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Profils moléculaires prédictifs du potentiel métastatique du carcinome urothélial de la vessie de stade pT1 ou supérieur

Abstract : Introduction: Recent data from genomic analysis of bladder tumors have identified subgroups with different aggressiveness patterns and chemotherapy response profiles. The aim of our study was to identify molecular markers that can be used in clinical practice, to predict the evolution of these tumors in order to personalize their management.Materials and Methods: DNAs extracted from 54 solid tumors and 50 urine samples from patients with bladder cancer were hybridized on the BCA-oligo CGH (Comparative Genome Hybridization) chip. TMAs (Tissue Micro Array) from 140 paraffine-embedded tissues of primary and metastatic tumors, were analyzed in immunohistochemistry with antibodies directed against proteins involved in DNA stability, cell proliferation and the definition of basal or luminal subgroup. Correlations with clinical data were sought at all levels of analysis.Results: The number of chromosomal alterations increased significantly with the tumor stage. In addition, the distribution of these alterations was consistent between the DNAs extracted from tumor tissue and those from urinary samples. If no immunohistochemical marker differentiated between metastatic and non-metastatic patients, similar labeling patterns were observed between primary tumors and metastases. Notably, the presence of lymphatic emboli was predictive of metastatic status.Conclusion: The use in clinical practice of the BCA-oligo chip to predict a progression of a bladder tumor to a higher stage or grade may be considered. This analysis is feasible on urine sample. The systematic search for lymphatic emboli on primary tumors can be used in clinical practice to predict a metastatic evolution.
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Luca Lunelli. Profils moléculaires prédictifs du potentiel métastatique du carcinome urothélial de la vessie de stade pT1 ou supérieur. Cancer. Université Pierre et Marie Curie - Paris VI; Università degli studi (Milan, Italie), 2017. Français. ⟨NNT : 2017PA066470⟩. ⟨tel-01795121⟩

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