Prognostic significance of angiogenesis in transitional cell carcinoma of the human urinary bladder

Br J Urol. 1996 Mar;77(3):352-7. doi: 10.1046/j.1464-410x.1996.08475.x.


Objectives: To quantify tumour angiogenesis in bladder cancer and determine whether it correlates with tumour stage, grade and survival.

Patients and methods: Archival samples from a total of 113 patients newly presenting with transitional cell carcinomas of the urinary bladder were graded and staged, and analysed for angiogenic blood vessel density by a double immunohistochemical technique. The findings were correlated with the information obtained during a minimum follow-up of 12 years.

Results: Univariate analysis showed that TNM stage (P = 0.02) and mean vessel count (P = 0.01) were significant predictors of death from bladder cancer. Blood vessel density was significantly correlated with tumour stage (P = 0.01) and the presence of vascular invasion (P = 0.007). Trained observers were essential for the accurate counting of blood vessels to prevent excessive inter-observer variability. Multiple regression analysis showed that the combination of mean vessel count and stage was a significant prognostic indicator.

Conclusion: Angiogenesis in primary bladder cancer is a predictor of death from the disease. Further work to determine whether it predicts invasion and recurrences in superficial tumours may be valuable.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Transitional Cell / blood supply*
  • Carcinoma, Transitional Cell / mortality
  • Carcinoma, Transitional Cell / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Neovascularization, Pathologic
  • Observer Variation
  • Prognosis
  • Regression Analysis
  • Survival Analysis
  • Urinary Bladder Neoplasms / blood supply*
  • Urinary Bladder Neoplasms / mortality
  • Urinary Bladder Neoplasms / pathology