Jeong Pildu, Ha Yun-Sok, Cho In-Chang, Yun Seok-Joong, Yoo Eun Sang, Kim Isaac Yi, Choi Yung Hyun, Moon Sung-Kwon, Kim Wun-Jae
Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Chungbuk.
Oncol Lett. 2011 Jul;2(4):679-684. doi: 10.3892/ol.2011.309. Epub 2011 May 13.
The clinical grades and staging methods currently employed for bladder cancer (BC) are inadequate for assessing treatment outcomes for non-muscle invasive bladder cancer (NMIBC). We have developed a clinically applicable quantitative real-time PCR (qPCR) gene signature to predict the progression of NMIBC. Three genes not previously described for BC were selected from our published progression-related gene classifier data set. Data were drawn from a previous study population and from new cases. Primary NMIBC tissue specimens (n=193) were analyzed by qPCR. Risk scores were then used to rank specimens into high- and low-risk signature groups based on their gene expression. The Kaplan-Meier method and a multivariate Cox regression model were used to identify the prognostic value of the three-gene signature for both recurrence and progression. The Kaplan-Meier estimates revealed significant differences in time-to-recurrence and progression between low- and high-risk signatures (log-rank test, p=0.011 and p<0.001, respectively). The multivariate Cox regression analysis showed that the three-gene risk signature is an independent predictor of bladder tumor progression (hazard ratio, 4.268; 95% CI, 1.542-11.814; p=0.005). In conclusion, our three-gene signature was found to be closely associated with progression among patients with NMIBC.
目前用于膀胱癌（BC）的临床分级和分期方法不足以评估非肌肉浸润性膀胱癌（NMIBC）的治疗效果。我们开发了一种临床适用的定量实时PCR（qPCR）基因特征来预测NMIBC的进展。从我们已发表的与进展相关的基因分类数据集里挑选出三个此前未被描述用于膀胱癌的基因。数据取自先前的研究人群和新病例。通过qPCR分析原发性NMIBC组织标本（n = 193）。然后根据基因表达情况使用风险评分将标本分为高风险和低风险特征组。采用Kaplan-Meier方法和多变量Cox回归模型来确定三基因特征对复发和进展的预后价值。Kaplan-Meier估计显示低风险和高风险特征在复发时间和进展时间上存在显著差异（对数秩检验，分别为p = 0.011和p < 0.001）。多变量Cox回归分析表明，三基因风险特征是膀胱肿瘤进展的独立预测因子（风险比，4.268；95%可信区间，1.542 - 11.814；p = 0.005）。总之，我们发现三基因特征与NMIBC患者的病情进展密切相关。
