Immunological Status of Bladder Cancer Patients Based on Urine Leukocyte Composition at Radical Cystectomy.

Elisabet Cantó,Georgia Anguera,Maria Mulet,Carlos Zamora,Pablo Maroto,Sílvia Vidal,Ana Palomino,Alberto Breda,Óscar Rodríguez Faba,Maria Soledad Garcia-Cuerva

doi:10.3390/biomedicines9091125

Abstract

Background: Bladder cancer (BC) is the ninth most common malignancy worldwide, with high rates of recurrence. The use of urine leukocyte composition at the time of radical cystectomy (RC) as a marker for the study of patients’ immunological status and to predict the recurrence of muscle-invasive bladder cancer (MIBC) has received little attention. Methods: Urine and matched peripheral blood samples were collected from 24 MIBC patients at the time of RC. Leukocyte composition and expression of PD-L1 and PD-1 in each subpopulation were determined by flow cytometry. Results: All MIBC patients had leukocytes in urine. There were different proportions of leukocyte subpopulations. The expression of PD-L1 and PD-1 on each subpopulation differed between patients. Neoadjuvant chemotherapy (NAC), smoking status, and the affectation of lymph nodes influenced urine composition. We observed a link between leukocytes in urine and blood circulation. Recurrent patients without NAC and with no affectation of lymph nodes had a higher proportion of lymphocytes, macrophages, and PD-L1+ neutrophils in urine than non-recurrent patients. Conclusions: Urine leukocyte composition may be a useful tool for analyzing the immunological status of MIBC patients. Urine cellular composition allowed us to identify a new subgroup of LN− patients with a higher risk of recurrence.

Highlights

Bladder cancer (BC), the ninth most common malignancy worldwide [1], has high rates of recurrence and progression [2]
Urine and peripheral blood samples were collected from 24 patients with muscleinvasive bladder cancer (MIBC) undergoing radical cystectomy (RC) and from 4 healthy donors (HD)
Urine leukocyte composition was associated with Neoadjuvant chemotherapy (NAC), smoking status, and affectation of LN at the time of RC

Summary

Introduction

Bladder cancer (BC), the ninth most common malignancy worldwide [1], has high rates of recurrence and progression [2]. Lymph node dissection is an essential step in the treatment of MIBC because it is known that approximately 25–30% of patients have lymph node metastasis at the time of surgery [4,5], and because lymph node status is one of the most important indicators of long-term overall survival (OS) and recurrence-free survival (RFS). The risk factors for bladder cancer include family history, history of bladder infections, occupational exposure to aromatic amines and polycyclic aromatic hydrocarbons, and cigarette smoking [6]. Tobacco use is one of the primary and most common risk factors

Methods

Results

Conclusion