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Impact of immunohistochemistry-based molecular subtype on predicting chemotherapy response and survival in patients with T1 stage bladder cancer after bladder-preserving treatment.

基于免疫组织化学的分子亚型对预测T1期膀胱癌患者保留膀胱治疗后化疗反应和生存的影响。

  • 影响因子:2.04
  • DOI:10.1093/jjco/hyaa219
  • 作者列表:"Lu J","Zhang Y","Wu C","Chu C","Liu Z","Cao Y
  • 发表时间:2021-03-03
Abstract

OBJECTIVE:To explore the immunohistochemistry-based molecular subtypes of bladder cancer, and their impact on the prognosis and the chemotherapy response between gemcitabine plus cisplatin intra-arterial chemotherapy and epirubicin-inducted intravesical chemotherapy, in patients with T1 stage bladder cancer after bladder-preserving treatment. METHODS:One hundred and seventy-six patients with T1 stage bladder cancer were selected for this study. Thirty-three patients underwent radical cystectomy, 43 received gemcitabine plus cisplatin intra-arterial chemotherapy and 100 received intravesical chemotherapy. The markers labeled with luminal (GATA3, Uroplakin II, CK20) and basal (CK5/6, CK14, CD44) phenotypes were chosen as candidate markers. RESULTS:One hundred and seventy-six patients were divided into 76 patients as basal/squamous (BASQ), 45 as the luminal A and 55 as the luminal B. Compared with the luminal B and BASQ tumors, the luminal A tumors showed a trend for better recurrence-free survival (P = 0.105) and progression-free survival (P = 0.093). The combination of CK20 and GATA3 was practical to identify the molecular phenotypes with total 84.9% accuracy and significantly associated with recurrence-free survival (P = 0.025) and progression-free survival (P = 0.004). The patient with BASQ tumors who received intravesical chemotherapy showed a trend for worse progression-free survival than the patient who received gemcitabine plus cisplatin intra-arterial chemotherapy or radical cystectomy. Furthermore, the patients with BASQ tumors experienced a significant improvement in progression-free survival after gemcitabine plus cisplatin intra-arterial chemotherapy compared with the patients who received intravesical chemotherapy (P = 0.011). CONCLUSIONS:The immunohistochemistry-based molecular subtypes could predict the patient's prognosis and clinically different chemotherapeutic survival outcomes in patients with T1 stage bladder cancer after bladder-preserving treatment.

摘要

目的: 探讨以免疫组化为基础的膀胱癌分子亚型,以及吉西他滨联合顺铂动脉内化疗与表柔比星膀胱灌注化疗对T1期膀胱癌患者保留膀胱治疗预后及化疗反应的影响。 方法: 选择T1期膀胱癌患者126例。33例患者接受根治性膀胱切除术,43例接受吉西他滨 + 顺铂动脉内化疗,100例接受膀胱内化疗。选择用luminal (GATA3,Uroplakin II,CK20) 和basal (CK5/6,CK14,CD44) 表型标记的标记作为候选标记。 结果: 126例患者分为基底/鳞状 (BASQ) 76例,管腔A 45例,管腔B 55例。与luminal B和BASQ肿瘤相比,luminal A肿瘤表现出更好的无复发生存期 (P = 0.105) 和无进展生存期 (P = 0.093) 的趋势。CK20和GATA3的组合对于鉴定分子表型是实用的,具有84.9% 的准确性,并且与无复发生存期 (P = 0.025) 和无进展生存期 (P = 0.004) 显著相关。与接受吉西他滨加顺铂动脉内化疗或根治性膀胱切除术的患者相比,接受膀胱内化疗的BASQ肿瘤患者显示出更差的无进展生存期趋势。此外,与接受膀胱内化疗的患者相比,吉西他滨联合顺铂动脉内化疗后,BASQ肿瘤患者的无进展生存期显著改善 (P = 0.011)。 结论: 基于免疫组织化学的分子亚型可以预测T1期膀胱癌患者保留膀胱治疗后的预后和临床不同的化疗生存结局。

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