RESUMEN
Most of the available data in the literature describe the cytomorphological features of exfoliated malignant epithelial cells in urine. There are no established diagnostic features that characterize the morphology of exfoliated malignant mesenchymal tumor in urine. Here we highlight the problems in the diagnosis of these groups of tumors. The presence of discohesive atypical cells which lack features of an epithelial nature should make one suspicious of this group of tumors.
Asunto(s)
Leiomiosarcoma/orina , Neoplasias de la Vejiga Urinaria/orina , Vejiga Urinaria/patología , Orina/citología , Citodiagnóstico , Humanos , Leiomiosarcoma/patología , Masculino , Persona de Mediana Edad , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
There are a wide variety of tumor markers now available that proved to be of value in the management of cancer patients. Of these markers, tissue polypeptide antigen (TPA) and tissue polypeptide specific antigen (TPS) are well known in the field of bladder cancer. TPA was found to be a mixture of cytokeratins 8, 18 and 19 and recent investigations proved that TPS is keratin 18. The aim of the present study was to assess the clinical value of urinary cytokeratin 19 (CYFRA21-1) in the differential diagnosis between bladder cancer and benign urinary tract diseases represented by bilharziasis. Two hundreds and seventy individuals were included in the present study: 186 with bladder cancer representing the different stages and grades, 44 with urinary tract bilharziasis and 40 normal healthy controls. CYFRA21-1 was evaluated in 24-hour urine samples by ELISA using the automatic set supplied by Boehringer Manheim, Manheim, Germany (ES 300). Results of this study revealed significant elevation of CYFRA21-1 in bladder cancer followed by bilharziasis. 82.3% (153/186) of bladder cancer patients and 11.4% (5/44) of bilharzial patients exhibited CYFRA21-1 levels above the upper limit of the control group (3 micrograms/24-hr). CYFRA21-1 was more sensitive in advanced than early stages of bladder cancer and in patients with positive than those with negative lymph nodes, but association of tumor with bilharziasis did not markedly affect its level.
Asunto(s)
Antígenos de Neoplasias/orina , Biomarcadores de Tumor/orina , Queratinas/orina , Esquistosomiasis Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/orina , Adenocarcinoma/diagnóstico , Adenocarcinoma/patología , Adenocarcinoma/orina , Adulto , Anciano , Carcinoma/diagnóstico , Carcinoma/patología , Carcinoma/orina , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/orina , Carcinoma de Células Transicionales/diagnóstico , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/orina , Diagnóstico Diferencial , Egipto , Femenino , Humanos , Queratina-19 , Leiomiosarcoma/diagnóstico , Leiomiosarcoma/patología , Leiomiosarcoma/orina , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Valores de Referencia , Reproducibilidad de los Resultados , Esquistosomiasis Urinaria/orina , Sensibilidad y Especificidad , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
High levels of urokinase-type plasminogen activator receptor (uPAR) are expressed in various types of cancer. Recent studies showed that cancer patients may have increased levels of soluble (s)uPAR in their serum. In the present study, we show that urine samples from healthy volunteers contain measurable amounts of suPAR. suPAR/creatinine levels from healthy controls showed only little variation over the day and were even stable during a month of continued monitoring. Importantly, urinary suPAR/creatinine levels were highly correlated with serum suPAR concentrations. Urinary suPAR levels were elevated in patients with different types of cancer. Interestingly, part of the urinary suPAR seemed to be present in a cleaved form, as has been found in tumor tissue extracts. Together with the recently established, cell migration-promoting effect of certain cleaved fragments of suPAR, the present data suggest that the measurement of urinary suPAR and/or its cleaved forms might have clinical implications.
Asunto(s)
Biomarcadores de Tumor/orina , Enfermedades de los Genitales Femeninos/orina , Neoplasias de los Genitales Femeninos/orina , Neoplasias Ováricas/orina , Receptores de Superficie Celular/metabolismo , Adulto , Anciano , Creatinina/orina , Neoplasias Endometriales/orina , Femenino , Humanos , Infertilidad Femenina/orina , Leiomiosarcoma/orina , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Ováricas/patología , Receptores de Superficie Celular/análisis , Receptores del Activador de Plasminógeno Tipo Uroquinasa , Recurrencia , Valores de Referencia , Reproducibilidad de los Resultados , Neoplasias del Cuello Uterino/orina , Prolapso Uterino/orinaRESUMEN
Tumours of the vulva and vagina are rare and there are relatively few studies of circulating markers in these conditions. The urinary measurement of the core fragment of the beta-subunit of hCG has been proposed as a useful tumour marker in non-trophoblastic gynaecological malignancies. This study describe the measurement of urinary beta-core in 50 patients with vulvovaginal malignancy. In contrast to other studies corrections were made for both the effect of urine concentration and the age of the patient. Each patient was followed up for at least 24 months, and at this time their status was correlated with their initial level of urinary beta-core. The sensitivity of beta-core was only 38%, but of those patients with elevated levels 90% had died within 24 months, while only 32% of those with normal levels had died. For both patients at initial presentation and those with recurrent disease, there was a highly significant difference in the survival curve between those with elevated beta-core levels and those with normal levels. This is similar to findings in cervical carcinoma, and suggests that for lower genital tract cancer the measurement of urinary beta-core may be valuable as a prognostic indicator, allowing a more informed approach to treatment and follow-up.