Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China.
SurExam Bio-Tech Co, Guangzhou, 510663, Guangdong, China.
BMC Urol. 2019 Jul 24;19(1):69. doi: 10.1186/s12894-019-0497-x.
The expression level of ribonucleotide reductase subunit M1 (RRM1) is closely related to the effect of gemcitabine-based therapy in advanced bladder cancer. However, the value of RRM1 expression in predicting progression-free survival in non-muscle-invasive bladder cancer (NMIBC) patients treated with intravesical gemcitabine chemotherapy has not been elucidated.
This study randomly assigned 162 patients to either the RRM1-known group or the unknown group. We collected cancer tissues from 81 patients to evaluate the mRNA expression of RRM1 by using liquid chip technology. All patients were diagnosed and then treated with intravesical gemcitabine monotherapy immediately after transurethral resection of the bladder tumour (TURBT).
RRM1 expression was high in 21% (17/81) of patients. The RRM1 mRNA level was not correlated with sex, age, weight, performance status, or CUA/EAU risk (p > 0.05). Progression-free survival (PFS) was significantly longer for patients with low RRM1 expression than for patients with high and unknown RRM1 expression (p = 0.009). Additionally, the 1- and 2-year relapse rates also differed according to RRM1 expression level. The 1-year relapse rates for RRM1-low, RRM1-high and RRM1-unknown patients were 0, 17.7 and 6.2% (p = 0.009), while the 2-year relapse rates for these groups were 3.1, 29.4, and 11.1% (p = 0.005), respectively.
This preliminary study showed that low RRM1 expression was associated with longer progression-free survival and lower 1-year/2-year relapse rates in NMIBC patients treated with intravesical gemcitabine monotherapy, despite the need for further verification with large sample sizes and considering more mixed factors and biases.
核苷酸还原酶亚单位 M1（RRM1）的表达水平与吉西他滨为基础的治疗在晚期膀胱癌中的疗效密切相关。然而，RRM1 表达在预测接受膀胱内吉西他滨化疗的非肌肉浸润性膀胱癌（NMIBC）患者无进展生存期方面的价值尚未阐明。
本研究将 162 例患者随机分为 RRM1 已知组和未知组。我们从 81 例患者中采集肿瘤组织，采用液体芯片技术评估 RRM1 的 mRNA 表达。所有患者均经诊断并在经尿道膀胱肿瘤切除术（TURBT）后立即接受膀胱内吉西他滨单药治疗。
21%（17/81）的患者 RRM1 表达较高。RRM1 mRNA 水平与性别、年龄、体重、表现状态或 CUA/EAU 风险无关（p>0.05）。RRM1 低表达患者的无进展生存期（PFS）明显长于 RRM1 高表达和未知 RRM1 表达患者（p=0.009）。此外，根据 RRM1 表达水平，患者的 1 年和 2 年复发率也有所不同。RRM1 低、RRM1 高和 RRM1 未知患者的 1 年复发率分别为 0、17.7%和 6.2%（p=0.009），而这些组的 2 年复发率分别为 3.1%、29.4%和 11.1%（p=0.005）。
这项初步研究表明，在接受膀胱内吉西他滨单药治疗的 NMIBC 患者中，低 RRM1 表达与更长的无进展生存期和更低的 1 年/2 年复发率相关，尽管需要进一步用更大的样本量验证，并考虑更多混合因素和偏倚。
