Comprehensive pathological assessment of histological subtypes, molecular subtypes based on immunohistochemistry, and tumor-associated immune cell status in muscle-invasive bladder cancer
Comprehensive pathological assessment of histological subtypes, molecular subtypes based on immunohistochemistry, and tumor-associated immune cell status in muscle-invasive bladder cancer
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DOI：
10.1111/pin.13060
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发表时间：
2021-01-27
影响因子：
2.2
通讯作者：
Matsuda, Tadashi
中科院分区：
文献类型：
--
作者：
Ikeda, Junichi;Ohe, Chisato;Matsuda, Tadashi
肌层浸润性膀胱癌 (MIBC) 的分子评估已经产生了几种与基底亚型和管腔亚型或肿瘤相关免疫细胞状态 (TAIC) 相关的分子分类。然而，组织学亚型、分子亚型和 TAIC 之间的组织学关系及其临床意义仍不清楚。因此，我们的目的是评估这些因素之间的组织学关联及其临床病理结果。我们回顾性分析了 106 例接受根治性膀胱切除术的 MIBC 患者。通过苏木精和伊红染色评估组织学亚型和 TAIC，通过细胞角蛋白 (CK) 5/6、CK14、CK20、GATA3 和 uroplakin II 的免疫组织化学表达确定基底和管腔分子亚型。鳞状分化尿路上皮癌和肉瘤样变异与基底亚型高度相关（分别为 P < 0.001 和 P = 0.04）。此外，高 TAIC 与基础亚型显着相关 (P < 0.001)。尽管分子亚型之间的癌症特异性生存率 (CSS) 没有显着差异 (P = 0.295)，但 TAIC 显着区分 CSS 率 (P < 0.001)。此外，分子亚型和 TAIC 的组合显着分层了癌症特异性死亡率。总之，对组织学亚型、分子亚型和 TAIC 进行综合病理学评估是可行的，并且可以影响肿瘤学结果。
Molecular assessments of muscle-invasive bladder cancer (MIBC) have yielded several molecular categorizations associated with basal and luminal subtypes or tumor-associated immune cell status (TAICs). However, the histological relationships among histological subtypes, molecular subtypes, and TAICs and their clinical implications remain unclear. Thus, we aimed to evaluate the histological associations among these factors and their clinicopathological outcomes. We retrospectively analyzed 106 patients with MIBC who underwent radical cystectomy. The histological subtypes and TAICs were evaluated with hematoxylin and eosin staining, while the basal and luminal molecular subtypes were determined by immunohistochemical expression of cytokeratin (CK) 5/6, CK14, CK20, GATA3 and uroplakin II. Urothelial carcinoma with squamous differentiation and the sarcomatoid variant were highly associated with the basal subtype (P < 0.001 and P = 0.04, respectively). Additionally, high TAICs were significantly correlated with the basal subtype (P < 0.001). Although there was no significant difference in the cancer-specific survival (CSS) rate between molecular subtypes (P = 0.295), TAICs significantly discriminated CSS rates (P < 0.001). Furthermore, the combination of molecular subtypes and TAICs significantly stratified cancer-specific mortality rates. In conclusion, a comprehensive pathological evaluation of histological subtypes, molecular subtypes, and TAICs is feasible and can influence the oncological outcome.