Wang Zhan, Zhou Zhaokai, Yang Shuai, Li Zhengrui, Shi Run, Wang Ruizhi, Liu Kui, Tang Xiaojuan, Li Qi
Department of Urology, The First Affiliated Hospital of Zhengzhou University, Henan, 450052, China.
Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
J Transl Med. 2025 Jun 17;23(1):666. doi: 10.1186/s12967-025-06682-1.
BACKGROUND: The heterogeneity of bladder cancer (BLCA) is affected by its inherent transcriptional properties and tumor microenvironment (TME). Stromal transcriptional components in the TME significantly influence the transcriptional classification of BLCA, and the intrinsic biological transcriptional characteristics of cancer cells may be obscured by the dominant, lineage-dependent transcriptional components of stromal origin. This study aimed to explore the degree and mechanisms by which cancer-intrinsic gene expression profiles contribute to the classification and prognosis of BLCA patients. MATERIALS AND METHODS: In this study, BLCA single-cell transcriptome data from GSE135337 were used to identify pure tumor cells in BLCA and explore the different intrinsic heterogeneous cell subgroups of BLCA through pathway-based cancer transcriptome classification. Additionally, BLCA intrinsic subtypes were uncovered in the TCGA BLCA dataset based on the characteristic genes of the subgroups. Lastly, various machine learning algorithms were applied to identify novel potential targets of BLCA, following which their pro-tumorigenic effects were experimentally verified. RESULTS: Four BLCA intrinsic subtypes with different molecular, functional and phenotypic characteristics were successfully identified. Specifically, MA and DP subtypes demonstrated malignant phenotypes, accompanied by unfavorable clinical prognoses, limited involvement in cell death pathways, marked cell proliferation, and diminished immune activation. Notably, MA subtype exhibited the most favorable response to immunotherapy, potentially attributable to its distinctive tumor immune microenvironment. DSM subtype represented an immune-rich subtype with the optimal prognosis, characterized by abundant immune cells, high levels of co-stimulatory, co-inhibitory, major histocompatibility complex molecules, and a potential for immunotherapy response. On the other hand, HM subtype was associated with a high level of autophagy and necrosis and an "immune-hot" TIME. Furthermore, BLCA intrinsic subtypes effectively classified independent sets of BLCAs, with limited overlap with existing transcriptional classifications and showcasing unprecedented predictive and prognostic value. Finally, the DP subtype, associated with the worst prognosis, was further analyzed, leading to the identification of three potential target genes (DAD1, CYP1B1, and REXO2) significantly associated with metabolic disorders, as well as BLCA stage and grade. CONCLUSION: This study identified a promising platform for understanding intrinsic tumor heterogeneity, which could offer new insights into the intricate molecular mechanisms of BLCA. Targeted therapy against BEXO2 may improve the prognosis of BLCA patients by regulating mitochondria-related metabolic disorders.
背景:膀胱癌(BLCA)的异质性受其固有转录特性和肿瘤微环境(TME)影响。TME中的基质转录成分显著影响BLCA的转录分类,癌细胞的内在生物学转录特征可能被基质来源的主导性、谱系依赖性转录成分所掩盖。本研究旨在探讨癌症内在基因表达谱对BLCA患者分类和预后的影响程度及机制。 材料与方法:在本研究中,使用来自GSE135337的BLCA单细胞转录组数据来识别BLCA中的纯肿瘤细胞,并通过基于通路的癌症转录组分类探索BLCA不同的内在异质细胞亚群。此外,基于亚群的特征基因在TCGA BLCA数据集中揭示BLCA内在亚型。最后,应用各种机器学习算法识别BLCA的新型潜在靶点,随后通过实验验证其促肿瘤作用。 结果:成功识别出四种具有不同分子、功能和表型特征的BLCA内在亚型。具体而言,MA和DP亚型表现出恶性表型,伴有不良临床预后,对细胞死亡途径的参与有限,细胞增殖明显,免疫激活减弱。值得注意的是,MA亚型对免疫疗法表现出最有利的反应,这可能归因于其独特的肿瘤免疫微环境。DSM亚型代表免疫丰富亚型,预后最佳,其特征是免疫细胞丰富,共刺激、共抑制、主要组织相容性复合体分子水平高,且有免疫治疗反应的潜力。另一方面,HM亚型与高水平的自噬和坏死以及“免疫热”肿瘤微环境相关。此外,BLCA内在亚型有效地对独立的BLCA集进行了分类,与现有转录分类的重叠有限,并展示出前所未有的预测和预后价值。最后,对预后最差的DP亚型进行了进一步分析,从而确定了三个与代谢紊乱以及BLCA分期和分级显著相关的潜在靶基因(DAD1、CYP1B1和REXO2)。 结论:本研究确定了一个有前景的平台,用于理解肿瘤内在异质性,这可为深入了解BLCA复杂的分子机制提供新见解。针对BEXO2的靶向治疗可能通过调节线粒体相关代谢紊乱来改善BLCA患者的预后。
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