12328Vanderbilt University, Nashville, TN, USA.
9968University of Alabama at Birmingham, Birmingham, AL, USA.
Int J Surg Pathol. 2022 Feb;30(1):6-14. doi: 10.1177/10668969211027264. Epub 2021 Jun 28.
. To compare the clinicopathologic characteristics of urothelial carcinoma (UC), urothelial carcinoma with squamous differentiation (UCSD), and squamous cell carcinoma (SCC) of the bladder, which have been suggested to differ in terms of risk factors, immunophenotype, and prognosis. . We evaluated the clinicopathologic features of radical cystectomy specimens between 1980 and 2015 with a diagnosis of SCC, UCSD, and UC. PD-L1 immunohistochemistry (clinically available clones 22C3, SP142, and SP263) was performed on SCC and UCSD. Multivariate Cox regression was used to identify prognostic factors. Kaplan-Meier curves were plotted to assess cancer-specific survival (CSS). . Of the 1478 cases, there were 1126 UC (76%), 217 UCSD (15%), and 135 SCC (9%). Bladder cancer was more common in men than women (80% vs 20%, < .0001). However, a higher proportion of SCC and UCSD occurred in women (SCC-36%, UCSD-22%, UC-18%). Women were significantly more likely to be never smokers in all 3 cohorts (UC: 45% vs 16%, UCSD: 44% vs 12%, SCC: 40% vs 18%, < .0001). Patients with SCC and UCSD were at a higher pathologic stage (>pT2) at the time of cystectomy (UCSD-74%, SCC 71%, UC-44%, < .0001) and had worse CSS compared to patients with UC ( = 0.006). SCC had higher PD-L1 scores (all clones) than UCSD ( < .0001). PD-L1 22C3 ( = .02, HR: 0.36) and SP142 scores ( = .046, HR: 0.27) predicted CSS on Kaplan-Meier analysis for SCC cases. . UC, UCSD, and SCC are associated with different risk factors, gender distributions, and clinical outcomes. PD-L1 is expressed in SCC and UCSD, suggesting some patients may benefit from targeted therapy.
. 为了比较尿路上皮癌（UC）、具有鳞状分化的尿路上皮癌（UCSD）和膀胱鳞状细胞癌（SCC）的临床病理特征，这些癌种在危险因素、免疫表型和预后方面存在差异。. 我们评估了 1980 年至 2015 年间接受根治性膀胱切除术的 SCC、UCSD 和 UC 患者的临床病理特征。对 SCC 和 UCSD 进行 PD-L1 免疫组化（临床可用克隆 22C3、SP142 和 SP263）检测。采用多变量 Cox 回归分析确定预后因素。绘制 Kaplan-Meier 曲线评估癌症特异性生存（CSS）。. 在 1478 例患者中，有 1126 例 UC（76%）、217 例 UCSD（15%）和 135 例 SCC（9%）。膀胱癌在男性中更为常见（80%对 20%，<0.0001）。然而，SCC 和 UCSD 中女性比例较高（SCC-36%，UCSD-22%，UC-18%）。在所有 3 个队列中，女性均为从不吸烟者（UC-45%比 16%，UCSD-44%比 12%，SCC-40%比 18%，<0.0001）。与 UC 患者相比，SCC 和 UCSD 患者在接受膀胱切除术时处于更高的病理分期（>pT2）（UCSD-74%，SCC 71%，UC-44%，<0.0001），且 CSS 更差（=0.006）。SCC 的 PD-L1 评分（所有克隆）均高于 UCSD（<0.0001）。SCC 病例的 Kaplan-Meier 分析显示，PD-L1 22C3（=0.02，HR：0.36）和 SP142 评分（=0.046，HR：0.27）预测 CSS。. UC、UCSD 和 SCC 与不同的危险因素、性别分布和临床结果相关。PD-L1 在 SCC 和 UCSD 中表达，表明一些患者可能受益于靶向治疗。
