Bladder cancer is the fourth most common malignant neoplasm in men and the tenth most common in women. Cystoscopy presents the gold standard for detection and monitoring of bladder cancer. However, it is an invasive and expensive procedure. Therefore, development of biomarkers for the purposes of screening, diagnosis and prediction of the prognosis in bladder cancer is required. Bladder tumor fibronectin is one of the new urinary tumor markers. The aim of this study is to evaluate the diagnostic performance of urinary bladder tumor fibronectin in detecting and monitoring bladder cancer. A total of 75 patients with the diagnosis of bladder cancer, 20 patients with the diagnosis of benign prostatic hyperplasia, 7 patients with the diagnosis of prostate cancer between the years 1996-2000, and 28 age-matched healthy individuals, were enrolled in the study. The patients were diagnosed by cystoscopy, with histopathological evaluation of the tumor, as having superficial or invasive bladder cancer. Patients were followed-up clinically with data pertinent to disease recurrence and progression. Bladder tumor fibronectin (BTF; ng/ml) was determined by solid phase, two-site chemiluminescent immunometric commercial diagnostic assay developed for the Immulite automated immunoassay system (Diagnostic Products Corporation, Los Angeles, CA, USA). All measured values were normalized by urinary creatinine, and the obtained data were evaluated by receiver-operating characteristics (ROC) curve analysis. Optimal cut-off was established at 43.4 ng/mg. This cut-off rendered overall sensitivities of 72% and specificity of 82.1%. The analytical evaluation of the BTF test displayed promising results in terms of a non-invasive in vitro test in the diagnosis of bladder cancer. Although it was not satisfactory in prediction of recurrence or progression of the disease, it correlated well with the stage, one of the most reliable prognostic factors. In conclusion, the urinary bladder tumor fibronectin test warrants further clinical evaluation.
[Show abstract][Hide abstract] ABSTRACT: xviii, 282 leaves : ill. (some col.) ; 30 cm. PolyU Library Call No.: [THS] LG51 .H577P HTI 2007 Yuen Background: Superficial transitional cell carcinoma (TCC) is the most common form of bladder cancer that can be managed by the transurethral resection (TUR) technique. TCC faces a challenge of exceptionally high recurrence rate, whereby Bacillus Calmette-Guerin (BCG) is used an adjuvant for prophylaxis. As the most effective immunotherapeutic agent, actions of BCG are based on its internalization by urothelium in order to trigger host immune response. However, the efficacy is unsatisfactory and side effects appear in over 90% of the patients, therefore a more powerful but also a safe chemopreventive agent is demanded. Methodology: An in vitro tumorigenic transferable human uroepithelial cell (HUC-PC) model with carcinogen 4-aminobiphenyl (ABP) was used to evaluate and elucidate the chemopreventive activities of two Ganoderma lucidum extracts - ethanol extract (GLe) and water extract (GLw) for the immunological, oxidative and antioxidant, apoptotic, molecular and cell signaling mechanisms. Results and Discussion: Potent cytotoxic and growth inhibitory effects of GLe were demonstrated as compared to GLw. Surprisingly, GLe induced oxidative stress and oxidative DNA damage in HUC-PC cell line, even though both G. lucidum extracts were found to possess rich antioxidant capacities. GLe was also able to induce interleukin-6 (IL-6) cytokine production, which is also an hallmark of BCG internalization. By using normal HUC-1 cells as control, cytotoxicity of GLe was selective to HUC-PC cells, in particular under ABP challenge. These findings have drawn our attention to demonstrate that the growth inhibition activity of GLe is mainly through (1) telomerase-related apoptosis and (2) up-regulation of intracellular calcium (Ca²⁺) together with nuclear factor-Kappa B (NF-KB) and protein kinase C (PKC). Furthermore, G. lucidum was capable of modulating the free fibronectin (FN) content as well as the membrane-bound glycosaminoglycans (GAGs) of HUC-PC cells, which may be synergistic to BCG binding efficiency. Conclusion: Conclusive findings support G. lucidum as a novel chemopreventive agent for TCC, whereby it may supplement with BCG for better outcome or potentially substitute BCG when more in vivo evidences become available. Ph.D., Dept. of Health Technology and Informatics, The Hong Kong Polytechnic University, 2007
[Show abstract][Hide abstract] ABSTRACT: Background: Fibronectin seems to play a very important role in the progression and invasion of bladder cancer. EDA, EDB, and IIICS domains of fibronectin are not expressed in the adult persons but they’re expressed in different cancers. The aim of this study is to investigate the mRNA of fibronectin in transitional carcinoma cells (TCC) of bladder to study these domains. Methods: A total of 20 patients with known bladder cancer were studied. Two of them excluded since their excised tissues were not enough for both the pathological examination and RNA study. Another 20 (control group) were normal volunteers who needed bladder operations. The excised tissue was immediately transferred to RNAlater (Ambion,TX). RNA was extracted via RNAWIZ (Ambion, TX). cDNA was made via RevertAid First Strand cDNA Synthesis Kit (Fermentas). PCR of the cDNAs was performed using primers for EDA, EDB, and IIICS (Eurogentec,Belgium). Results: For the first time, we present the expression of the oncofetal fibronectin mRNA in the transitional cell carcinoma of bladder. The high grade muscle invasive (G3T2) tumor, expressed ED-A, ED-B, and IIICS. Expression of ED-A, ED-B, and IIICS was confirmed in the two patients with G3T1 TCC. The four patients with G2Ta and G3Ta expressed both ED-A and ED-B. The four patients with G1T1 tumor expressed ED-A only, similar to the nine patients with G1Ta tumor. None of the normal volunteers expressed the oncofetal extra domains. The sensitivity of ED-A positive fibronectin RNA for detecting TCC of any kind is 100%, and of ED-B was only 35%. The specificity of ED-B positive fibronectin RNA for the high grade TCC is 100%. Conclusion: ED-A, ED-B, and IIICS could be used as useful markers for the diagnosis and following up of bladder carcinoma. Keywords: Transitional Cell Carcinoma, bladder cancer, fibronectin, RT-PCR, oncofetal.
[Show abstract][Hide abstract] ABSTRACT: Objective: Alpha fetoprotein (AFP) is an important tumor marker in childhood. However, AFP levels remain high during the first few months of life, making clinical interpretation difficult in this period. The aim of the present study is to determine normal AFP levels in healthy full-term neonates and infants followed-up at Kocaeli University Hospital, Department of Pediatrics.
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