Das Transitionalzellkarzinom der Harnblase

Abstract

Up to now markers for transitional cell carcinoma of the bladder (TCC) are missing. Fibronectin (FN) seems to play a key role in progression and invasion of malignant tumors. The aim of this study was to assess the value of cellular FN (cFN), a more specific subform of produced FN, in different stages of TCC.cFN was determined using a highly sensitive immunoassay which we developed. Blood samples were taken of 45 patients with the first diagnosis of TCC before undergoing TUR-B and 6 patients with metastatic TCC before chemotherapy; 70 patients with nonmalignant urological disorders served as a control group.Patients with TCC showed significantly elevated cFN plasma levels compared to controls (p<0.05). Patients with muscle-invasive disease (n=15) showed significantly higher cFN plasma levels compared to the group with superficial TCC. Patients with metastatic TCC showed the highest, but not significantly elevated cFN plasma levels compared to patients with muscle-invasive TCC.The elevated cFN plasma levels in TCC underline the important role of cFN for tumor progression and its potential role as a marker for TCC. Upcoming investigations are necessary to prove the value of the potential marker cFN during follow-up and its impact as a prognostic factor for recurrence and progression of TCC.

The Role of Urinary Fibronectin and Telomerase in Patients with Superficial Bladder Cancer after Transurethral Resection Treated with BCG

“…Fibronectin is a glycoprotein with a mo lecular weight of 440 kDa, found in soluble form in plas ma and other body fluids, and in an insoluble (matrix) form in basement membranes and the extracellular matrix. Fibronectin (FN) seems to play a key role in progression and invasion of malignant tumors (10) .…”

“…BCG ce lls possess specific high-affinity receptors to fibronectin molecules (9) . The initial crucial step in BCG therapy seems to be the binding of mycobacteria to the urothelial lining which depends on the interaction of a fibronectin attachment protein (FAP) on the bacterial surface with the fibronectin in the bladder wall (10) . In vitro studies showed that a stable BCG/ fibronectin interaction was dependent on FAP binding to fibronectin (9) .…”

“…In vitro studies showed that a stable BCG/ fibronectin interaction was dependent on FAP binding to fibronectin (9) . In vivo studies show FAP to be a necessary protein for the stable attachment of BCG to the bladder wall (10) . Pretreat ment of BCG with soluble fibronectin competit ively blocks the binding of BCG to exposed matrix (insoluble) fibronectin; this could result in the preferential and irreversible binding of BCG to soluble fibronectin.…”

“…Established approaches for detecting bladder cancer include urine cytology and cystoscopy, used singly or in sequence (10) . However, the invasiveness and relatively high cost of cystoscopic examination and the limited sensitivity of urinary cytology, especially for low-grade superficial lesions, make it of the utmost importance to develop a non invasive, reliable, and simp le test to increase the rate of detection of superficial bladder cancer.…”