Agerbaek Mads, Alsner Jan, Marcussen Niels, Lundbeck Finn, Von der Maase Hans
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Eur Urol. 2006 Oct;50(4):777-85. doi: 10.1016/j.eururo.2006.02.027. Epub 2006 Mar 9.
The prognosis of patients with apparently localized, operable, muscle-invasive bladder cancer depends to a large extent on the presence or absence of subclinical, microscopic distant metastases at the time of surgery. Expression of the S100A4 protein has been shown to correlate with the risk of metastasis in both animal tumour-model systems and clinical investigations in other tumour types. The purpose of the present study was to investigate the prognostic potential of S100A4 protein expression for predicting distant metastatic relapse in muscle-invasive bladder cancer.
We analyzed 108 consecutive patients, treated for transitional cell bladder cancer with preoperative radiotherapy and cystectomy. Pretherapeutic biopsies of the bladder tumours were investigated for immunohistochemical expression of S100A4 protein and results, along with clinical and histopathological data, compared with the pattern of relapses over a 10+ yr follow-up period.
Focal S100A4 protein expression emerged as the only significant independent predictor of distant metastatic relapse and distant metastasis-free survival in multivariate analysis.
There is a potential role for this marker in denoting patients with high or low risk of distant relapse independent of clinical stage and grade.
明显局限、可手术切除的肌层浸润性膀胱癌患者的预后在很大程度上取决于手术时是否存在亚临床微小远处转移。在动物肿瘤模型系统和其他肿瘤类型的临床研究中，S100A4蛋白的表达均已显示与转移风险相关。本研究的目的是探讨S100A4蛋白表达对预测肌层浸润性膀胱癌远处转移复发的预后价值。
我们分析了108例连续接受术前放疗和膀胱切除术治疗的移行细胞膀胱癌患者。对膀胱肿瘤的治疗前活检组织进行S100A4蛋白免疫组化表达检测，并将结果与临床和组织病理学数据一起，与10多年随访期内的复发模式进行比较。
在多变量分析中，局灶性S100A4蛋白表达是远处转移复发和无远处转移生存的唯一显著独立预测因素。
该标志物在区分远处复发风险高低的患者中具有潜在作用，且独立于临床分期和分级。
