Liu Yidong, Liu Zheng, Fu Qiang, Wang Zewei, Fu Hangcheng, Liu Weisi, Wang Yiwei, Xu Jiejie
Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China.
Department of Urology, Ninth People׳s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Urol Oncol. 2017 Jun;35(6):349-355. doi: 10.1016/j.urolonc.2017.02.008. Epub 2017 Mar 24.
Galectin-9, a member of the "tandem repeat" type galectins performing as animal lectins with an affinity for β-galactosides, has been well documented to exert crucial functions in immunomodulation, survival, and growth of various tumors. This study aims to reveal the clinical significance of galectin-9 in urothelial carcinoma of the bladder (UCB) postoperatively.
We retrospectively included 202 patients with UCB who underwent radical cystectomy at a single institute from 2002 to 2014. Galectin-9 expression was assessed by immunohistochemistry on tissue microarrays. The Kaplan-Meier method was conducted to plot survival curves. Prognostic nomograms were constructed via integrating all the independent indicators from multivariate Cox analysis for recurrence-free survival (RFS) and cancer-specific survival (CSS). In addition, we evaluate whether patients with increased or decreased galectin-9 expression might benefit from adjuvant chemotherapy.
Low galectin-9 expression was significantly correlated with lymphovascular invasion (P = 0.002), early recurrence (P = 0.010), and short CSS (P = 0.002). Furthermore, multivariate analysis identified galectin-9 expression as a potential independent indicator for RFS (hazard ratio = 0.62; 95% CI: 0.40-0.95; P = 0.030) and CSS (hazard ratio = 0.46; 95% CI: 0.26-0.81; P = 0.008). Moreover, the benefit associated with adjuvant chemotherapy was superior among galectin-9 low patients than among galectin-9 high patients (P = 0.014).
Expression of galectin-9 is an independent prognostic factor for RFS and CSS in patients with UCB. Evaluation of galectin-9 expression may predict the benefit from adjuvant chemotherapy.
半乳糖凝集素-9是“串联重复”型半乳糖凝集素家族成员，作为一种对β-半乳糖苷具有亲和力的动物凝集素，已被充分证明在多种肿瘤的免疫调节、存活及生长过程中发挥关键作用。本研究旨在揭示半乳糖凝集素-9在膀胱尿路上皮癌（UCB）术后的临床意义。
我们回顾性纳入了2002年至2014年间在单一机构接受根治性膀胱切除术的202例UCB患者。通过组织微阵列上的免疫组织化学法评估半乳糖凝集素-9的表达。采用Kaplan-Meier法绘制生存曲线。通过整合多因素Cox分析中无复发生存期（RFS）和癌症特异性生存期（CSS）的所有独立指标构建预后列线图。此外，我们评估半乳糖凝集素-9表达升高或降低的患者是否可能从辅助化疗中获益。
半乳糖凝集素-9低表达与淋巴管侵犯（P = 0.002）、早期复发（P = 0.010）及较短的CSS（P = 0.002）显著相关。此外，多因素分析确定半乳糖凝集素-9表达是RFS（风险比=0.62；95%CI：0.40 - 0.95；P = 0.030）和CSS（风险比=0.46；95%CI：0.26 - 0.81；P = 0.008）的潜在独立指标。此外，半乳糖凝集素-9低表达患者从辅助化疗中获得的益处优于半乳糖凝集素-9高表达患者（P = 0.014）。
半乳糖凝集素-9的表达是UCB患者RFS和CSS的独立预后因素。评估半乳糖凝集素-9表达可能预测辅助化疗的获益情况。
