Microvessels density in relation to prognostic parameters (grading and staging)‎ in transitional cell carcinoma of urinary bladder : Immunohistochemical study

Abstract EN

Background : Tumor stage, histologic grade, and regional lymph node status are currently used to obtain prognostic information about bladder cancers.

However, additional prognostic indicators are needed to aid clinicians in selecting patients who would benefit most from specific therapies.

A majority of studies assessing the prognostic value of measuring tumor angiogenesis (i.e., measurement of tumor microvessel densities) have found a positive association between increasing microvessel densities and worsening prognosis.

Purpose : We explored the relationship between established prognostic indicators and the extent of tumor-associated angiogenesis in patients with invasive transitional cell carcinoma (TCC) of the bladder.

Methods : Tumor angiogenesis were assessed by calculating standard microvessels density (MVD) identified by using immunostaining of endothelial cells with murine antihuman monoclonal antibody recognizing CD34 on endothelial cells Each slide was first scanned on low magnification (X10) to identify the four areas with highest density of microvessels (hot spots) ; each spots then was evaluated at high power magnification (X40) and the number of stained vessels per high power field (X40) were determined.

The final MVD score was obtained from these four field and MVD was determined and calculated.

Results : We found that there is significant correlation between mivrovessels and tumor grade (P < 0.5), (Table 3), and also significant correlation of microvessels density with staging of the bladder carcinoma, (Table 4).

Conclusion : Neovasculrization (angiogenesis) is very important for establishment and progression of tumor, so assessment of tumor vascularization whether by counting the microvessels density or other method may be of value regarding predicting further management and prognosis.