Vol. 9, No 1, 2002 pp. 98 - 103
UC 616.61-004 616.613-006 616.617-006
UPPER UROTHELIAL CARCINOMAS ASSOCIATED
WITH BALKAN ENDEMIC NEPHROPATHY AND THEIR SIMILARITIES WITH UPPER UROTHELIAL
CARCINOMAS IN ANALGESIC NEPHROPATHY
Vladimir Petronic, Marina Savin
Institute of Urology and Nephrology, School of Medicine, University
of Belgrade, Serbia
E-mail: marinas@ybc.co.yu
Summary. The incidence of upper urothelial carcinomas (UUC) is even
more than hundred times higher in the foci of Balkan endemic nephropathy
(BEN), by investigations of our team, and others. Every tenth patient suffers
from both diseases. Etiology is unknown. It would seem that BEN is a tubulointerstitial
nephritis associated with urothelial malignancy. We found that apoptosis
plays an important role in the early phase of BEN, similarly as in other
toxic nephropathies. Petronic shows great similarity between Balkan nephropathy
and analgesic nephropathy, as well as between upper urothelial carcinomas
associated with both diseases. Based on investigation of grade to stage
ratio in 100 tumors from our series of UUC, the upper urothelial carcinomas
from BEN areas are characterized by slow growth of tumor mass in comparison
to the same carcinomas outside BEN regions in former Yugoslavia and the
evaluated cut-off point % cErb-B2+ cells for aggressive tumors of grade
3 or stage 2 is slightly greater for the UUC in the general population.
Smaller cell population in proliferation in the UUC from BEN regions than
what is detected in the UUC outside these regions may explain BEN tumor
resistance to putative toxic agent effect during tumor progression in grade
2, although the same toxin has probably realized tumor induction. It would
seem that the cErb-B2 (a receptor for EGF) is differently involved in the
control of a cell cycle proliferation in urothelial tumor associated with
BEN.
Key words: Upper urothelial carcinomas, Balkan endemic nephropathy,
analgesic nephropathy, cErb-B2
