Magri Valentina, Marino Luca, Del Giudice Francesco, De Meo Michela, Siringo Marco, De Berardinis Ettore, Gandini Orietta, Santini Daniele, Nicolazzo Chiara, Gazzaniga Paola
Department of Pathology, Oncology and Radiology, Policlinico Umberto I Hospital, "Sapienza" University of Rome, 00161 Rome, Italy.
Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy.
Biomedicines. 2024 Oct 16;12(10):2359. doi: 10.3390/biomedicines12102359.
Non-muscle-invasive bladder cancer (NMIBC) prognosis varies significantly due to the biological and clinical heterogeneity. High-risk stage T1-G3, comprising 15-20% of NMIBCs, involves the lamina propria and is associated with higher rates of recurrence, progression, and cancer-specific mortality. In the present study, we have evaluated the enumeration of tumour-derived extracellular vesicles (tdEVs) and circulating tumour cells (CTCs) in high-risk NMIBC patients and their correlation with survival outcomes such as time to progression (TTP), and cancer-specific survival (CSS). Eighty-three high-risk T1-G3 NMIBC patients treated between September 2010 and January 2013 were included. Blood samples were collected before a transurethral resection of the bladder (TURB) and analysed using the CellSearch system. The presence of at least one CTC was associated with a shorter TTP and CSS. Extending follow-up to 120 months and incorporating automated tdEV evaluation using ACCEPT software demonstrated that tdEV count may additionally stratify patient risk. Combining tdEVs and CTCs improves risk stratification for NMIBC progression, suggesting that tdEVs could be valuable biomarkers for prognosis and disease monitoring. Further research is needed to confirm these findings and establish the clinical significance of tdEVs in early-stage cancers.
非肌层浸润性膀胱癌（NMIBC）的预后因生物学和临床异质性而有显著差异。高危T1-G3期占NMIBC的15%-20%，累及固有层，与更高的复发率、进展率和癌症特异性死亡率相关。在本研究中，我们评估了高危NMIBC患者肿瘤来源的细胞外囊泡（tdEVs）和循环肿瘤细胞（CTCs）的计数，以及它们与生存结局如进展时间（TTP）和癌症特异性生存（CSS）的相关性。纳入了2010年9月至2013年1月期间接受治疗的83例高危T1-G3 NMIBC患者。在膀胱经尿道切除术（TURB）前采集血样，并使用CellSearch系统进行分析。至少存在一个CTC与较短的TTP和CSS相关。将随访延长至120个月，并使用ACCEPT软件纳入自动tdEV评估，结果表明tdEV计数可能进一步对患者风险进行分层。结合tdEVs和CTCs可改善NMIBC进展的风险分层，这表明tdEVs可能是用于预后和疾病监测的有价值的生物标志物。需要进一步研究来证实这些发现，并确定tdEVs在早期癌症中的临床意义。
