Department of Urology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China (mainland).
Med Sci Monit. 2018 Jan 23;24:438-447. doi: 10.12659/msm.905393.
BACKGROUND The aim of this study was to investigate the expression of long non-coding RNAs (lncRNA) cancer susceptibility candidate 2a (CASC2a) in patients with urothelial carcinoma of the bladder (UCB) and its predictive value in the recurrence of UCB after radical cystectomy (RC). MATERIAL AND METHODS Tumor and paired adjacent normal tissues were obtained from 112 patients with UCB who underwent RC in our hospital from March 2010 to March 2012. The expression of CASC2a was evaluated by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and fluorescence in situ hybridization (FISH). RESULTS CASC2a was down-regulated in UCB tissues, and was highly negatively correlated with the pT, pN, tumor size, and lymphovascular invasion (LVI). The sensitivities of CASC2a for diagnosing UCB and its recurrence after RC were 89.30% and 81.55%, respectively, and the specificities were 71.43% and 58.21%, respectively. Patients with a high expression of CASC2a had a higher 5-year recurrence-free survival rate than those with low expression of CASC2a. Kaplan-Meier survival analysis demonstrated that the pT, pN, tumor grade, tumor size, concomitant carcinoma in situ (CIS), LVI, soft tissue surgical margin (STSM), and CASC2a expression were related to the recurrence in patients undergoing RC for UCB. Cox proportional hazard model analysis showed that CASC2 expression, pT4, lymph node metastasis, and CIS were independent risk factors. CONCLUSIONS CASC2a was down-regulated in patients with UCB, and was associated with the risk of recurrence among patients undergoing RC, indicating that lncRNAs could act as predictive biomarkers and potential therapeutic targets in bladder cancer, including CASC2a.
本研究旨在探讨长链非编码 RNA（lncRNA）癌症易感性候选基因 2a（CASC2a）在膀胱癌（UCB）患者中的表达及其在根治性膀胱切除术后 UCB 复发中的预测价值。
收集我院 2010 年 3 月至 2012 年 3 月行根治性膀胱切除术的 112 例 UCB 患者的肿瘤及配对癌旁正常组织。采用实时荧光定量逆转录聚合酶链反应（qRT-PCR）和荧光原位杂交（FISH）检测 CASC2a 的表达。
CASC2a 在 UCB 组织中表达下调，与 pT、pN、肿瘤大小及脉管浸润（LVI）高度负相关。CASC2a 诊断 UCB 及其术后复发的灵敏度分别为 89.30%和 81.55%，特异度分别为 71.43%和 58.21%。CASC2a 高表达患者的 5 年无复发生存率高于低表达患者。Kaplan-Meier 生存分析显示，pT、pN、肿瘤分级、肿瘤大小、伴原位癌（CIS）、LVI、软组织手术切缘（STSM）及 CASC2a 表达与行 RC 治疗的 UCB 患者的复发有关。Cox 比例风险模型分析显示，CASC2a 表达、pT4、淋巴结转移及 CIS 是独立的危险因素。
CASC2a 在 UCB 患者中表达下调，与行 RC 治疗的患者的复发风险相关，表明 lncRNA 可作为膀胱癌的预测生物标志物和潜在治疗靶点，包括 CASC2a。
