Carcinoma, Squamous Cell CarcinomaSudan Journal of Medical Sciences Vol. 3 (3) 2008: pp. 211-21

p53 mutations in urinary bladder cancer

We have screened for mutations in exons 5–8 of the p53 gene in a series consisting of 189 patients with urinary bladder neoplasms. 82 (44%) neoplasms were lowly malignant (Ta, G1–G2a) and 106 (56%) were highly malignant (G2b–G4 or ≥T1). Only one mutation was in a lowly malignant urinary bladder neoplasm, in total we found p53 mutations in 26 (14%) of the 189 patients. 30% of the samples had loss of heterozygosity (LOH) for one or both of the p53 exogenic (CA)n repeat and the p53 intragenic (AAAAT)n repeat markers. 31 samples (21%) showed LOH but were not mutated, suggesting other mechanisms inactivating p53 than mutations. 4 mutations were found at codon 280 and 2 mutations were found at codon 285, 2 previously reported hot spots for urinary bladder cancer. The study indicate a boundary between G2a and G2b tumours concerning the occurrence of genetic events affecting p53 function; moderately differentiated (G2) urinary bladder neoplasms probably are genetically heterogeneous which supports the suggestion that they should not be grouped together but instead, for example, be categorized as either lowly or highly malignant. © 2001 Cancer Research Campaign http://www.bjcancer.co

ASPETTI ECOGRAFICI DELLE NEOFORMAZIONI VESCICALI NEL CANE E NEL GATTO

The data of 26 ultrasound examinations suggestive for diagnosis of urinary bladder neoplasia were selected and reclassified on basis of anatomopathological diagnosis in two group: group A (primary urinary bladder neoplasms) and group B (non-neoplastic diseases or non-primary urinary bladder neoplasms). Site envolvment, dimensions, ultrasonographic features, vascularization and regional lymph-nodes of the two groups were than revalued. The two groups showed pathological features detectable with ultrasound imaging which resulted a useful instrument in differentiating urinary bladder neoplasm from chronic cystitis or secondary organ involvement from tumors otherwhere localized

Evaluation of the immunohistochemical expression of HER2/NEU in urinary bladder neoplasms in a tertiary care hospital

Background: HER2/NEU expression in urothelial neoplasms has been reported to range from 9% to 80% on immunohistochemistry. We studied the expression of HER2/NEU in urothelial neoplasms and its variability according to histological grade along with the prognostic value. Methods: The present study was conducted on 60 formalin-fixed, paraffin-embedded specimens of urinary bladder neoplasms, which comprised 45 cases of high-grade urothelial carcinoma followed by 13 cases of low-grade and 2 cases of PUNLMP. These were then subjected to IHC by HER2/NEU. Membrane positivity for HER2/NEU was noted. Results: A total of 65% of cases showed positive membranous HER2/NEU expression. HER2/NEU expression was noted in 82.6% of cases of high grade while 8.4% of cases of low grade were positive for HER2/NEU expression. Conclusions: The majority of high grade invasive urothelial carcinomas showed positive HER2/NEU expression with a significant p-value <0.001. Thus patients with high grade urothelial carcinoma may benefit from HER2/NEU targeted therapy

Disease map-based biomarker selection and pre-validation for bladder cancer diagnostic

YesContext: Urinary biomarkers are promising as simple alternatives to cystoscopy for the diagnosis of de novo and recurrent bladder cancer. Objective: To identify a highly sensitive and specific biomarker candidate set with potential clinical utility in bladder cancer. Materials and methods: Urinary biomarkers concentrations were determined by ELISA. The performance of individual markers and marker combinations was assessed using ROC analysis. Results: A 5-biomarker panel (IL8, MMP9, VEGFA, PTGS2 and EN2) was defined from the candidate set. Discussion and conclusion: This panel showed a better overall performance than the best individual marker. Further validation studies are needed to evaluate its clinical utility in bladder cancer.This work has been supported in part by the European Commission Program DIPROMON - HEALTH-F5-2012-306157-2: Development of an integrated protein- and cell-based device for non-invasive diagnostics in the urogenital tract

Bladder cancer - the neglected tumor: a descriptive analysis of publications referenced in MEDLINE and data from the register clinicaltrials.gov

Background: Uro-oncological neoplasms have both a high incidence and mortality rate and are therefore a major public health problem. The aim of this study was to evaluate research activity in uro-oncology over the last decade. Methods: We searched MEDLINE and ClinicalTrials.gov systematically for studies on prostatic, urinary bladder, kidney, and testicular neoplasms. The increase in newly published reports per year was analyzed using linear regression. The results are presented with 95% confidence intervals, and a p value <0.05 was considered statistically significant. Results: The number of new publications per year increased significantly for prostatic, kidney and urinary bladder neoplasms (all <0.0001). We identified 1,885 randomized controlled trials (RCTs); also for RCTs, the number of newly published reports increased significantly for prostatic (p = 0.001) and kidney cancer (p = 0.005), but not for bladder (p = 0.09) or testicular (p = 0.44) neoplasms. We identified 3,114 registered uro-oncological studies in ClinicalTrials.gov. However, 85% of these studies are focusing on prostatic (45%) and kidney neoplasms (40%), whereas only 11% were registered for bladder cancers. Conclusions: While the number of publications on uro-oncologic research rises yearly for prostatic and kidney neoplasms, urothelial carcinomas of the bladder seem to be neglected despite their important clinical role. Clinical research on neoplasms of the urothelial bladder must be explicitly addressed and supported

Post Mortem Ultrasound and Computed Tomography Findings of an Extraluminal Urinary Bladder Leiomyoma in a Dog

Background: Neoplasia of the urinary bladder is common in dogs, accounting approximately 0.5 to 1.0 percent of all neoplasms. Most of the neoplasia of the urinary bladder is epithelial in origin and only 10% of urinary bladder neoplasms in dogs are from mesenchymal origin, of which the most frequent types are leiomyoma / leiomyosarcoma, and hemangioma / hemangiosarcoma. Virtual autopsy refers to the postmortem use of radiology, ultrasound and cross-sectional imaging prior to conventional necropsy. This paper reports the detection of a rare extra-luminal urinary bladder mass diagnosed as leiomyoma with a virtual autopsy techniques.Case: A 16-year-old male Schnauzer had previous history of seizure and no complains related to the urinary system. The animal was treated symptomatically to the neurological signs and responded to medical treatment. Nine weeks later from the first visit to the hospital the dog was found dead at home. Then postmortem ultrasound and computed tomography of the abdomen were performed. Postmortem ultrasound revealed a homogenously hypoechoic, rounded and slightly irregularly marginated mass located externally but adjacent to the left cranial wall of the urinary bladder and appears to extend from its serosal margins. Postmortem computed tomography was performed after postmortem ultrasound. A pedunculated homogenous soft tissue attenuating mass was located at the left lateral aspect of the urinary bladder and extended cranially. It had a stalk that connected to the left lateral wall of the urinary bladder. A partial necropsy of the abdomen was done just to examine the mass. A round extraluminal, pedunculated mass was observed at the left lateral aspect of the urinary bladder wall. It was pale pink on the outside and white inside, with a soft to firm consistency. The lumen and mucosal surface of the urinary bladder was smooth and regular. The histology of the mass revealed a densely cellular neoplastic proliferation, expansive, composed of spindle-shaped cells with moderate to large eosinophilic cytoplasm, sometimes wavy and with indistinct edges. The nuclei were large, oval to flattened, with dense chromatin and inconspicuous nucleoli. Anisocytosis and anisokariosis were discrete and no mitotic figures were observed. The arrangement consisted of dense, irregular and multidirectional bundles and the stroma was scarce. The mass was histologically confirmed as leiomyoma.Discussion: In this case, we performed postmortem ultrasound and computed tomography as part of a virtual necropsy study and in both modalities the urinary bladder mass was able to be identified, followed by a partial necropsy to further investigate the nature of the mass and to collect a sample to obtain the histological diagnosis. A few of the disadvantages of the postmortem ultrasound and computed tomography specially in this case were the lack of color Doppler investigation on ultrasound and the lack of evaluation of the patter of contrast enhancement on computed tomography. These techniques could have added important information related to the vascularity characteristics of the mass in a live patient. This is the first case report in veterinary medicine that describes an extra-luminal pedunculated urinary bladder leiomyoma in a canine patient, and it is emphasized the approach by postmortem ultrasound, postmortem computed tomography and conventional necropsy findings to reach the definitive diagnosis

miRegulome: a knowledge-base of miRNA regulomics and analysis

miRNAs regulate post transcriptional gene expression by targeting multiple mRNAs and hence can modulate multiple signalling pathways, biological processes, and patho-physiologies. Therefore, understanding of miRNA regulatory networks is essential in order to modulate the functions of a miRNA. The focus of several existing databases is to provide information on specific aspects of miRNA regulation. However, an integrated resource on the miRNA regulome is currently not available to facilitate the exploration and understanding of miRNA regulomics. miRegulome attempts to bridge this gap. The current version of miRegulome v1.0 provides details on the entire regulatory modules of miRNAs altered in response to chemical treatments and transcription factors, based on validated data manually curated from published literature. Modules of miRegulome (upstream regulators, downstream targets, miRNA regulated pathways, functions, diseases, etc) are hyperlinked to an appropriate external resource and are displayed visually to provide a comprehensive understanding. Four analysis tools are incorporated to identify relationships among different modules based on user specified datasets. miRegulome and its tools are helpful in understanding the biology of miRNAs and will also facilitate the discovery of biomarkers and therapeutics. With added features in upcoming releases, miRegulome will be an essential resource to the scientific community. Availability:http://bnet.egr.vcu.edu/miRegulome