Tomioka Masayuki, Yoneyama Tohru, Tobisawa Yuki, Kawase Kota, Nakai Chie, Takai Manabu, Kato Daiki, Iinuma Koji, Nakane Keita, Mizutani Kosuke, Hashimoto Yasuhiro, Koie Takuya
Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan.
Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Transl Androl Urol. 2021 Mar;10(3):1192-1201. doi: 10.21037/tau-20-1489.
Although the patients with muscle-invasive bladder cancer (MIBC) generally have poor prognosis, the utility of these biomarkers for the prediction of oncological outcomes in MIBC has not been completely explored. Ghrelin regulates processes associated with cancer, including cell proliferation, apoptosis, cell migration, cell invasion, and angiogenesis. Thus, we aimed to evaluate the impact of serum ghrelin levels on survival in MIBC.
In this study, we reviewed the clinical and pathological records of 56 patients who were diagnosed with MIBC between November 2015 and November 2019 at Gifu and Hirosaki University Hospitals. We focused on 27 patients who had received chemotherapy and collected blood samples before and after chemotherapy. Blood samples were collected before chemotherapy and after completing two cycles of chemotherapy. Serum acyl (AG) and desacyl ghrelin (DG) were measured using AG and DG enzyme-linked immunosorbent assay kits (SCETI, Tokyo, Japan), respectively.
The 3-year overall and progression-free survival (PFS) rates were 82.9% and 68.3%, respectively. According to the AG level after chemotherapy, the 3-year PFS rates were 77.5% and 53.0% in patients with AG levels ≥1.34 and <1.34 pg/mL, respectively (P=0.038). With regard to DG levels after chemotherapy, the 3-year PFS rates were 90.9% and 43.3% in patients with DG levels <92.3 and ≥92.3 pg/mL, respectively (P=0.039). On multivariate analysis, serum AG levels were significantly associated with PFS.
This study suggested the usefulness of the ghrelin as a prognostic predictor of PFS in patients with MIBC.
尽管肌肉浸润性膀胱癌（MIBC）患者的预后通常较差，但这些生物标志物在预测MIBC肿瘤学结局方面的效用尚未得到充分探索。胃饥饿素调节与癌症相关的过程，包括细胞增殖、凋亡、细胞迁移、细胞侵袭和血管生成。因此，我们旨在评估血清胃饥饿素水平对MIBC患者生存的影响。
在本研究中，我们回顾了2015年11月至2019年11月期间在岐阜大学和弘前大学医院被诊断为MIBC的56例患者的临床和病理记录。我们重点关注27例接受化疗的患者，并在化疗前后采集血样。在化疗前和完成两个周期化疗后采集血样。分别使用AG和DG酶联免疫吸附测定试剂盒（日本东京SCETI）测量血清酰基胃饥饿素（AG）和去酰基胃饥饿素（DG）。
3年总生存率和无进展生存率（PFS）分别为82.9%和68.3%。根据化疗后的AG水平，AG水平≥1.34和<1.34 pg/mL的患者3年PFS率分别为77.5%和53.0%（P = 0.038）。关于化疗后的DG水平，DG水平<92.3和≥92.3 pg/mL的患者3年PFS率分别为90.9%和43.3%（P = 0.039）。多因素分析显示，血清AG水平与PFS显著相关。
本研究表明胃饥饿素作为MIBC患者PFS的预后预测指标具有一定价值。
