Fibulin-3在T1期非肌层浸润性膀胱癌组织中的表达及其与肿瘤复发和进展的相关性

目的:检测Fibulin-3在T1期非肌层浸润性膀胱癌组织中的表达，探讨其与膀胱癌复发和进展的相关性。方法:收集我院泌尿外科2013年1月至2014年12月期间确诊为T1期非肌层浸润性膀胱癌的患者34例，免疫组织化学法检测膀胱癌组织中Fibulin-3的表达水平，分析Fibulin-3表达与患者临床病理特征的关系，进行Fibulin-3表达水平与膀胱癌复发和进展的相关性分析。结果:34例患者中有22例Fibulin-3高表达，12例Fibulin-3低表达；Fibulin-3表达水平与肿瘤分级相关，高级别癌组织中Fibulin-3表达水平显著增高，差异有统计学意义（P<0.05）；随访结果显示，8例患者出现了复发，5例患者出现了进展；肿瘤分级和Fibulin-3高表达与复发和进展相关，为肿瘤复发和进展的影响因素（P<0.05）；8例复发患者的中位复发时间为15（4~48）个月，5例进展患者的中位进展时间为21（8~32）个月。Fibulin-3表达的Kaplan-Meier曲线显示，Fibulin-3低表达患者具有较高无进展生存率（P<0.05）。将单因素有意义的指标纳入Cox回归分析，回归方程差异具有统计学意义（P<0.05）；Fibulin-3高表达和肿瘤分级是膀胱癌患者复发和进展的独立危险因素（P<0.05）。结论:Fibulin-3高表达是T1期非肌层浸润性膀胱癌复发和进展的独立预后因素，对Fibulin-3水平进行检测可以预测膀胱癌复发和进展，为膀胱癌术后及时治疗提供指导。

Expression of Fibulin-3 in stage T1 non-muscle invasive bladder cancer and its correlation with tumor recurrence and progression

Objective:To investigate the expression of Fibulin-3 in stage T1 non-muscle invasive bladder cancer (NMIBC) and its correlation with tumor recurrence and progression.Methods:34 cases of stage T1 NMIBC treated in the urinary surgery department of our hospital from January 2013 to December 2014 were selected，and the tumor tissues were collected for the detection of Fibulin-3 expression.Then the correlation of Fibulin-3 with clinicopathological features，recurrence and progression of bladder cancer was analyzed.Results:Of 34 patients，Fibulin-3 was highly expressed in 22 cases and lowly expressed in 12 cases.The expression level of Fibulin-3 was positively correlated with tumor grade (P<0.05).8 patients had recurrence with a median recurrence time of 15 (4~48)months，and 5 patients had progress with a median progression time of 21(8~32)months during the follow-up period.Tumor grade and high expression of Fibulin-3 were associated with recurrence and progression，confirmed their role as influencing factors of tumor recurrence and progression (P<0.05).Kaplan-Meier curve of Fibulin-3 expression showed that patients with low expression of Fibulin-3 had a higher progression-free survival rate (P<0.05).Cox regression analysis showed that the single factors had statistic difference (P<0.05).Fibulin-3 high expression and tumor grade were independent risk factors for recurrence and progression of bladder cancer patients (P<0.05).Conclusion:Fibulin-3 overexpression is an independent prognostic factor for recurrence and progression of stage T1 NMIBC，so its detection can be used to predict recurrence and progression of bladder cancer and provide guidance for timely treatment.