Intense inflammation in bladder carcinoma is associated with angiogenesis and indicates good prognosis

• Published in: British journal of cancer Vol. 87; no. 12; pp. 1422 - 1430
• Main Authors: OFFERSEN, B. V, KNAP, M. M, MARCUSSEN, N, HORSMAN, M. R, HAMILTON-DUTOIT, S, OVERGAARD, J
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 02-12-2002
• Subjects: Angiogenesis; Biological and medical sciences; Bladder; Cancer research; Carcinoma, Transitional Cell - blood supply; Carcinoma, Transitional Cell - mortality; Carcinoma, Transitional Cell - pathology; Classification; Cystitis - diagnosis; Cystitis - metabolism; Disease-Free Survival; Endothelial Growth Factors - metabolism; Female; Humans; Immunoenzyme Techniques; Inflammation; Intercellular Signaling Peptides and Proteins - metabolism; Lymphokines - metabolism; Male; Medical prognosis; Medical research; Medical sciences; Metastasis; Microcirculation; Middle Aged; Molecular and Cellular Pathology; Neoplasm Invasiveness; Neoplasm Staging; Neovascularization, Pathologic - metabolism; Neovascularization, Pathologic - pathology; Nephrology. Urinary tract diseases; Oncology; Pathology; Prognosis; Survival Rate; Tumors; Tumors of the urinary system; Urinary Bladder Neoplasms - blood supply; Urinary Bladder Neoplasms - mortality; Urinary Bladder Neoplasms - pathology; Urinary tract. Prostate gland; Urological surgery; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factors; Denmark; Aarhus Denmark; Human; Angiogenesis; Urinary system disease; Prognosis; Urinary bladder; bladder carcinoma; Bladder disease; Inflammation; Malignant tumor; Urinary tract disease; Transitional cell carcinoma; Neovascularization
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6600615

The aim of this study was to investigate the prognostic influence of microvessel density using the hot spot method in 107 patients diagnosed with transitional cell carcinoma of the bladder. In each case, inflammation was found in the invasive carcinoma, therefore we classified the degree of inflammation as minimal, moderate or intense. Microvessel density was then reevaluated in each tumour in areas corresponding to these three categories. Median microvessel density irrespective of degree of inflammation was 71. Areas of minimal, moderate and intense inflammation were found in 48, 92 and 32 tumours. Microvessel density increased significantly with increasing degree of inflammation. Disease-specific survival was improved if areas of intense inflammation were present in the carcinoma (P=0.004). High microvessel density, irrespective of the degree of inflammation, was associated with a significantly better disease-specific survival (P=0.01). Multivariate analysis using death of disease as endpoint demonstrated an independent prognostic value of N-classification (N0, hazard ratio (HR)=1 vs N1, HR=2.89 (range, 1.52-5.52) vs N2, HR=3.61 (range, 1.84-7.08)), and intense inflammation, HR=0.48 (range, 0.24-0.96). Malignancy grade, T classification and microvessel density were not independent significant markers of poor outcome. In conclusion, inflammation was significantly correlated to microvessel density, and areas of intense inflammation were an independent marker of good prognosis.