Positive urinary cytology in patients with lung cancer in the absence of obvious urine tract metastases (Journal article)

Voulgaris, E./ Pentheroudakis, G./ Pappa, L./ Bafa, M./ Goussia, A./ Dalezis, P./ Tsombanidou, C./ Geromichalos, G./ Papageorgiou, A./ Koutsilieris, M./ Malamou-Mitsi, V./ Pavlidis, N.


PURPOSE: To study the phenomenon of positive urine cytology in patients with lung cancer in the absence of obvious urothelial metastases. PATIENTS AND METHODS: 150 patients with small (SCLC) and non-small cell lung cancer (NSCLC) of all stages and 3 control groups were prospectively studied. Immunocytochemical study (cytokeratins 7-20, TTF1) in all positive urine specimens and chemokine profile (CXCR4, CCL21) study of the primary tumor in selected positive patients was performed. In experimental study, C57Bl/6 BALB/C mice injected with LLC lung and 4T1 mammary cancer cells were used for the detection of positive urine cytology. RESULTS: 11% of patients with NSCLC, 7% of patients with SCLC and none of the control group had positive urine cytology. In NSCLC, metastatic disease and high tumor burden positively correlated (p=0.01 and 0.03 respectively) with the phenomenon. In SCLC, correlation with extensive disease and multiple metastatic sites (p=0.02 and 0.04 respectively) was found. No correlation was found in either group with: age, gender, histology, performance status, line of chemotherapy, previous platinum-based chemotherapy, adrenal metastases, renal function, abnormal urinary sediment, response to chemotherapy and overall survival (p=0.9). Distinctive chemokine expression was identified in positive patients studied and was not observed in negative patients (x2 p=0.008). In the experimental study, only the LLC lung cancer cells were detected in the urine cytology of mice. CONCLUSION: This phenomenon, carrying undefined pathophysiological mechanisms, seems to characterize only patients with metastatic/extensive disease and high tumor burden. Further studies are needed to validate our preliminary chemokine expression results.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Adult,Aged,Aged, 80 and over,Animals,Carcinoma, Lewis Lung/pathology/urine,Carcinoma, Non-Small-Cell Lung/metabolism/mortality/pathology/*urine,Case-Control Studies,Chemokine CCL21/metabolism,Female,Humans,Lung Neoplasms/metabolism/mortality/pathology/*urine,Male,Mammary Neoplasms, Experimental/pathology/urine,Mice,Mice, Inbred BALB C,Mice, Inbred C57BL,Middle Aged,Neoplasm Staging,Neoplasm Transplantation,Receptors, CXCR4/metabolism,Small Cell Lung Carcinoma/metabolism/mortality/pathology/*urine,Transplantation, Heterologous,Urologic Neoplasms/secondary
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/19215
ISSN: 1872-8332
Link: http://www.ncbi.nlm.nih.gov/pubmed/21111510
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