Background/Objectives: While cytoskeleton-associated protein 4 (CKAP4) has been associated with prognosis in various malignancies, its prognostic value for bladder cancer (BCa) remains unclear. The aim of this study was to evaluate CKAP4 expression in tumor cells and cancer-associated fibroblasts (CAFs) following radical cystectomy (RC) in patients with BCa.Methods: In this study, CKAP4 in tumor cells was defined as CKAP4-1, while CKAP4 expressed in CAFs was defined as CKAP4-2. CKAP4-2 expression was evaluated to explore its potential association with tumor aggressiveness and patient outcomes. CKAP4 expression in 86 RC specimens was assessed using immunohistochemistry. CKAP4-1 positivity was considered when ≥5% cytoplasmic staining of cancer cells, with at least moderate staining intensity, was observed. CKAP4-2 positivity was evaluated using a point scale (0–3), with scores based on the number of CKAP4 positive CAFs in the tumor stroma. Scores of 2 (moderate number of CAFs) and 3 (significant number of CAFs) were considered to indicate positivity.Results: CKAP4-1 and CKAP4-2 were expressed in 53 (61.6%) and 34 (39.5%) patients, respectively. Kaplan–Meier analysis showed that patients with CKAP4-1 had significantly shorter cancer-specific survival and recurrence-free survival (RFS;p= 0.046 andp= 0.0173, respectively). Multivariate analysis showed that CKAP4-1 positivity was an independent predictor of RFS (p= 0.041, hazard ratio: 2.09, 95% confidence interval: 1.03–4.25).Conclusions: This study showed that CKAP4 expression in tumor cells may serve as a useful prognostic biomarker for patients with BCa who undergo RC.
背景/目的：尽管细胞骨架相关蛋白4（CKAP4）与多种恶性肿瘤的预后相关，但其对膀胱癌（BCa）的预后价值尚不明确。本研究旨在评估膀胱癌患者接受根治性膀胱切除术（RC）后肿瘤细胞及癌相关成纤维细胞（CAFs）中CKAP4的表达情况。方法：本研究将肿瘤细胞中的CKAP4定义为CKAP4-1，CAFs中表达的CKAP4定义为CKAP4-2。通过评估CKAP4-2的表达，探讨其与肿瘤侵袭性及患者预后的潜在关联。采用免疫组织化学方法检测86例RC标本中CKAP4的表达。当观察到≥5%的癌细胞出现至少中等强度的胞质染色时，判定为CKAP4-1阳性。CKAP4-2阳性采用评分量表（0-3分）进行评估，评分依据肿瘤间质中CKAP4阳性CAFs的数量。评分2分（中等数量CAFs）和3分（大量CAFs）被视为阳性。结果：分别有53例（61.6%）和34例（39.5%）患者表达CKAP4-1和CKAP4-2。Kaplan-Meier分析显示，CKAP4-1阳性患者的癌症特异性生存期和无复发生存期（RFS）显著缩短（p值分别为0.046和0.0173）。多变量分析表明，CKAP4-1阳性是RFS的独立预测因子（p=0.041，风险比：2.09，95%置信区间：1.03-4.25）。结论：本研究表明，肿瘤细胞中CKAP4的表达可能作为接受RC的膀胱癌患者有用的预后生物标志物。
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