Аргентофильные ядрышковые организаторы и прогноз у больных поверхностным и местно-распространенным переходно-клеточным раком мочевого пузыря

Аннотация

The aim of the study was to estimate distribution of the nucleoli and argentophilic nucleolar organizers in surface and locally advanced
transitional cell tumors of the urinary bladder (TCTUB), to analyse correlation between this distribution, tumor recurrence and survival of the patients. The data on primary examination and 5-year followup of 61 patients (47 male and 14 female, mean age 64 x 1 year) with surface and locally advanced TCTUB were studied retrospectively. AH the patients were radically operated on, 5-year progression-free survival made up 62%, recurrences of the urinary bladder tumors were detected in 61% patients. In addition to the standard morphological examination, tumor tissue was stained with silver nitrate according to the Howell and Black technique and the number of the nucleoli and argentophilic granules in them was counted in magnification lOOO.The findings were compared with the invasion depth, grade of cancer differentiation, tumor recurrence and 5-year survival. The count of argentophilic granules increased with reduction of differentiation grade and an increase of cancer invasion depth. Distribution of the nucleoli and granules significantly differed in the subgroups of patients with recurrent and recurrence-free course of the disease, depending on 5-year survival without progression. Probable duration of the recurrence-free period was estimated best by coefficient of variation of argentophilic granules distribution (p = 0.001). Parameters of distribution of the nucleoli and granules allowed specification of the risk of tumor progression for 5 years for all the patients (p = 0,035) and patients with surface tumors (p = 0.007) irrespective of categories T and G. Thus, the number of nucleoli and argentophilic nucleolar organizers increases with lowering of differentiation and deepening of tumor invasion. The analysis of nucleoli and argentophilic granules distribution provides additional information on recurrence and transient cell carcinomas probability.