Risk Factors For Bladder Carcinoma Research Articles

Comprehensive Analysis of the Significance of Breast Cancer Gene 1 (BRCA-1) in Bladder Cancer.

Bladder carcinoma (BLCA) is characterized by high morbidity, mortality, and treatment costs. Breast cancer gene 1 (BRCA1), a tumor suppressor gene, inhibits the development of malignant tumors. However, research on the significance of BRCA1 in BLCA is limited. This study aims to explore the importance of BRCA1 in BLCA using bioinformatic methods and immunohistochemistry. Gene expression, clinical, and survival data were collected from the TCGA databases through the UCSC Xena platform (http://xena.ucsc.edu/). The TPM data from the TCGA and GETEx databases were integrated using the GEPIA database (http://GEPIA.cancer-pku.cn). The study then explored the differential expression, survival prognosis, functional enrichment, and immune cell infiltration analyses of BRCA1 in BLCA. A PPI network of BRCA1 was constructed using the STRING database, and a BRCA1-associated gene-gene interaction network was generated using the GeneMANIA database. Immunohistochemistry (IHC) assays were performed to verify the expression levels of BRCA1 in bladder tumour tissues and adjacent normal tissues. BRCA1 is associated with BLCA. Differential analysis indicated that BRCA1 acts as a risk factor for BLCA but does not show significant expression differences across genders, stages, tumor stages, lymph node stages, or metastasis stages. Additionally, staging was based on the eighth edition of the American Joint Committee on Cancer (AJCC) for BLCA. Co-expression network and Gene Set Enrichment Analysis (GESA) confirmed that BRCA1 is involved in various BLCA pathways. Furthermore, BRCA1 expression was also linked to immune cell infiltration. However, survival prognosis analysis revealed no significant correlation between the prognosis of BLCA and BRCA1. We demonstrated that BRCA1 is a prospective predicted and immunological biomarker in BLCA, offering new avenues for potential therapies.

The UF-5000 Atyp.C parameter is an independent risk factor for bladder cancer

Bladder carcinoma (BC) accounts for > 90% of all urothelial cancers. Pathological diagnosis through cytoscopic biopsy is the gold standard, whereas non-invasive diagnostic tools remain lacking. The “Atyp.C” parameter of the Sysmex UF-5000 urine particle analyzer represents the ratio of nucleus to cytoplasm and can be employed to detect urinary atypical cells. The present study examined the association between urinary Atyp.C values and BC risk. This two-center, retrospective case–control study identified clinical primary or newly recurrent BC (study period, 2022–2023; n = 473) cases together with controls with urinary tract infection randomly matched by age and sex (1:1). Urinary sediment differences were compared using non-parametric tests. The correlations between urinary Atyp.C levels and BC grade or infiltration were analyzed using Spearman’s rank correlation. The BC risk factor odds ratio of Atyp.C was calculated using conditional logistic regression, and potential confounder effects were adjusted using stepwise logistic regression (LR). Primary risk factors were identified by stratified analysis according to pathological histological diagnosis. The mean value of urinary Atyp.C in BC cases (1.30 ± 3.12) was 8.7 times higher than that in the controls (0.15 ± 0.68; P < 0.001). Urinary Atyp.C values were positively correlated with BC pathological grade and invasion (r = 0.360, P < 0.001; r = 0.367, P < 0.001). Urinary Atyp.C was an independent risk factor for BC and closely related with BC pathological grade and invasion. Elevated urinary Atyp.C values was an independent risk factor for BC. Our findings support the use of Atyp.C as a marker that will potentially aid in the early diagnosis and long-term surveillance of new and recurrent BC cases.

729 - Prostate cancer as a risk factor for bladder carcinoma

729 - Prostate cancer as a risk factor for bladder carcinoma

OP31.07: Papillary bladder carcinoma of low‐malignant potential during pregnancy: 2D and 3D ultrasonography

Bladder neoplasm detected during pregnancy is a rare condition. The cardinal symptoms dysuria and hematuria are often mistakenly attributed to the pregnancy complications. Ninety percent of cases in women under 40 fortunately belong to superficial papillary urothelial neoplasm of low malignant potential (PUNLMP), known even as transitional cell cancer (TCC). Cigarette smoking, frequent urinary tract infections and environmental chemical carcinogens exposure are the most important risk factors for bladder carcinoma. A healthy 28-year-old pregnant primigravida woman, non-smoker, presented in gestational week 30+3 with intermittent painless macrohematuria, interpreted as vaginal bleeding. She underwent gynecological examinations twice without detection of any signs of bleeding. At the third examination an irregular papillary bladder neoplasm was suspected on 2D ultrasound. 3D image of the neoplasm was rendered using HDlive and the volume was measured. Colour and spectral Doppler shown a moderate vascularity with high peak systolic velocity (PSV=28cm/sec) inside of the neoplasm. Cystoscopy confirmed a suspicious neoplasm. Urine cytology was negative. In gestational week 34+0 an emergency Caesarean section was performed due to failure of induction of labour. Three days later a transurethral resection of neoplasm (TUR-B) was performed, uneventfully. Histology shown non-invasive papillary urothelial cancer (stage pTaG1). No adjuvant therapy was needed. Follow-up with cystoscopy, 4 and 10 months after treatment, were negative. Despite the rarity of bladder carcinoma during pregnancy an examination of urinary bladder should always be performed in case of atypical genital bleeding. Different diagnostic imaging as 2D and 3D ultrasound, followed by cystoscopy are sufficient and comfortable diagnostic modalities for bladder neoplasm during pregnancy. Transurethral resection of non-invasive bladder carcinoma can be performed safely either during pregnancy or after delivery.

Microhematuria at Point of Care

The case of a 35-year-old man presenting microscopic hematuria allows the following topics to be examined in depth: 1. How is hematuria defined and classified? 2. What are the causes of hematuria? 3. Hematuria is an important sign for the diagnosis of cancer of the urinary system. What are the risk factors for bladder carcinoma? 4. What is the role of the urinary dipstick test in the diagnosis of hematuria? 5. What is the role of the examination of urine sediment in the diagnosis of hematuria? 6. Once microscopic hematuria is confirmed, how can we proceed to reach a final diagnosis?

O descortinar de um diagnóstico de hematúria: relato de caso

Introduction: The prevalence of lower urinary tract symptoms (LUTS) increases with age. They have significant impact on quality of life and commonly cause adults to seek medical care. When a middle-aged man presents with LUTS, we must consider diseases that affect the prostate, urethra, bladder and detrusor muscle. Case report: A 50 year-old male welder, with a previous history of dyslipidemia, 3,5 pack-years of smoking, and an episode of renal colic with renal microlithiasis came to his Family Physician in October 2012. He complained of dysuria, urinary frequency, terminal hematuria, and hypogastric pain. A diagnosis of cystitis was made and antibiotic therapy was prescribed after obtaining a urine culture. The urine culture was negative. In the absence of prostration, fever, and purulent discharge, and given a previous history of urolithiasis, this episode was reinterpreted as a second episode of renal colic. In August 2013, the patient presented with terminal dribbling, sporadic dysuria, and hematuria on urine dipstick analysis. An assay of total prostate specific antigen, an analysis of urinary sediment, and a transabdominal vesicoprostatic ultrasound were ordered. One month later a bulky neoplastic lesion of the bladder was found on ultrasound examination. Comment: Despite the presence of risk factors for bladder carcinoma (previous smoking and age over 35 years), this diagnosis was not considered at the initial consultation. On follow-up, other confounding factors emerged, including a past history of renal stones and the presence of symptoms suggestive of other diseases more common in this age group. The case report explores the complexity of the differential diagnosis of LUTS in an adult male. This is a common complaint in Family Medicine consultations, pointing to a set of disorders with defined diagnostic and therapeutic guidelines.

Variation of Urinary and Serum Trace Elements (Ca, Zn, Cu, Se) in Bladder Carcinoma in China

Deficiency or excess of trace elements can induce body metabolic disorders and cellular growth disturbance, even mutation and cancerization. Since there are few studies of the effect of trace elements in bladder carcinoma in China, the aim of this study was thus to assess variation using a case control approach. To determine this, 81 patients with bladder carcinoma chosen as a study group and 130 healthy persons chosen as a control group were all assayed for urinary and serum trace elements (calcium [Ca], zinc [Zn], copper [Cu], selenium [Se]) using an atomic absorption spectrophotometer, and the results were analyzed by independent sample t tests. The correlative factors on questionnaires answered by all persons were analyzed by logistic regression. The results showed urinary Ca, Zn and serum Cu levels of the study group to be significantly higher (P<0.05) than those of he control group. Serum Ca and Se levels of study group were significantly lower (P<0.05) than those of control group. There were higher urinary Zn and serum Cu concentrations in bladder carcinoma cases. Bladder carcinoma may be associated with Ca metabolic disorder, leading to higher urinary Ca and lower serum Ca. Low serum Se and smoking appear to be other risk factors for bladder carcinoma in China.

Non-alcoholic beverages and risk of bladder cancer in Uruguay.

BackgroundBladder cancer is the fourth most frequent malignancy among Uruguayan men. A previous study from Uruguay suggested a high risk of bladder cancer associated with maté drinking. We conducted an additional case-control study in order to further explore the role of non-alcoholic beverages in bladder carcinogenesis.MethodsIn the time period 1996–2000, 255 incident cases with transitional cell carcinoma of the bladder and 501 patients treated in the same hospitals and in the same time period were frequency matched on age, sex, and residence. Both cases and controls were face-to-face interviewed on occupation, tobacco smoking, alcohol drinking and intake of maté, coffee, tea, and soft drinks. Statistical analysis was carried out by unconditional multiple logistic regression.ResultsEver maté drinking was positively associated with bladder cancer (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.2–3.9) and the risk increased for increasing duration and amount of maté drinking. Both coffee and tea were strongly associated with bladder cancer risk (OR for coffee drinking 1.6, 95% CI 1.2–2.3; OR for tea drinking 2.3, 95% CI 1.5–3.4). These results were confirmed in a separate analysis of never-smokers.ConclusionOur results suggest that drinking of maté, coffee and tea may be risk factors for bladder carcinoma in Uruguay.

Polyoma virus infection is a prominent risk factor for bladder carcinoma in immunocompetent individuals

Despite various reports of BK viral (BKV) DNA sequences or proteins in tumors of the urogenital tract, there has been no study statistically linking infection by this polyoma virus (PV) to tumor development. All PV are potential transforming viruses, the large T-antigen of which interacts with tumor suppressor proteins. Here, we have performed a cross-sectional study of 3,782 patients having had urine cytologic analyses, comparing those diagnosed with PV infection with those not so diagnosed. In order to focus on immunocompetent individuals, renal transplant patients, for whom a diagnosis of PV infection followed immunosuppressive therapy, were excluded. Among the 133 immunocompetent patients diagnosed with PV infection, the most frequently occurring neoplasms were bladder carcinoma (15.8%) and prostate carcinoma (3.8%). The incidence of bladder carcinoma was sufficient to statistically establish temporality in a two-sided test, linking a prior diagnosis of PV infection to a subsequent diagnosis of bladder carcinoma (odds ratio = 3.419, P < 0.001).

Tobacco smoking, GSTP1 polymorphism, and bladder carcinoma

Although cigarette smoking is considered a major risk factor for bladder carcinoma, little is known about the interaction between metabolic genes such as glutathione-S-transferase P1 and tobacco smoking in this process. GSTP1 may play a role in detoxification of tobacco-related carcinogens. In this case-control study of 145 cases with bladder carcinoma (male:female = 7.5:1) and 170 noncancer controls (male:female = 3.7:1), the relation between genetic polymorphisms of GSTP1 and susceptibility to bladder carcinoma was investigated and the gene-environment interaction between tobacco smoking and GSTP1 polymorphism was evaluated. Epidemiological data were collected for all cases and controls by a standard questionnaire. Polymorphisms of GSTP1 were measured by polymerase chain reaction-restriction fragment length polymorphism. The logistic regression model in SAS was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Cigarette smoking was confirmed as a risk factor of bladder carcinoma with an OR of 3.1 (95% CI: 1.7-5.9) after controlling for potential confounding factors. The OR for pack-years of smoking as a continuous variable was 2.4 (95% CI: 2.0-2.8). The ORs were 7.6 (95% CI: 1.18-49.51) for isoleucine/valine (Ile/Val) and 6.5 (95% CI: 1.01-41.56) for Ile/Ile when the homozygous Val/Val was considered as comparison group after adjusting for age, gender, race, and education. The adjusted OR for interaction between smoking and the GSTP1 (any Ile genotype) was 11.42 (95% CI: 0.53-248.15). The results indicate that the Ile 105 allele is associated with an increased risk of bladder carcinoma and suggest that individuals who smoke and possess the Ile allele might be at increased risk for bladder carcinoma.

Clinico-pathological features of bladder carcinoma in women in Pakistan and smokeless tobacco as a possible risk factor.

BackgroundBladder carcinoma is one of the common urological malignancies occurring worldwide in both sexes. Use of smokeless tobacco by women is common in rural areas of Pakistan. The clinico-pathological features of bladder carcinoma in women and association of smokeless tobacco as a possible risk factor for bladder carcinoma has not been well described in the literature. The objective of the study was to determine the clinico-pathological features of histologically confirmed bladder carcinoma in women and to investigate the role of smokeless tobacco use as a possible risk factor for its development.Patients and methodsOf the 204 patients (160 male and 44 female M:F ratio 3.6:1) of newly diagnosed bladder carcinoma treated at Nishtar Medical College Hospital Multan from January 1998 to December 2004, the 44 female patients were evaluated with respect to age, clinical presentation, cystoscopic findings, histopathological reports and possible etiological factors. Data were collected and prospectively updated at the time of discharge from hospital and during follow-up in urology out-patient clinic.ResultsTransitional cell carcinoma accounted for all of the bladder carcinoma in women. Median age of the patients was 55 years and 68% patients were under 60 years of age. Majority of patients (88%) presented with hematuria. Eleven (25%) patients had superficial (pTa/pT1) while 33 (75%) patients had muscle invasive (T2–T4) bladder carcinoma. Most (81%) superficial tumors were papillary while muscle invasive tumors had solid configuration at cystoscopy. Of these, 21 (47%) patients had long history of smokeless tobacco use (chewable or moist snuff).ConclusionTransitional cell carcinoma is the most common bladder malignancy in women in Pakistan. Many women with bladder carcinoma had long history of use of smokeless tobacco. Majority of patients presented with hematuria and were under 60 years of age. At the time of diagnosis 75% women had muscle invasive bladder carcinoma. In women using smokeless tobacco, the correlation between stage of bladder carcinoma and duration of smokeless tobacco use was significant (p = 0.03). Further studies are needed to clarify the role of smokeless tobacco in the development of bladder carcinoma.

Risk factors for urinary bladder carcinoma in postmenopausal women. The Iowa Women's Health Study.

We evaluated prospectively the association of smoking and other potential risk factors with bladder carcinoma incidence in postmenopausal women. A total of 37,459 women participating in the Iowa Women's Health Study completed baseline questionnaires in 1986 and were followed 13 years for bladder carcinoma incidence (n = 112). Adjusted for potential confounders, the relative risk (RR) of bladder carcinoma in women who were current smokers compared with those who had never smoked was 3.58 (95% confidence interval [CI] = 1.86-6.88). The RR declined as years since quitting increased. Currently, married women, compared with unmarried women, had a RR of 0.66 (95% CI = 0.44-0.99). A 2.46-fold (95% CI = 1.32-4.59) increase in bladder carcinoma risk was identified for women who reported, versus did not report, diabetes. Regular versus no physical activity (RR = 0.66, 95% CI 0.43-1.01) and body mass index were inversely associated (P = 0.06) with bladder carcinoma incidence. We confirmed that cigarette smoking is an important risk factor for bladder carcinoma in women; women who had quit smoking had a reduction of risk. We also identified diabetes as a potential risk factor, which may invite more research on its role in the development of urinary bladder carcinoma.

Are tobacco use and urine pH indicated as risk factors for bladder carcinoma?

Many case-control and cohort studies have shown a positive relationship between bladder carcinoma and tobacco use. Recently, urine pH has been reported to influence aromatic amine carcinogenesis, which have been implicated as potent carcinogens in bladder carcinoma patients. Herein the correlation between bladder carcinoma, tobacco use and urine pH is reported. One hundred and forty-one patients with bladder carcinoma and 128 patients with benign prostatic hyperplasia or urolithiasis as controls were selected. All patients were admitted to Osaka City University Hospital for the purpose of surgical treatment. Urine pH was checked by a test tape. Of the patients with bladder carcinoma, 106 were smokers and 35 were non-smokers. In contrast, the number of smokers in the control group was 76 and that of non-smokers was 52. The odds ratio in the bladder carcinoma group calculated for the smoker patients was 2.07, showing a significant correlation between bladder carcinoma and tobacco use. Regarding urine pH, acidic urine was found in 126 patients in the bladder carcinoma group and in 116 patients in the control group. The odds ratio in the bladder carcinoma group for acidic urine was 0.87, showing no significant relationship between bladder carcinoma and urine pH. The study found a positive relationship between bladder carcinoma and tobacco use; however, it could not establish a clear relationship between bladder carcinoma and urine pH, even in the smoker group.