THE DISTRIBUTION OF ARGENTOPHILIC NUCLEOLAR PROTEINS IN URINARY SEDIMENT AND PROGNOSIS OF PATIENTS WITH SUPERFICIAL CANCER OF THE URINARY BLADDER

THE AIM of the investigation was to study the distribution of nucleoli and argentophilic nucleolar organizers in the superficial transitional cell tumors of the bladder and to analyze the correlation of the obtained indices with recurrences of cancer and survival of the patients after surgical treatment. PATIENTS AND METHODS. The data of primary examination and dispensary observation were retrospectively studied in 22 patients with superficial transitional cell cancer of the bladder in whom transurethral resections (TUR) of the tumors were fulfilled. In addition to standard examination the sediment of urine taken before TUR was stained with 50% solution of AgNO3 , identified and the tumor cell nuclei were counted. The numbers of nucleoli were determined in the nuclei and the argentophilic granules in them were counted. The indices of the distribution of the signs studied were compared with the results of a histochemical investigation of the ablated tumor tissue as well as with the clinical findings obtained before operations and during the postoperative dispensary follow-up. RESULTS. The number of cell nuclei in the preparation proved to be associated with the number of nucleoli (p<0.001), and the argentophilic granules (p=0.001), the number of nucleoli - with the number of granules (p<0.001). Neither the number of nucleoli, nor the argentophilic granules were associated with the depth of invasion and degree of the cancer differentiation (p>0.1). Higher indices of the 5 year survival were noted in patients with less number of the argentophilic granules in the nucleoli (p=0.007), nuclei (p=0.023) and content of nucleoli in cell nuclei (p=0.062). Recurrence of cancer was observed more often in patients with great number of nuclei (p=0.057) and nucleoli (p=0.081). A short period without recurrences corresponded to a great number of the argentophilic granules (p=0.078) and more saturation with them in nucleoli (p=0.074). CONCLUSION. Investigation of the urine sediment using the method of silver impregnation provides additional information of belonging of patients with superficial transitional cell cancer of the bladder to groups of risk of recurrences and progression.

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