Molecular changes in superficial bladder cancer

Urinary bladder cancers represent a spectrum of diseases that can be grouped into three general categories: superficial, invasive and metastasis. Each differs in clinical behavior, prognosis and primary management. For superficial tumors, the aim is to prevent recurrences and progression to an incurable stage, recognizing that surgical removal of the bladder (over treatment for most tumors) is curative up to a point. For more invasive disease, the issue becomes how to determine which tumors can be cured with a single therapy such as surgery, and which, by virtue of a high metastatic potential, requires an integrated systemic approach to achieve cure. For metastatic disease, combination chemotherapy is the standard yet, despite responses in more than 50% of cases, overall cure rates remain low, and progression has been minimal over the past few years. We analyzed histopathological and immunohistochemical 70 patients with bladder carcinomas searching the stage, the grade and other associated lesions. The results showed that 70% were papillary transitional carcinomas infiltrated in lamina propria (T1), and almost 22.85% represent non-invasive papillary carcinomas (Ta); we found only five cases in Tis stage (7.15%). The immunohistochemistry investigated three antibodies: p53 oncoprotein, bcl-2 oncoprotein and retinoblastoma protein (pRb). We noticed the antibodies distribution related to stage: carcinoma in situ (Cis or Tis) high percent of p53 (69) and bcl-2 (37.5%). Concerning the superficial tumors we found low values of p53 in T1 (45%) versus invasive tumors (51%); oncoprotein bcl-2 is higher in T1 (35%) versus non-invasive one (6%).