Prediction of intravesical recurrence of non-muscle-invasive bladder cancer by evaluation of intratumoral Foxp3.sup.+ T cells in the primary transurethral resection of bladder tumor specimens

Patients with a history of non-muscle-invasive bladder cancer sometimes have recurrence of tumors after transurethral resection of bladder tumor treatment. To find factors related to the recurrence of non-muscle-invasive bladder cancer, we examined tissue specimens taken at transurethral resection o...

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Bibliographic Details
Published in:PloS one 2018-09, Vol.13 (9), p.e0204745
Main Authors: Murai, Ryosuke, Itoh, Yasushi, Kageyama, Susumu, Nakayama, Misako, Ishigaki, Hirohito, Teramoto, Kazuo, Narita, Mitsuhiro, Yoshida, Tetsuya, Tomita, Keiji, Kobayashi, Ken-ichi, Wada, Akinori, Nagasawa, Masayuki, Kubota, Shigehisa, Ogasawara, Kazumasa, Kawauchi, Akihiro
Format: Article
Language:English
Subjects:
Analysis
Bladder cancer
Cancer recurrence
Care and treatment
Prognosis
T cells
Transurethral prostatectomy
Treatment outcome
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Summary:Patients with a history of non-muscle-invasive bladder cancer sometimes have recurrence of tumors after transurethral resection of bladder tumor treatment. To find factors related to the recurrence of non-muscle-invasive bladder cancer, we examined tissue specimens taken at transurethral resection of bladder tumor as an initial treatment. We revealed the association between prognosis of non-muscle-invasive bladder cancer and infiltration of Foxp3.sup.+ T cells that suppress anti-tumor immunity in 115 primary non-muscle-invasive bladder cancer patients retrospectively identified and followed for at least 3 months after primary transurethral resection. In immunohistological staining, we counted the number of cells positive for CD3 and positive for CD3 and Foxp3 together and calculated the percentage of Foxp3.sup.+ T cells among the CD3.sup.+ T cells. The recurrence-free survival rate was calculated by the Kaplan-Meier method, and a Cox regression analysis of recurrence factors was performed. The median (interquartile range) percentage of Foxp3.sup.+ T cells in all cases was 17.1% (11.9, 11.4-23.3%). Compared by risk stratification, it was 11.4% (10.4, 7.8-18.2%) in the low-risk group (n = 32), 16.8% (12.6, 11.6-24.2%) in the intermediate-risk group (n = 45), and 22.0% (9.7, 16.4-26.1%) in the high-risk group (n = 38). The Kaplan-Meier survival analysis indicated that the Foxp3.sup.+ T cell high group ([greater than or equal to] 17.1%) had a worse RFS rate than did the low group (< 17.1%) (P = 0.006). In multivariate analysis, the percentage of Foxp3.sup.+ T cells was an independent risk factor for intravesical recurrence (hazard ratio 2.25). Thus, peritumoral Foxp3.sup.+ T cell infiltration was correlated to risk stratification and recurrence-free survival. Therefore, the percentage of Foxp3.sup.+ T cells in tumor specimens may predict a risk for intravesical recurrence.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0204745