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膀胱肿瘤中分子生物标志物的临床组织病理学相关性及预后意义:一项综合分析

Clinicohistopathological Correlation and Prognostic Significance of Molecular Biomarkers in Urinary Bladder Neoplasms: A Comprehensive Analysis.

作者信息

Mane Avinash, Patil Nanda J, Hulwan Atul B, Koley Avishek

机构信息

Department of Pathology, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.

Department of General Surgery, Sarojini Naidu Medical College, Agra, IND.

出版信息

Cureus. 2024 Aug 3;16(8):e66088. doi: 10.7759/cureus.66088. eCollection 2024 Aug.

Abstract

BACKGROUND

Urinary bladder neoplasms constitute a heterogeneous group of tumors with diverse clinical behaviors and outcomes. Understanding the correlation between clinicopathological characteristics and the prognostic significance of molecular biomarkers in bladder cancer is vital for personalized treatment strategies and improved patient outcomes.

OBJECTIVE

This prospective observational study aimed to comprehensively investigate the clinicopathological correlations and prognostic significance of molecular biomarkers in urinary bladder neoplasms.

METHODS

A cohort of 174 patients diagnosed with urinary bladder neoplasm participated in this study. Clinicopathological data, including demographic information, medical history, imaging findings, and histopathological reports, were collected from the patient records. Tissue samples obtained from transurethral resection or biopsy were subjected to molecular biomarker analysis using immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and molecular profiling techniques. Longitudinal follow-up assessments were conducted to monitor disease progression, recurrence, and overall survival.

RESULT

Out of 174 patients diagnosed with bladder neoplasms, the mean age of the patients was 62.4 years (±8.7), indicating that the study cohort primarily comprised elderly individuals. The majority of patients were male (126, 72.4%), reflecting the higher prevalence of bladder cancer among men compared to women. Preliminary analysis revealed significant associations between clinicopathological parameters, molecular biomarker expression profiles, and clinical outcomes in patients with urinary bladder neoplasms. Elevated expression levels of specific biomarkers such as tumor protein p53 (p53), Ki-67, and estimated glomerular filtration rate (EGFR) were observed in advanced tumor stages (p < 0.001) and higher histological grades (p < 0.05), indicating their potential prognostic significance. Furthermore, genetic alterations detected using molecular profiling techniques, including chromosomal gains and losses, were significantly correlated with aggressive disease phenotypes and increased recurrence risk (p < 0.01). Longitudinal follow-up data demonstrated that patients with elevated biomarker expression levels or genetic alterations had poorer treatment responses and shorter overall survival durations than those with lower biomarker expression levels.

CONCLUSION

This study highlights the importance of integrating clinicopathological parameters and molecular biomarker data for the risk stratification, treatment selection, and prognostic assessment of urinary bladder neoplasms.

摘要

背景

膀胱肿瘤是一组异质性肿瘤,具有不同的临床行为和预后。了解膀胱癌的临床病理特征与分子生物标志物的预后意义之间的相关性,对于个性化治疗策略和改善患者预后至关重要。

目的

这项前瞻性观察性研究旨在全面调查膀胱肿瘤中分子生物标志物的临床病理相关性和预后意义。

方法

174例诊断为膀胱肿瘤的患者参与了本研究。从患者记录中收集临床病理数据,包括人口统计学信息、病史、影像学检查结果和组织病理学报告。经尿道切除或活检获得的组织样本采用免疫组织化学(IHC)、荧光原位杂交(FISH)和分子谱分析技术进行分子生物标志物分析。进行纵向随访评估以监测疾病进展、复发和总生存期。

结果

在174例诊断为膀胱肿瘤的患者中,患者的平均年龄为62.4岁(±8.7),表明研究队列主要由老年人组成。大多数患者为男性(126例,72.4%),这反映出男性膀胱癌的患病率高于女性。初步分析显示,膀胱肿瘤患者的临床病理参数、分子生物标志物表达谱与临床结局之间存在显著关联。在肿瘤晚期(p<0.001)和更高的组织学分级(p<0.05)中观察到特定生物标志物如肿瘤蛋白p53(p53)、Ki-67和表皮生长因子受体(EGFR)的表达水平升高,表明它们具有潜在的预后意义。此外,使用分子谱分析技术检测到的基因改变,包括染色体的增减,与侵袭性疾病表型和复发风险增加显著相关(p<0.01)。纵向随访数据表明,生物标志物表达水平升高或有基因改变的患者比生物标志物表达水平较低的患者治疗反应更差,总生存期更短。

结论

本研究强调了整合临床病理参数和分子生物标志物数据对于膀胱肿瘤的风险分层、治疗选择和预后评估的重要性。

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