Department of Urology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China.
Mol Diagn Ther. 2012 Oct;16(5):311-6. doi: 10.1007/s40291-012-0005-4.
Previous studies have suggested that the plasma level of osteopontin may be a biomarker for cancer metastases and clinical prognosis; however, its role in bladder urothelial carcinoma (BUC) remains unknown. The purpose of this study was to explore the significance of plasma osteopontin levels in evaluating the pathologic features of BUC and its potential as a prognostic marker in BUC patients.
A total of 225 patients with BUC were enrolled in this study, and 230 age-matched and sex-matched healthy volunteers were enrolled as control subjects. The histologic classification of BUC, clinical stage of the disease, and plasma osteopontin levels were determined at admission. Patients with non-muscle-invasive BUC underwent transurethral resection, while those with muscle-invasive BUC underwent radical cystectomy. Patients receiving transurethral resection and radical cystectomy were followed up to determine their tumor-free interval and overall survival, respectively.
The mean plasma osteopontin levels were significantly higher in BUC patients than in controls, significantly higher in patients with high-grade BUC than in those with low-grade BUC, and significantly higher in patients with muscle-invasive BUC than in those with non-muscle-invasive BUC. Patients with bladder-confined disease had the lowest osteopontin levels, while those with lymph node-positive disease had higher osteopontin levels, and those with metastatic BUC had the highest osteopontin expression. Kaplan-Meier analyses showed that a higher plasma osteopontin level was associated with a lower overall survival rate in muscle-invasive BUC patients receiving radical cystectomy.
Our results show that the plasma osteopontin level is associated with the clinical features of BUC and predicts the prognosis of muscle-invasive BUC in patients receiving radical cystectomy.
既往研究表明，血浆骨桥蛋白水平可能是癌症转移和临床预后的生物标志物；然而，其在膀胱尿路上皮癌（BUC）中的作用尚不清楚。本研究旨在探讨血浆骨桥蛋白水平在评估 BUC 病理特征中的意义及其作为 BUC 患者预后标志物的潜力。
本研究共纳入 225 例 BUC 患者，同时纳入 230 例年龄和性别匹配的健康志愿者作为对照组。入院时确定 BUC 的组织学分类、疾病临床分期和血浆骨桥蛋白水平。非肌层浸润性 BUC 患者行经尿道切除术，肌层浸润性 BUC 患者行根治性膀胱切除术。接受经尿道切除术和根治性膀胱切除术的患者分别随访以确定其无瘤间期和总生存期。
BUC 患者的平均血浆骨桥蛋白水平显著高于对照组，高级别 BUC 患者显著高于低级别 BUC 患者，肌层浸润性 BUC 患者显著高于非肌层浸润性 BUC 患者。膀胱局限型疾病患者的骨桥蛋白水平最低，淋巴结阳性疾病患者的骨桥蛋白水平较高，转移性 BUC 患者的骨桥蛋白表达水平最高。Kaplan-Meier 分析显示，在接受根治性膀胱切除术的肌层浸润性 BUC 患者中，较高的血浆骨桥蛋白水平与较低的总生存率相关。
我们的研究结果表明，血浆骨桥蛋白水平与 BUC 的临床特征相关，并可预测接受根治性膀胱切除术的肌层浸润性 BUC 患者的预后。
