Selected protein expression in a new prognostic model for patients with non-muscle-invasive bladder cancer

Abstract

Introduction After transurethral resection of a bladder tumor, patients frequently have a recurrence of the disease, thereby requiring adjuvant therapy. Purpose The study aimed to determine the prognostic value of expression levels of p53, Ki-67, and survivin, and to develop a new prognostic model for patients with non-muscle-invasive bladder cancer (NMIBC) after transurethral resection of a bladder tumor. Methods The study group consisted of 101 patients with primary NMIBC. Univariate followed by multivariate Cox proportional hazard regression analysis was performed to obtain a model including the smallest possible number of descriptive variables with the highest statistical significance and impact on risk. Results The RECINT model (RECurrence In Not Treated) including factors independently associated with cancer recurrence (tumor size [HR 1.148; p = 0.034], intensity of the color reaction for p53 [HR 1.716; p = 0.008], Ki-67 [HR 3.001; p = 0.022], and survivin [HR 1.461; p = 0.021]) adequately stratified recurrence free-survival (R 2 = 0.341, p < 0.001) in patients with primary NMIBC. Patients with the lowest RECINT score (0-6) had the lowest probability of cancer recurrence (1-and 5-year recurrence of 16%) in comparison with other groups (p < 0.001). Conclusions The RECINT model may be useful for stratifying the risk of recurrence in patients with non-muscle-invasive bladder cancer and may allow for identification of those who may benefit the most from adjuvant BCG immunotherapy.

Identification of New Prognostic Markers and Therapeutic Targets for Non-Muscle Invasive Bladder Cancer: HER2 as a Potential Target Antigen

“…However, in NMIBC patients, many recurrences are not related to primary UC that was surgically removed, such as by incomplete TURB. For the reasons mentioned here, unlike previous studies reporting that Ki67 is related to prognosis under certain conditions, in NMIBC ( 43 , 44 ), we found no significant relationship between Ki67 expression levels and recurrence/progression.…”

“…Ki67 is a DNA-bound protein activated only during the proliferation phase and is not detected during cell cycle quiescence. Studies on Ki67 in UC have reported it as a prognostic factor for recurrence and progression in upper tract UC ( 19 , 42 ) NMIBC after TURB ( 43 , 44 ). In the present study, we found a correlation between higher stages of UC and increased Ki67 expression levels.…”

Construction and Validation of a Protein Prognostic Model for Lung Squamous Cell Carcinoma

“…Besides, it would be more accessible in health-providing centers. Some studies had successfully validated protein prognostic model in malignancies, such as bladder cancer, lung adenocarcinoma and diffuse large B-cell lymphoma [22][23][24]. The protein models demonstrated vital role for predicting prognosis, which including bladder cancer, esophageal squamous cell carcinoma and pancreatic ductal adenocarcinoma [25][26][27].…”

Oncological impact of cystoscopic findings in non‐muscle‐invasive bladder cancer: a meta‐analysis

“…After screening, a full‐text review was performed for 201 articles. According to the inclusion criteria, we finally identified 72 studies comprising 28 139 patients eligible for the meta‐analysis [12–83]. The demographics of each included study are shown in Table 1 and Table S2.…”