Dr. Suryalakshmi. S, Dr. Saravanan. B


Introduction: Bladder carcinoma is a neoplasm arising from the lining transitional epithelium. More than 90% of bladder cancer cases are urothelial (transitional cell) carcinomas. Out of various prognostic factors, grade and stage are important. The non-muscle-invasive disease in spite of lower stage has a high recurrence of about 50–70% of the patients. Thus additional Prognostic factors play a role in determining the recurrence. Microvessel density is one such factor which is associated with recurrence. In this study, microvessel density is calculated using CD 34 and compared with standard clinicopathological variables.

Materials and Methods: This study is an observational study of randomly selected 50 cases of Transitional cell carcinomas of urinary bladder that were submitted for histopathological evaluation during the period of 2 years in our institution. The slides were reviewed from the archive and histopathological parameters assessed. Immunohistochemical analysis was done with CD 34 and microvessel density (MVD) was calculated by counting the hot spots in 200X power. The results were compared with clinicopathological parameters.

Results: The mean MVD values showed statistically significant increase in male gender and non-papillary tumours. The increase shows no statistical significance in multiple tumours, high grade and in recurrent tumours. The mean MVD values showed a decrease with increasing stage, size and infiltration and this association was statistically insignificant.

Conclusion: Though MVD values were reducing with stage, patients with high microvessel density (>50) presented with recurrence. Thus evaluating microvessel density can be an adjuvant factor in determining the prognosis of the patients.


Transitional cell carcinoma, urinary bladder, CD 34, Microvessel density

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Richters,A., Aben,K.K.M & Kiemeney,L.A.L.M. The Global burden of urinary bladder cancer; an update. World J Urol (2019).

India –Global cancer Observatory.>populations

Kirkali Z, Chan T, Manoharan M et al. Bladder cancer: epidemiology, staging and grading, and diagnosis. Urology 2005; 66, 4–34.

Lopez-Beltran A et al. Non-invasive urothelial neoplasm: according to the most recent WHO classification. Eur Urol 2004; 46:170-6.

Cheng L, Pan CX, Yang XJ et al. Small cell carcinoma of the urinary bladder: a clinicopathologic analysis of 64 patients. Cancer 2004; 101: 957–62.

Jemal A, Siegel R, Ward E et al. Cancer statistics, 2007. CA Cancer J Clin 2006; 57; 43-66.

Dae sung cho et al. Prognostic Factors in Transitional Cell Carcinoma of the Upper Urinary Tract after Radical Nephroureterectomy. Korean J Urol. 2011 May; 52(5): 310–316.

Cheng L, Neumann RM et al: Tumor size predicts the survival of patients with pathologic stage T2 bladder carcinoma: A critical evaluation of the depth of muscle invasion. Cancer 1999; 85:2638-2647.

Pagano F GA, Milani C, B assi P et al. Prognosis of bladder cancer I. Risk factors in superficial transitional cell carcinoma. Eur Urol 1987; 13: 145–9.

Skinner DG: Current perspectives in the management of high-grade invasive bladder cancer. Cancer 1980; 45:1866-1874.

Jordan AM, Weingarten J, Murphy WM: Transitional cell neoplasm of the urinary bladder. Can biologic potential be predicted from histologic grading? Cancer 1987; 60:2766-2774.

Heney NM, Ahmed S, Flanagan MJ et al. National Bladder Cancer Collaborative Group A: Superficial bladder cancer. Progression and recurrence. J Urol 1983; 130:1083-1086

Stephenson WT, Holmes FF, Noble MJ, Gerald KB: Analysis of bladder carcinoma by subsite. Cystoscopic location may have prognostic value. Cancer 1990; 66:1630-1635.

Afonso J, Santos LL, Amaro T, Lobo F, Longatto-Filho A: The aggressiveness of urothelial carcinoma depends to a large extent on lymphovascular invasion – the prognostic contribution of related molecular markers. Histopathology 2009; 55:514-524.

A study of prognostic factors of transitional cell carcinomas of urinary bladder, Dr.Suryalakshmi s, Prof. Sudha Venkatesh, International Journal of Scientific Research : volume-8 | issue-3 | march-2019

Shruthi Hosur puttappa et al.utiity of CK 20 and Microvascular density in diagnosis and prognosis. Indian journal of Pathology and Oncology.2017;4(1):85-91.

Comperat EM,et al. Grading of Urothelial carcinoma and The New “World health organization Classification of the urinary system and Male genital Organs 2016”.Eur Urol Focus (2018),

Zynger D.Pathologic TNM Staging of bladder, AJCC 8TH edition. Pathology .website. staging.

Khaled El Gehani et al. Angiogenesis in urinary bladder carcinoma as defined by microvessel density (MVD) after immunohistochemical staining for Factor VIII and CD31. Libyan J Med 2011, 6: 6016.

Canoglu A,Gogus C,Beduk Y,Orhan D,Tulunay Oand Baltaci S. Microvessel density as a prognostic marker in bladder carcinoma: correlation with tumor grade, stage and prognosis. Internal urology and nephrology 2004;36(3):401-405.

Eun Yong Choi et al. Microvessel density and its utility by CD 34 staining in bladder transitional cell carcinomas. Korean Journal of Urology 1999;40:1445-8.

E.A. Philp et al. Prognostic significance of angiogenesis in transitional cell carcinoma of the human urinary bladder. British Journal of Urology (1996), 77. 352–357.

C.K. Hawke et al. Microvessel density as a prognostic marker for transitional cell carcinoma of the bladder. British Journal of Urology (1998), 81, 585–590.

Jonathan C. Goddard et al. Microvessel Density at Presentation Predicts Subsequent Muscle Invasion in Superficial Bladder Cancer. Clin Cancer Res 2003;9:2583-2586.

N. E. Stavropoulos et al. Prognostic significance of angiogenesis in superficial bladder cancer. International Urology and Nephrology 2004;36: 163–167.

L. Santos et al. Neovascularisation is a prognostic factor of early recurrence in T1/G2 urothelial bladder tumours. Annals of Oncology 2003 14: 1419–1424.


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