Abstract
BackgroundTo investigate associations between dual-specificity tyrosine phosphorylation-regulated kinase 2 (DYRK2) expression and survival in T1 high-grade or T2 bladder cancer patients treated with neoadjuvant chemotherapy.MethodsThe cohort under investigation comprised 44 patients who underwent neoadjuvant chemotherapy for pT1 high-grade or pT2N0M0 bladder cancer at our institution between 2002 and 2011. Immunohistochemical analysis was used to determine expression of DYRK2 in bladder cancer specimens obtained by transurethral resection before chemotherapy. Relationships between DYRK2 expression and both response to chemotherapy and survival in these patients were analyzed.ResultsDYRK2 expression was positive in 21 of 44 patients (47.7 %) and negative in 23 patients (52.3 %). In total, 20 of 21 DYRK2-positive cases showed complete response to neoadjuvant chemotherapy, whereas 11 of 23 DYRK2-negative cases did not show complete response. Sensitivity and specificity were 62.5 % and 91.7 %, respectively (P = 0.0018). In addition, disease-specific survival rate was significantly higher for DYRK2-positive patients than for DYRK2-negative patients (P = 0.017). In multivariate analysis, DYRK2 expression level was identified as an independent prognostic factor for disease-specific survival (P = 0.029). We also showed that DYRK2 mRNA expression was significantly higher in DYRK2-positive samples by immunohistochemistry than DYRK2-negative samples (P = 0.040).ConclusionsDYRK2 expression level may predict the efficacy of neoadjuvant chemotherapy for T1 high-grade and T2 bladder cancer.
Highlights
To investigate associations between dual-specificity tyrosine phosphorylation-regulated kinase 2 (DYRK2) expression and survival in T1 high-grade or T2 bladder cancer patients treated with neoadjuvant chemotherapy
To optimize survival, selecting patients with muscle-invasive bladder cancer who are expected to show a good response to neoadjuvant chemotherapy is important
Cystectomy was performed after intra-arterial chemotherapy in four patients (9.1 %)
Summary
To investigate associations between dual-specificity tyrosine phosphorylation-regulated kinase 2 (DYRK2) expression and survival in T1 high-grade or T2 bladder cancer patients treated with neoadjuvant chemotherapy. Radical cystectomy is widely performed to treat muscleinvasive bladder cancer. Radical cystectomy only results in 5-year survival in about 50 % of patients [1–5]. To improve these unsatisfactory results, the use of peri-operative chemotherapy has been explored. Some patients with muscle-invasive bladder cancer do not achieve results even from neoadjuvant chemotherapy. To optimize survival, selecting patients with muscle-invasive bladder cancer who are expected to show a good response to neoadjuvant chemotherapy is important. Various pathological factors have been reported as prognostic markers of poor survival in patients with bladder cancer, but are inadequate for predicting survival in bladder cancer patients.
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