The Reseach Of Relationship Between Significatums In Bladder Carcinoma And Development Of Tumor

Human Bladder Transitional Cell Carcinoma (BTCC) is ranked first in terms of the number of malignant tumor of the urinary system with the characteristics of high recurrence.The biological behavior and malignant potential of BTCC is variable.But the mechanism of cancer recurrence and development is still unclear.According to immunohistochemical staining,the present study will explore the role of CD34,lymphaticvessel endothelial hyaluronanreceptor-1(LYVE-1),podoplanin,microvessel density(MVD)and lymphatic vessel density(LVD)in the development of BTCC and its potential clinical significance.Objective:To reseach the effect of CD34,LYVE-1and podoplanin in the development of BTCC and the relationship between the above indicators and the sex,age of bladder cancer patients,tumor grade and depth of invasion,lymph node metastasis and clinical stage so as to explore the relationship between the above factors and the prognosis for clinical treatment by detecting the different expression of CD34,LYVE-1,podoplanin and counting MVD,LVD in normal mucosa and BTCC.Methods:45cases of the tissue archive paraffin blocks of bladder transitional cell carcinoma that were surgically removed and certified by pathology from August,2008to July,2009,from Surgical Urology of Chengde Medical College affiliated hospital were collected.(35cases were male and10cases were female,aged33-82years,and mean58.51years).All patients did not receive the preoperative radiotherapy,chemotherapy and immunotherapy.The BTCC specimens were the total resection of bladder cancer patients or the partial bladder resection,and the other10cases of normal bladder tissue taken from patients with benign prostatic hyperplasia through suprapubic prostatectomy.Clinical stage according to WHO criteria:37cases belong to Ⅰ stage,8cases belong to Ⅱ-Ⅲ,and36cases without lymph node metastasis,9cases with lymph node metastasis.To detect CD34,LYVE-1,and podoplanin of the tissue sections through immunohistochemistry S-P method, labeling in MVD with CD34monoclonal antibody,and LVD with LYVE-1and podoplanin polyclonal antibody,and statistical analysis combined with clinical data.Results:1. The expression of CD34,LYVE-1, podoplanin and counting the corresponding MVD and LVD in normal mucosa tissue and bladder cancer1.1The expression of CD34in normal mucosa tissue and bladder cancerThe expression of CD34in45cases of bladder cancer was42.22%(19/45) and in10cases of normal bladder mucosa was0%(0/10).The rate of positive expression of CD34between the two was statistical significance(P<0.01).1.2The compare of MVD marked by CD34in normal mucosa tissue and bladder cancerThe value of MVD (18.54±3.04) in bladder cancer was significantly higher than that of in normal mucosa (5.50±2.64),the compare of both was statistical significance (P<0.01).1.3The compare of LVD in normal mucosa tissue and bladder cancer of the expression of LYVE-1The value of LVD (4.81±0.93) in bladder cancer of the the expression of LYVE-1was significantly higher than that of in normal mucosa(1.56±0.37),the compare of both was statistical significance (P<0.01).1.4The expression of podoplanin in normal mucosa and bladder cancerThe expression of podoplanin in45cases of bladder cancer was46.67%(21/45) and in10cases of normal bladder mucosa was0%(0/10).The rate of positive expression of podoplanin between the two was statistical significance (P<0.01).1.5The compare of LVD in normal mucosa and bladder cancer of the expression of podoplanin The value of LVD (4.93±1.06) in bladder cancer of the expression of podoplanin was significantly higher than that of in normal mucosa (1.86±0.64),the compare of both was statistical significance (P<0.01).2. The relationship between CD34,LYVE-l,podoplanin,the corresponding MVD,LVD and clinical pathological characteristic of bladder cancer2.1The relationship between CD34and pathological characteristic of bladder cancerThe expression of CD34infiltration more than muscle in bladder cancer100%(10/10) compared with not48.57%(17/35),which achieves statistical significance(P<0.01).The positive rate of infiltration more than muscle in bladder cancer was significantly higher than those without infiltration more than muscle in bladder cancer.The positive rate of CD34of lymph node metastasis in bladder cancer100%(9/9) compared with not38.89%(14/36), which achieves statistical significance(P<0.01).The positive rate of CD34of lymph node metastasis in bladder cancer was significantly higher than those without lymph node metastasis.The expression of CD34did not achieve statistical significance between different sex and age(<65year,≥65year)(P>0.05,P>0.05).2.2The relationship between MVD marked by CD34and clinicalpathological characteristic of bladder cancer The MVD (23.71±1.45) of infiltration more than muscle in bladdercancer was significantly higher than those (17.25±1.60)without infiltration more than muscle in bladder cancer, which achieves statistical significance(P<0.01).The group of lymph node metastasis (22.68±1.26)was significantly higher than those without lymph node metastasis (17.36±1.68), which achieves statistical significance(P<0.01).The value of MVD marked by CD34in moderate-high differentiated group was lower than that of poorly differentiated group (19.24±3.23,20.38±3.45, P<0.01). The expression of MVD did not achieve statistical significance betweendifferent sex and age(<65year,≥65year)(P>0.05,P>0.05). 2.3The relationship between LVD marked by LYVE-1and pathological characteristic of bladder cancerThe value of LVD (6.22±0.32) infiltration more than muscle in bladder cancer was significantly higher than not (4.45±0.64)(P<0.01).The value of LVD (6.20±0.32) lymph node metastasis was significantly higher than without (4.46±0.66)(P<0.01).The value of LVD marked by LYVE-1in moderate-high differentiated group was lower than that of poorly differentiated group (4.45±0.65,6.20±0.34, P<0.01).The expression of LVD did not achieve statistical significance between different sex and age (<65year,≥65year)(P>0.05,P>0.05).2.4The relationship between podoplanin and pathological characteristic of bladder cancerThe expression of podoplanin infiltration more than muscle in bladder cancer100%(9/9) compared with not52.78%(19/36),which achieves statistical significance(P<0.01). The positive rate of infiltration more than muscle in bladder cancer was significantly higher than those without infiltration more than muscle in bladder cancer. The positive rate of podoplanin of lymph node metastasis in bladder cancer100%(9/9) compared with not44.44%(16/36), which achieves statistical significance(P<0.01).The positive rate of podoplanin of lymph node metastasis in bladder cancer was significantly higher than those without lymph node metastasis.The expression of podoplanin did not achieve statistical significance between different sex and age(<65year,≥65year)(P>0.05, P>0.05).2.5The relationship between LVD marked by podoplanin and pathological characteristic of bladder cancerThe value of LVD infiltration more than muscle in bladder cancer (6.78±0.39)was significantly higher than not (4.47±0.54)(P<0.01).The group of lymph node metastasis (6.76±0.48)was significantly higher than without (4.53±0.52)(P<0.01).The value of LVD in poorly differentiated group(5.34±0.97) was not significantly than moderate-high differentiated group(4.76±1.16)(P>0.05). The expression of LVD did not achieve statistical significance between different sex and age(<65year,≥65year)(P>0.05, P>0.05).3. The relationship between CD34,podoplanin,MVD,LVD in bladder cancer3.1The relationship between the expression of CD34in bladder cancer and MVDThe value of MVD in bladder cancer of the strongly positive expression of CD34was significantly higher than that in bladder cancer of the moderately-weakly positive expression of CD34,indicating that the expression of CD34in bladder cancer was significantly correlated with the expression of MVD in bladder cancer (r=0.72;P<0.01).3.2The relationship between the expression of podoplanin in bladder cancer and LVDThe value of LVD in bladder cancer of the strongly positive expression of podoplanin was significantly higher than that in bladder cancer of the moderately-weakly positive expression of podoplanin,indicating that the expression of podoplanin in bladder cancer was significantly correlated with the expression of LVD in bladder cancer (r=0.67;P<0.01).Conclusions:1. CD34,LYVE-1, podoplanin in bladder cancer and the corresponding MVD,LVD were higher than those of normal mucosa group.Suggesting that CD34,LYVE-1,podoplanin,MVD and LVD may interact with the development of bladder cancer.2. CD34,LYVE-1,podoplanin,MVD,LVD were correlated with lymph node metastasis of bladder cancer. The patients with bladder cancer who have the high expression of CD34,LYVE-1,podoplanin,MVD,LVD have the incidence of lymph node metastasis.3. The expression of CD34,MVD,LYVE-1,MVD and LVD maked by podoplanin was correlated with depth of invasion, determineing the depth of invasion of bladder cancer and assessing the prognosis of patients with bladder cancer with the above indicators. 4. The counting of MVD by the expression of CD34, the depth of invasion,with or without lymph node metastasis may play an important role in the growth in bladder cancer invasion and the distant spread and may be factors of judging of bladder cancer invasion and prognostic.5. The counting of LVD by the expression of LYVE-l,podoplanin, the depth of invasion,with or without lymph node metastasis,with or without significantly difference in clinical stage and grouping may play an important role in the development of bladder cancer and may be factors of judging the progress of bladder cancer.CD34,LYVE-1,podoplanin,MVD and LVD play an important role in the development, invasion,and metastasis of tumor in bladder cancer. So the five indicators could be a determining the extent and recurrence of bladder cancer, evaluating the prognosis and selecting a reasonable treatment factor of bladder cancer.