Introduction: A tumor microenvironment plays an important role in bladder cancer development and in treatment response. Purpose: The aim of the study was to assess how the components of the microenvironment affect tumor recurrence and to find the potential biomarkers for immunotherapy in NMIBC. Methods: The study group consisted of 55 patients with primary NMIBC. Immunohistochemistry was performed on sections of primary papillary urothelial carcinoma of the bladder. Cox proportional hazard multiple regression analysis was performed to characterize tumors with the highest probability of an unfavorable outcome. Results: Multivariate analysis confirmed that the CD4 (p =0.001), CD20 (p =0.008) and PD-L1 expressed on tumor cells (p =0.01) were independently associated with the risk of recurrence of bladder cancer. Patients with weak CD4+cell infiltration (<4.6%) and severe CD20+infiltration (>10%) belong to the group with a lower risk of recurrence. The cancer in this group also frequently recurs after 12 months (p= 0.0005). Conclusions: The evaluation of CD4+and CD20+cells in the tumor microenvironment, in addition to PD-L1 on tumor cells, facilitates the determination of a group of patients with a low risk of recurrence.
引言：肿瘤微环境在膀胱癌的发生发展及治疗反应中扮演着重要角色。目的：本研究旨在评估微环境组分如何影响肿瘤复发，并寻找非肌层浸润性膀胱癌免疫治疗的潜在生物标志物。方法：研究组纳入55例原发性非肌层浸润性膀胱癌患者，对膀胱原发性乳头状尿路上皮癌组织切片进行免疫组化检测。采用Cox比例风险多元回归分析筛选具有最高不良预后风险的肿瘤特征。结果：多变量分析证实，CD4（p=0.001）、CD20（p=0.008）及肿瘤细胞表达的PD-L1（p=0.01）与膀胱癌复发风险独立相关。CD4+细胞弱浸润（<4.6%）且CD20+细胞重度浸润（>10%）的患者属于低复发风险组，该组肿瘤多在12个月后复发（p=0.0005）。结论：通过评估肿瘤微环境中CD4+与CD20+细胞及肿瘤细胞PD-L1表达，有助于识别低复发风险的患者群体。
CD4, CD20 and PD-L1 as Markers of Recurrence in Non-Muscle-Invasive Bladder Cancer
肿瘤(癌症)患者之家