Cell Cycle Markers in the Evaluation of Bladder Cancer
Cell Cycle Markers in the Evaluation of Bladder Cancer
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DOI：
10.1007/s12253-018-0389-5
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发表时间：
2020-01-01
影响因子：
2.8
通讯作者：
Bica, Claudia Giuliano
中科院分区：
文献类型：
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作者：
da Silva, Jessica Niederauer Leote;Ranzi, Alana Durayski;Bica, Claudia Giuliano
膀胱癌（BC）是一种异质性肿瘤，其特征在于高数量的复发。标准化的临床和形态学参数并不总是足以预测个体肿瘤行为。本研究的目的是评估细胞周期调节蛋白的表达作为潜在的辅助预后和监测这种疾病。收集经尿道电切术（TUR）治疗的膀胱尿路上皮癌患者的石蜡块标本，进行p16、p21、p27、p53、pRb和Ki-67蛋白的免疫组化分析。采用卡方检验、Logistic回归分析和Kaplan-Meier曲线分析这些指标的预后价值。在纳入研究的93例患者中，观察到的主要分期类别为T1（53%）和Ta（29%），肿瘤分级之间的分布为58%的低级别患者至42%的高级别患者。p16、p21、p27、p53、pRb和Ki-67的表达分别为31%、42%、60%、91%、27%和56%。Ki-67的免疫组化表达与肿瘤组织学分级相关（p = 0.016），pRb的表达与无复发生存期相关（p = 0.035），但在多变量分析中，没有孤立的标记物与复发和进展显著相关。两种以上标志物异常表达与复发（p = 0.005）和较低的无复发生存率（p = 0.004）相关。我们的面板标记物具有重要的预后价值的BC，特别是当两个以上的表达改变预测良好的临床复发的含义。
Bladder cancer (BC) is a heterogeneous neoplasia characterized by a high number of recurrences. Standardized clinical and morphological parameters are not always sufficient to predict individual tumor behavior. The aim of this study was to evaluate the expression of cell cycle regulators proteins as potential adjuvant in prognosis and monitoring of this disease. Block paraffin samples from patients with urothelial bladder carcinoma treated by transurethral resection (TUR) were collected to immunohistochemistry analysis for proteins p16, p21, p27, p53, pRb and Ki-67. Chisquare, logistic regression and Kaplan-Meier curve were used to analyze the prognostic value of these markers. Of the 93 patients included in the study, the main categories of staging observed were T1 (53%) and Ta (29%), and the distribution between tumor grades was 58% of patients with low grade to 42% of patients with high grade. The expressions of p16, p21, p27, p53, pRb and Ki-67 were altered in 31%, 42%, 60%, 91%, 27% and 56% of patients, respectively. The immunohistochemical expression of Ki-67 was associated with tumor histological grade (p = 0.016), and expression of pRb with recurrence-free survival (p = 0.035), but no isolated marker was significant associated with recurrence and progression in multivariate analysis. More than two markers abnormally expressed were associated with presence of recurrence (p = 0.005) and lower recurrence-free surviva (p = 0.004). Our panel marker has important prognostic value for BC, especially when more than two have altered expression predicting good clinical recurrence implication.