PROGNOSIS OF INTRAVESICAL BACILLUS CALMETTE-GUERIN THERAPY FOR SUPERFICIAL BLADDER CANCER BY IMMUNOLOGICAL URINARY MEASUREMENTS: STATISTICALLY WEIGHTED SYNDROMES ANALYSIS

Abstract

No AccessJournal of UrologyInvestigative Urology1 Mar 1998PROGNOSIS OF INTRAVESICAL BACILLUS CALMETTE-GUERIN THERAPY FOR SUPERFICIAL BLADDER CANCER BY IMMUNOLOGICAL URINARY MEASUREMENTS: STATISTICALLY WEIGHTED SYNDROMES ANALYSIS A.M. JACKSON, A.V. IVSHINA, O. SENKO, A. KUZNETSOVA, A. SUNDAN, M.A. O'DONNELL, S. CLINTON, A.B. ALEXANDROFF, P.J. SELBY, K. JAMES, and V.A. KUZNETSOV A.M. JACKSONA.M. JACKSON , A.V. IVSHINAA.V. IVSHINA , O. SENKOO. SENKO , A. KUZNETSOVAA. KUZNETSOVA , A. SUNDANA. SUNDAN , M.A. O'DONNELLM.A. O'DONNELL , S. CLINTONS. CLINTON , A.B. ALEXANDROFFA.B. ALEXANDROFF , P.J. SELBYP.J. SELBY , K. JAMESK. JAMES , and V.A. KUZNETSOVV.A. KUZNETSOV View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63835-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The goal of this research was to discover new biological indicators in urine which could be used for short-term prognosis of local Bacillus Calmette-Guerin (BCG) therapy outcome in patients with superficial bladder cancer. Patients and Methods: We measured and statistically evaluated soluble immunological molecules in urine from bladder cancer patients (n = 34) receiving BCG intravesically. Urine was collected following each of 6 weekly treatments, processed and assayed. The data base included measurements of interleukin-1 (IL-1), IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, soluble intercellular adhesion molecule-1 (sICAM-1), tumour necrosis factor-alpha (TNF alpha), soluble CD14 (sCD14), interferon-gamma (IFN gamma), GM-CSF, volume of urine and its pH. The clinical response was evaluated by urine histology and random quadrant biopsy 3 months after the start of therapy. Patients were divided into 2 groups, with good and poor therapeutic effect. The initial complete response rate was 62% (21/34). The data base was analyzed using traditional multivariate statistical methods and a pattern recognition method which deals with combinatorial-statistical analysis (statistically weighted syndromes (SWS) method) of the gradated features. The SWS method is capable of identifying robust patterns in small "fuzzy" sets with high dimensional objects and some missing values. Results: Only one parameter gave significant differences at p <0.05, GM-CSF at instillation 6. Repeated measurement analysis of variance, backward stepwise multiple logistic regression and linear discriminant analysis failed to show any significance. However, significant differences in the structure of correlation between features in the groups with and without therapeutic effect were observed and four highly informative variables (the masses of sICAM-1, TNF alpha, sCD14 and pH) relating to 5th–6thinstallations were selected by SWS. These features provided accurate individual prediction of therapeutic outcome for all our patients. Cross-validation analysis and computer simulation showed the statistically significant stability of the prediction. Conclusion: We have selected a set of urinary variables that could be considered as a perspective combination of indicators (syndromes) of outcome of pre-operation BCG therapy of patients with superficial bladder cancer. A larger patient database will provide testing and evaluation of the biological and clinical significance of selected features. The computational syndrome-disease approach should be applicable for the solution of decision-making problems for management of cancer. 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Google Scholar From the ICRF Cancer Medicine Research Unit, University of Leeds, and the Department of Surgery, University of Edinburgh, United Kingdom; the Institute of BioChemical Physics, Moscow, Russia; the Frederick Cancer and Development Center, National Cancer Institute, Frederick, and the Center for Biologics Evaluation and Research, FDA, Bethesda, Maryland; the Computer Center of the Russian Academy of Sciences, Moscow, Russia; the Institute for Cancer Research, University of Trondheim, Norway; and the Department of Urologic Surgery, Beth-Israel Hospital, and the Dana-Farber Cancer Institute, Boston, Massachusetts.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byTakayama H, Nishimura K, Tsujimura A, Nakai Y, Nakayama M, Aozasa K, Okuyama A and Nonomura N (2009) Increased Infiltration of Tumor Associated Macrophages is Associated With Poor Prognosis of Bladder Carcinoma In Situ After Intravesical Bacillus Calmette-Guerin InstillationJournal of Urology, VOL. 181, NO. 4, (1894-1900), Online publication date: 1-Apr-2009.BÖHLE A and BRANDAU S (2018) Immune Mechanisms in Bacillus Calmette-Guerin Immunotherapy for Superficial Bladder CancerJournal of Urology, VOL. 170, NO. 3, (964-969), Online publication date: 1-Sep-2003.KUMAR A, DUBEY D, BANSAL P, MANDHANI A and NAIK S (2018) Urinary Interleukin-8 Predicts the Response of Standard and Low Dose Intravesical Bacillus Calmette-Guerin (Modified Danish 1331 Strain) for Superficial Bladder CancerJournal of Urology, VOL. 168, NO. 5, (2232-2235), Online publication date: 1-Nov-2002.SAINT F, PATARD J, MAILLE P, SOYEUX P, HOZNEK A, SALOMON L, ABBOU C and CHOPIN D (2018) PROGNOSTIC VALUE OF A T HELPER 1 URINARY CYTOKINE RESPONSE AFTER INTRAVESICAL BACILLUS CALMETTE-GUERIN TREATMENT FOR SUPERFICIAL BLADDER CANCERJournal of Urology, VOL. 167, NO. 1, (364-367), Online publication date: 1-Jan-2002.SAINT F, PATARD J, MAILLE P, SOYEUX P, HOZNEK A, SALOMON L, DE LA TAILLE A, ABBOU C and CHOPIN D (2018) T HELPER 1/2 LYMPHOCYTE URINARY CYTOKINE PROFILES IN RESPONDING AND NONRESPONDING PATIENTS AFTER 1 AND 2 COURSES OF BACILLUS CALMETTE-GUERIN FOR SUPERFICIAL BLADDER CANCERJournal of Urology, VOL. 166, NO. 6, (2142-2147), Online publication date: 1-Dec-2001.THALMANN G, SERMIER A, RENTSCH C, MÖHRLE K, CECCHINI M and STUDER U (2018) URINARY INTERLEUKIN-8 AND 18 PREDICT THE RESPONSE OF SUPERFICIAL BLADDER CANCER TO INTRAVESICAL THERAPY WITH BACILLUS CALMETTE-GUERINJournal of Urology, VOL. 164, NO. 6, (2129-2133), Online publication date: 1-Dec-2000. Volume 159Issue 3March 1998Page: 1054-1063 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information A.M. JACKSON More articles by this author A.V. IVSHINA More articles by this author O. SENKO More articles by this author A. KUZNETSOVA More articles by this author A. SUNDAN More articles by this author M.A. O'DONNELL More articles by this author S. CLINTON More articles by this author A.B. ALEXANDROFF More articles by this author P.J. SELBY More articles by this author K. JAMES More articles by this author V.A. KUZNETSOV More articles by this author Expand All Advertisement PDF downloadLoading ...