Department of Urology and Andrology, Tirol Kliniken Landeskrankenhaus Hall, Hall in Tirol, Austria.
Department of Urology and Urologic Oncology, Hannover University Medical School, Hannover, Germany.
Adv Ther. 2018 Nov;35(11):2054-2068. doi: 10.1007/s12325-018-0789-7. Epub 2018 Sep 19.
There is an urgent need to identify patients with bladder cancer (BC) who are at high risk of recurrence or progression. Calgranulin A is a strong marker for muscle-invasive or advanced BC and recent studies have shown its potential for identifying patients at risk even in non-muscle-invasive bladder cancer (NMIBC). The present study examines risks of recurrence and progression dependent on immunostaining with calgranulin A in NMIBC.
Calgranulin A protein expression was evaluated through the immunohistochemistry of 158 randomly selected, transurethrally resected BC specimens of separate patients (pTa 89, pT1 69) using tissue microarrays. Kaplan-Meier survival analysis and Cox regression were performed to determine whether calgranulin A expression is associated with recurrence-free survival (RFS), progression-free survival (PFS), or cancer-specific survival (CSS).
Calgranulin A expression is significantly different between pTa and pT1 tumors (p = 0.000, Mann-Whitney U test) and between tumor grades (p = 0.015, Kruskal-Wallis test). Kaplan-Meier estimates produced significant results for low and high calgranulin A expression concerning RFS [5y-RFS 70.4 ± 4.0% vs. 35.9 ± 12.5%, median RFS not reached (NR) vs. 12.0 ± 4.4 month, p = 0.029, log-rank test], PFS (5y-PFS 90.3 ± 2.7% vs. 51.5 ± 14.0%, median PFS NR in both groups, p = 0.000, log-rank test), and CSS (5y-CSS 92.9 ± 2.6% vs. 70.7 ± 12.4%, median CSS NR in both groups, p = 0.005, log-rank test). Calgranulin A remained an independent factor for RFS (p = 0.024, HR 2.43) and PFS (p = 0.002, HR 5.92) according to the multivariate Cox regression model.
Calgranulin A expression in NMIBC, detected through immunohistochemistry, is a promising marker for the identification of NMIBC patients at high risk of recurrence and progression.
迫切需要识别膀胱癌(BC)患者,这些患者具有高复发或进展的风险。钙粒蛋白 A 是肌层浸润性或晚期 BC 的强标志物,最近的研究表明,即使在非肌层浸润性膀胱癌(NMIBC)中,它也具有识别高危患者的潜力。本研究通过免疫组织化学检查 158 例随机选择的经尿道切除的 BC 标本(分别为 pTa89、pT169)来评估钙粒蛋白 A 在 NMIBC 中的复发和进展的风险。使用组织微阵列进行钙粒蛋白 A 蛋白表达评估。采用 Kaplan-Meier 生存分析和 Cox 回归分析来确定钙粒蛋白 A 表达是否与无复发生存(RFS)、无进展生存(PFS)或癌症特异性生存(CSS)相关。
钙粒蛋白 A 表达在 pTa 和 pT1 肿瘤之间存在显著差异(p=0.000,Mann-Whitney U 检验),在肿瘤分级之间也存在显著差异(p=0.015,Kruskal-Wallis 检验)。Kaplan-Meier 估计在低和高钙粒蛋白 A 表达组的 RFS [5 年 RFS 70.4±4.0% vs. 35.9±12.5%,中位 RFS 未达到(NR)vs. 12.0±4.4 个月,p=0.029,对数秩检验]、PFS(5 年 PFS 90.3±2.7% vs. 51.5±14.0%,两组中位 PFS NR,p=0.000,对数秩检验)和 CSS(5 年 CSS 92.9±2.6% vs. 70.7±12.4%,两组中位 CSS NR,p=0.005,对数秩检验)方面产生了显著的结果。根据多变量 Cox 回归模型,钙粒蛋白 A 仍然是 RFS(p=0.024,HR2.43)和 PFS(p=0.002,HR5.92)的独立因素。
通过免疫组织化学检测到的 NMIBC 中钙粒蛋白 A 的表达是识别高危 NMIBC 患者复发和进展的有前途的标志物。