Role of microvessel density, HER-2/ NEU expression and CD-34 in prognostication and grading of bladder carcinomas.

Suryalakshmi, S (2013) Role of microvessel density, HER-2/ NEU expression and CD-34 in prognostication and grading of bladder carcinomas. Masters thesis, Madras Medical College, Chennai.


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Bladder Cancer Is The Sixth Common Cancer In Developed Countries(1) And Comprises 3.2% Of All Cancers. Though The Mortality Due To Bladder Cancer Shows A Steady Decrease, There Is An Increase In Its Incidence, Especially In Females. It Is More Common In Westernised Countries Like North America, United Kingdom And Australia. The Incidence Of Bladder Cancer In India Is 3.2% In Males And 0.7% In Females Among All Malignancies. The Two Main Causes Of Bladder Cancer Have Been Smoking And Industrial Exposure. The Industrialised Countries Show A Heavy Burden Of Bladder Cancer Due To Increase In Smoking, Especially In Females.(3) Transitional Cell Carcinoma (TCC) Is The Commonest Carcinoma In Urinary Bladder. However, In Countries Like Egypt And In Parts Of African Continent, Squamous Cell Carcinoma (SCC) Predominates.(2) This Is Due To The Endemic Presence Of Schistosomiasis Which Causes Chronic Irritation Of The Bladder. Though There Are Many Prognostic Factors In Bladder Carcinoma, Histological Stage And Grade Of The Tumour Have Been Considered As Important Factors. In Some Cases, Tumours With Higher Grade And Stage Behave In An Indolent Way Whereas Tumours With Lower Grade And Stage Show High Incidence Of Recurrence. Hence Additional Prognostic Information Is Required To Guide Clinicians In The Management Of These Patients. Microvessel Density (MVD) Has Been Considered As An Important Prognostic Factor In Many Solid Tumours And Also In Carcinomas Of Bladder.(4). Immunohistological Methods Can Be Used To Identify The Density Of Newly Formed Blood Vessels. The Hot-Spot Method Is Commonly Employed Where The Areas Of High MVD Are Identified In Low Power And Then They Are Counted In High Power. Though There Are Many Other Methodologies In Assessing Microvessel Density, No Standard Technique Has Yet Been Adopted Either In Urology Or In General Medicine.(4) Increased MVD Has Been Found To Be Associated With Increased Stage, Grade And Increased Chances Of Recurrence. The HER-2/Neu Gene Is Located On Chromosome 17 Which Encodes A 185 Kilodalton Transmembrane Protein. The Role Of HER-2/Neu Overexpression Has Been Reported In Many Tumours Like Breast, Lung, Gastric, Ovarian And Oral Cancers. HER-2/Neu Expression In Bladder Carcinoma Has Been Studied By Many Authors And Its Expression Has Been Found To Range From 9% To 81%.(5) This Over-Expression Has Been Found To Be Associated With Increased Grade, Stage And Poorer Outcome. Also, Targeted Therapy Is Being Tried In Cases Of HER-2/Neu Positive Tumours.(6) In This Study Of 50 Cases, An Attempt Is Made To Study The Role Of Microvessel Density And Overexpression Of HER-2/Neu Immunohistochemically In Correlation With Stage, Grade, Recurrence, Positive Urine Cytology And Other Clinico-Pathological Parameters.

Item Type: Thesis (Masters)
Uncontrolled Keywords: microvessel density; HER-2/ NEU expression; CD-34; prognostication; grading of bladder carcinomas
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 23 Jun 2017 11:40
Last Modified: 23 Jun 2017 11:40

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