Department of Urology, Inje University College of Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
Department of Urology, Seoul National Univervity College of Medicine, Seoul National University Hospital, Seoul, Korea.
BMC Cancer. 2019 Sep 9;19(1):897. doi: 10.1186/s12885-019-6042-1.
We evaluated the clinical efficacy and prognosis of muscle-invasive bladder cancer according to the basal/squamous-like (BASQ) classification system based on immunohistochemical staining [CK5/6(+), CK14(+), GATA3(-), and FOXA1(-)].
One hundred patients diagnosed with muscle-invasive bladder cancer (cT2-4 N0-3 M0) were included in the study. All patients underwent radical cystectomy after transurethral removal of bladder tumor. Immunostaining was performed for CK5/6, CK14, FOXA1, and GATA3 antibodies on tissue microarray slides, and expression patterns were quantitatively analyzed using a scanning program.
The median follow-up time was 77.4 (interquartile range: 39-120.9) months. The mean age of the patients was 65.1 ± 11.2 years. FOXA1 or CK14 expression greater than 1% was respectively positively and negatively correlated with overall survival (OS; p = 0.011 and p = 0.042, respectively), cancer-specific survival (CSS; p = 0.050 for both), and recurrence-free survival (RFS; p = 0.018 and p = 0.040, respectively). For CK5/6+ and GATA3- or FOXA1- expression, 10% CK5/6+ cells were negatively correlated with OS (p = 0.032 and p = 0.039, respectively) and with RFS in combination with FOXA1- only (p = 0.050).
In this study, CK14 expression was associated with a poor prognosis. The new classification system of bladder cancer based on molecular characteristics is expected to helpful tool for the establishment of personalized treatment strategies and associated prediction of therapeutic responses.
我们根据基于免疫组织化学染色的基底/鳞状样（BASQ）分类系统（CK5/6(+)、CK14(+)、GATA3(-)和 FOXA1(-)）评估肌层浸润性膀胱癌的临床疗效和预后。
本研究纳入了 100 例诊断为肌层浸润性膀胱癌（cT2-4N0-3M0）的患者。所有患者均在经尿道膀胱肿瘤切除术后行根治性膀胱切除术。在组织微阵列载玻片上对 CK5/6、CK14、FOXA1 和 GATA3 抗体进行免疫染色，并使用扫描程序对表达模式进行定量分析。
中位随访时间为 77.4（四分位间距：39-120.9）个月。患者的平均年龄为 65.1±11.2 岁。FOXA1 或 CK14 表达大于 1%分别与总生存（OS；p=0.011 和 p=0.042）、癌症特异性生存（CSS；两者均为 p=0.050）和无复发生存（RFS；p=0.018 和 p=0.040）呈正相关。对于 CK5/6+和 GATA3-或 FOXA1-表达，10% CK5/6+细胞与 OS（p=0.032 和 p=0.039）以及与 FOXA1-表达相结合的 RFS 呈负相关（p=0.050）。
在这项研究中，CK14 表达与预后不良相关。基于分子特征的新膀胱癌分类系统有望成为制定个体化治疗策略和预测治疗反应的有用工具。
