Prognostic significance of the Ki67 index and programmed death-ligand 1 expression after radical cystectomy in patients with muscle-invasive bladder cancer
Prognostic significance of the Ki67 index and programmed death-ligand 1 expression after radical cystectomy in patients with muscle-invasive bladder cancer
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DOI：
10.1016/j.urolonc.2020.11.029
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发表时间：
2021-03-09
影响因子：
2.7
通讯作者：
Ohyama, Chikara
中科院分区：
文献类型：
--
作者：
Horiguchi, Hirotaka;Hatakeyama, Shingo;Ohyama, Chikara
目的：探讨肌肉浸润性膀胱癌(MIBC)术后Ki67指数与程序性死亡配体1(PD-L1)表达的关系。材料与方法：对2004年4月至2020年4月接受RC治疗的262例MIBC患者进行回顾性分析。用单因素Cox回归分析Ki67指数和PD-L1表达对预后的影响。此外，还开发了包括Ki67和PD-L1在内的病理分子风险评分来预测预后和病理因素。我们还评价了T24和5637细胞系在IL-6刺激下Ki67指数与PD-L1的关系。结果：中位年龄69岁，随访期52个月。Ki67指数和PD-L1表达与肿瘤复发显著相关。单因素Cox回归分析显示，PT3-4、混合组织学类型、淋巴血管侵犯阳性(LVI+)、PN+、Ki67高表达(>；17%)和PD-L1+与无复发生存率(RFS)显著相关。根据手术切缘+(1分)、混合组织学(1分)、LVI+(1分)、PN+(1分)和Ki67-High(1分)进行病理分子风险评分。具有较高病理分子风险评分(>；1)的患者的RFS和总生存期显著短于风险评分较低的患者(
Objectives: To investigate the association between Ki67 index and programmed death-ligand 1 (PD-L1) expression in muscle-invasive bladder cancer (MIBC) patients after RC.Materials and Methods: We retrospectively evaluated 262 MIBC patients treated with RC between April 2004 and April 2020. The impact of Ki67 index and PD-L1 expression on prognosis was evaluated by univariate Cox regression analysis. In addition, a pathomolecular risk score, including Ki67 and PD-L1, was developed to predict prognosis and pathological factors. We also evaluated the link between the Ki67 index and PD-L1 under the IL-6 stimulation in the bladder cancer cell lines of T24 and 5637 cells.Results: The median age and follow-up period was 69 years and 52 months, respectively. Ki67 index and PD-L1 expression were significantly associated with tumor recurrence. Univariate Cox regression analysis showed that pT3-4, mixed histology, lymphovascular invasion positive (LVI+), pN+, Ki67-high (> 17%), and PD-L1+ were significantly associated with recurrence-free survival (RFS). The pathomolecular risk score was developed using resection margin+ (1 point), mixed histology (1 point), LVI+ (1 point), pN+ (1 point), and Ki67-high (1 point). RFS and overall survival were significantly shorter in patients with higher pathomolecular risk scores (> 1) than in those with lower risk scores (