Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210029, China , lipengchao_edu@outlook.com
Abstract: (110 Views)
Background:The presence of tertiary lymphoid structures (TLS) is related with good prognosis of various cancers including bladder cancer. The majority of bladder tumors are identified as non-muscle-invasive bladder cancer (NMIBC) when they are discovered in their early stages. We aimed to evaluate the prognostic value and clinical relevance of TLS in NMIBC. Materials and Methods:This cohort included 130 NMIBC samples, with 39 (30%) having TLS, as confirmed by hematoxylin and eosin and immunohistochemistry staining. The chi-square test was utilized to examine the relationship between TLS and the biomarkers and clinicopathologic characteristics of NMIBC. Results: It was found that TLS has significant association with pT stage, Ki-67 expression, and COX-2 expression. Using Kaplan-Meier analysis and Gehan-Breslow-Wilcoxon test, we found that the presence of TLS is associated with longer recurrence-free survival and overall survival of NMIBC patients. Moreover, we used bioinformatics to analyze the association of TLS marker L1CAM and bladder cancer. L1CAM is downregulated in bladder cancer, linked to an advanced stage of the disease, and indicates a poorer prognosis for those who have bladder cancer. In bladder cancer, there is a positive correlation between its expression and B cell infiltration. We also indicated that NMIBC with TLS have a higher level of TLS than that without TLS. Conclusion: To conclude, the presence of TLS is an important favorable prognostic indicator in NMIBC. A further understanding on TLS can provide new insights to improve immunotherapy for bladder cancer.