Life and Health Sciences Research Institute - ICVS, School of Health Sciences, University of Minho, Braga, Portugal.
Eur J Surg Oncol. 2011 Sep;37(9):811-7. doi: 10.1016/j.ejso.2011.06.006. Epub 2011 Jul 5.
Urothelial bladder carcinoma (UBC) is a chemo-sensitive tumour, but the response to treatment is heterogeneous. CD147 has been associated with chemotherapy resistance. We aimed to define tumours with an aggressive phenotype by the combined analysis of clinicopathological and biological parameters.
77 patients with T1G3 or muscle-invasive UBC treated by radical cystectomy were studied. Immunohistochemistry was performed to detect CD147, heparanase, CD31 (blood vessels identification) and D2-40 (lymphatic vessels identification) expressions. The immunohistochemical reactions were correlated with the clinicopathological and the outcome parameters. 5-year disease-free survival (DFS) and overall survival (OS) rates were estimated using the Kaplan-Meier method. Multivariate analysis was performed by Cox proportional hazards analysis.
The 5-year DFS and OS rates were significantly influenced by the classical clinicopathological parameters, and by the occurrence of lymphovascular invasion. CD147 and heparanase immunoexpression did not affect patients' outcome. However, patients with pT3/pT4 tumours had a median OS time of 14.7 months (95% CI 7.1-22.3, p = 0.003), which was reduced to 9.2 months (95% CI 1.5-17.0, p = 0.008) if the tumours were CD147 positive. We developed a model of tumour aggressiveness using parameters as stage, grade, lymphovascular invasion and CD147 immunoexpression, which separated a low aggressiveness from a high aggressiveness group, remaining as an independent prognostic factor of DFS (HR 3.746; 95% CI 1.244-11.285; p = 0.019) and OS (HR 3.247; 95% CI 1.015-10.388, p = 0.047).
CD147 overexpression, included in a model of UBC aggressiveness, may help surgeons to identify patients who could benefit from a personalized therapeutic regimen. Additional validation is needed.
尿路上皮膀胱癌（UBC）是一种对化疗敏感的肿瘤，但治疗反应存在异质性。CD147 与化疗耐药有关。我们旨在通过联合分析临床病理和生物学参数来定义具有侵袭性表型的肿瘤。
研究了 77 例接受根治性膀胱切除术治疗的 T1G3 或肌层浸润性 UBC 患者。进行免疫组织化学检测以检测 CD147、肝素酶、CD31（血管鉴定）和 D2-40（淋巴管鉴定）的表达。免疫组织化学反应与临床病理和结果参数相关。使用 Kaplan-Meier 方法估计 5 年无病生存率（DFS）和总生存率（OS）。通过 Cox 比例风险分析进行多变量分析。
5 年 DFS 和 OS 率受经典临床病理参数和淋巴血管侵犯的显著影响。CD147 和肝素酶免疫表达不影响患者的预后。然而，pT3/pT4 肿瘤患者的中位 OS 时间为 14.7 个月（95%CI 7.1-22.3，p=0.003），如果肿瘤呈 CD147 阳性，则 OS 时间缩短至 9.2 个月（95%CI 1.5-17.0，p=0.008）。我们使用参数（包括分期、分级、淋巴血管侵犯和 CD147 免疫表达）建立了肿瘤侵袭性模型，该模型将低侵袭性与高侵袭性组分开，仍然是 DFS（HR 3.746；95%CI 1.244-11.285；p=0.019）和 OS（HR 3.247；95%CI 1.015-10.388，p=0.047）的独立预后因素。
CD147 过表达，包含在 UBC 侵袭性模型中，可能有助于外科医生识别可能受益于个体化治疗方案的患者。需要进一步验证。
