Journal Mobile Options
Table of Contents
Vol. 81, No. 3, 2008
Issue release date: October 2008
Urol Int 2008;81:306–311

Identification of Immunohistochemical Factors That Predict the Synchronous or Metachronous Development of Bladder Tumors in Patients with Upper Urinary Tract Tumors

Joung J.Y. · Yang S.O. · Jeong I.G. · Han K.S. · Seo H.K. · Chung J. · Park W.S. · Lee G.K. · Lee K.H.
aUrologic Oncology Clinic and bDepartment of Pathology, Institute and Hospital, National Cancer Center, Goyang, Korea

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Objective: To identify markers that predict the synchronous or metachronous development of bladder cancer in patients with upper urinary tract (UUT) tumors. Materials and Methods: Between March 2001 and December 2005, we identified 38 consecutive patients who had been histologically diagnosed as having transitional cell carcinoma in the renal pelvis and ureter. These patients were divided into 2 groups (n = 19 per group): group 1 patients with metachronous or synchronous bladder cancer, and group 2 patients with UUT tumors only. We analyzed the differences between the 2 groups with respect to the expression of various biomarkers (p53, Rb, Ki-67, PTEN, and bcl-2) and in terms of clinical parameters. Results: The 2 groups differed significantly in terms of multiplicity (p = 0.029), papillary configuration (p = 0.001), the presence of lymphovascular emboli (p = 0.019), and Ki-67 overexpression (p = 0.029) in UUT tumors. Multivariate analysis revealed that Ki-67 overexpression in UUT tumor tissues significantly predicts bladder cancer development (HR 6.440; 95% CI 1.121–37.014; log rank p = 0.037). Conclusion: Ki-67 overexpression in UUT tumor tissues was found to be an independent predictor of the development of bladder cancer in UUT tumor patients.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Matsui Y, Utsunomiya N, Ichioka K, Ueda N, Yoshiura K, Terai A, Arai Y: Risk factors for subsequent development of bladder cancer after primary transitional cell carcinoma of the upper urinary tract. Urology 2005;65:279–283.
  2. Palou J, Roudriguez-Rubio F, Huguet J, Segarra J, Ribal MJ, Alcaraz A, Villavicencio H: Multivariate analysis of clinical parameters of synchronous primary superficial bladder cancer and upper urinary tract tumor. J Urol 2005;174:859–861.
  3. Sekin H, Fukui I, Yamada T, Kihara K, Ishizaka K, Ohshima H: Clinicopathological study of upper urinary tract tumors associated with bladder tumors. Eur Urol 1991;19:19–23.

    External Resources

  4. Kamijima S, Tobe T, Suyama T, Ueda T, Igarashi T, Ichikawa T: The prognostic value of p53, Ki-67 and metalloproteinases MMP-2 and MMP-9 in transitional cell carcinoma of the renal pelvis and ureter. Int J Urol 2005;12:941–947.
  5. Margulis V, Shariat SF, Ashfaq R, Sagalowsky AI, Lotan Y: Ki-67 is an independent predictor of bladder cancer outcome in patients treated with radical cystectomy for organ-confined disease. Clin Cancer Res 2006;12:7369–7373.
  6. Seo HK, Joung JY, Chung JS, Hwang HS, Hong EK, Lee KH: Clinical significance of p53, retinoblastoma (Rb) and PTEN expression in bladder cancer. Korean J Urol Oncol 2004;2:36–40.
  7. Nakopoulou L, Vourlakou C, Zervas A, Tzonou A, Gakiopoulou H, Dimopoulos MA: The prevalence of bcl-2, p53, and Ki-67 immunoreactivity in transitional cell bladder carcinomas and their clinicopathologic correlates. Hum Pathol 1998;29:146–154.
  8. Vardar E, Gunlusoy B, Minareci S, Postaci H, Ayder AR: Evaluation of p53 nuclear accumulation in low- and high-grade (WHO/ISUP classification) transitional papillary carcinomas of bladder for tumor recurrence and progression. Urol Int 2007;57:158–161.
  9. Kamai T, Takagi K, Asami Y, Ito Y, Arai K, Yoshida KI: Prognostic significance of P27Kip1 and Ki-67 expression in carcinoma of the renal pelvis and ureter. BJU Int 2000;86:14–19.
  10. Tsai YS, Tzai TS, Chow NH, Wu CL: Frequency and clinicopathologic correlates of ErbB1, ErbB2, and ErbB3 immunoreactivity in urothelial tumors of upper urinary tract. Urology 2005;66:1197–1202.
  11. Cheville JC, Terrell RB, Cohen MB: Use of proliferative markers Ki-67 (MIB-1) and proliferating cell nuclear antigen (PC10) in transitional cell carcinoma of the renal pelvis. Mod Pathol 1994;7:794–800.
  12. Mukamel E, Simon D, Edelman A, Konichezky M, Hadar H, Servadio C: Metachronous bladder tumors in patients with upper urinary tract transitional cell carcinoma. J Surg Oncol 1994;57:187–190.
  13. Hafner C, Knuechel R, Stoehr R, Hartmann A: Clonality of multifocal urothelial carcinoma: 10 years of molecular genetic studies. Int J Cancer 2002;101:1–6.
  14. Takahashi T, Kakehi Y, Mistsumori K, Akao T, Terachi T, Kato T: Distinct microsatellite alterations in upper urinary tract tumors and subsequent bladder tumors. J Urol 2001;165:672–677.
  15. Hafner C, Knuechel R, Zanardo L, Dietmaier W, Blaszyk H, Cheville J: Evidence for oligoclonality and tumor spread by intraluminal seeding in multifocal urothelial carcinomas of the upper and lower urinary tract. Oncogene 2001;20:4910–4915.
  16. Krogh J, Kvist E, Rye B: Transitional cell carcinoma of the upper urinary tract: prognosis variables and post-operative recurrences. Br J Urol 1991;67:32–36.
  17. Hatch TR, Hefty TR, Barry JM: Time-related recurrence rates in patients with upper tract transitional cell carcinoma. J Urol 1998;140:40–41.
  18. Hisataki T, Miyao N, Masumori N, Takahashi A, Sasai M, Yanase M, Itoh N, Tsukamoto T: Risk factors for the development of bladder cancer after upper tract urothelial cancer. Urology 2000;55:663–667.
  19. Rey A, Lara PC, Redondo E, Valdes E, Apolinario R: Overexpression of p53 in transitional cell carcinoma of the renal pelvis and ureter. Relation to tumor proliferation and survival. Cancer 1997;79:2178–2185.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50