The practical use of tumor marker determination in bladder washing specimens: Assessing the urothelium of patients with superficial bladder cancer Journal Article
| Authors: | Orihuela, E.; Varadachay, S.; Herr, H. W.; Melamed, M. R.; Whitmore, W. F. Jr |
| Article Title: | The practical use of tumor marker determination in bladder washing specimens: Assessing the urothelium of patients with superficial bladder cancer |
| Abstract: | Bladder washing specimens from 81 patients with recurrent multifocal superficial bladder cancer were evaluated for DNA profile by flow cytometry and cell‐surface blood group (ABH) antigen reactivity by a modified specific erythrocyte adherence test. The study was conducted in a prospective, blind, nonrandomized fashion. Fifteen patients were treated with transurethral resection (TUR) alone and 66 with TUR and intravesical administration of bacillus Calmette‐Guerin weekly for 6 weeks (TUR + BCG). Among the patients treated with TUR only, there was a notably greater rate of tumor recurrence and progression in patients with unfavorable tumor markers (aneuploidy and ABH‐negative reactivity) than in those with favorable markers (diploidy and ABH‐positive reactivity). The difference was less striking in patients treated with BCG, which reduced the frequency of recurrence or progression at 30 months from 87% to 44% and from 60% to 23%, respectively. This favorable effect of BCG was virtually confined to patients with initially favorable markers and to those whose initially unfavorable markers became favorable during BCG administration. Aneuploidy and negative ABH are phenotypic expressions of undifferentiation that can forecast the potential of the urothelium to form new tumors and predict invasion. To an extent, these markers are independent of the grade and stage of the disease. BCG can induce prognostically favorable conversion of the markers expression. Lack of such conversion indicates lack of response to BCG and should be regarded as evidence of persistent disease even if conventional methods do not reveal it. Therefore, sequential determination of markers is useful in monitoring patients with superficial bladder cancer treated with intravesical BCG. Copyright © 1987 American Cancer Society |
| Keywords: | adult; aged; aged, 80 and over; major clinical study; cancer recurrence; combined modality therapy; flow cytometry; prospective studies; bcg vaccine; cancer immunotherapy; neoplasm recurrence, local; bladder cancer; tumor marker; antigens, neoplasm; diagnosis; dna, neoplasm; neoplasm metastasis; bladder neoplasms; cancer epidemiology; transurethral resection; double-blind method; therapy; antigens, surface; bladder; middle age; dna content; male genital system; irrigation; human; male; female; blood group antigen; blood groups; bladder irrigation; blood and hemopoietic system |
| Journal Title: | Cancer |
| Volume: | 60 |
| Issue: | 5 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 1987-09-15 |
| Start Page: | 1009 |
| End Page: | 1016 |
| Language: | English |
| DOI: | 10.1002/1097-0142(19870901)60:5<1009::Aid-cncr2820600515>3.0.Co;2-b |
| PUBMED: | 3607723 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 5 February 2021 -- Source: Scopus |
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