title: A four-gene signature predicts disease progression in muscle invasive bladder cancer.
abstract: There are no reliable criteria to handle disease progression of muscle invasive bladder cancer (MIBC), which strongly influences patient survival. Therefore, an accurate predicting method to identify progressive MIBC patients is greatly needed. The aim of this study was to identify a genetic signature associated with disease progression in MIBC. To address this issue, we analyzed three independent cohorts (a training set, test set 1 and test set 2) comprising a total of 128 MIBC patients. Microarray gene expression profiling, including gene network analysis, was performed in the training set to identify a gene expression signature associated with disease progression. The prognostic value of the signature was validated in test set 1 and test set 2 by microarray and real-time reverse transcriptase polymerase chain reaction (RT-PCR), respectively. The determination of gene expression patterns by microarray data analysis identified 1,320 genes associated with disease progression. Gene network analysis of the 1,320 genes suggested that IL1B, S100A8, S100A9 and EGFR were important mediators of MIBC progression. We validated this putative four-gene signature in two independent cohorts (log-rank test, P < 0.05 each, respectively) and estimated the predictive value of the signature by multivariate Cox regression analysis (hazard ratio [HR], 6.24; 95% confidence interval [CI], 1.58-24.61; P = 0.009). Finally, signature-based stratification demonstrated that the four-gene signature was an independent predictor of MIBC progression. In conclusion, a molecular signature defined by four genes represents a promising diagnostic tool for the identification of MIBC patients at high risk of progression.
authors.affiliation: Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea. wjkim@chungbuk.ac.kr
authors.forename: Wun-Jae
authors.initials: WJ
authors.lastname: Kim
authors.forename: Seon-Kyu
authors.initials: SK
authors.lastname: Kim
authors.forename: Pildu
authors.initials: P
authors.lastname: Jeong
authors.forename: Seok-Joong
authors.initials: SJ
authors.lastname: Yun
authors.forename: In-Chang
authors.initials: IC
authors.lastname: Cho
authors.forename: Isaac Yi
authors.initials: IY
authors.lastname: Kim
authors.forename: Sung-Kwon
authors.initials: SK
authors.lastname: Moon
authors.forename: Hong-Duck
authors.initials: HD
authors.lastname: Um
authors.forename: Yung Hyun
authors.initials: YH
authors.lastname: Choi
mesh_terms: D018450:Disease Progression; D020869:Gene Expression Profiling; D006801:Humans; D019042:Muscle Neoplasms / Q000235:genetics* / Q000556:secondary*; D020411:Oligonucleotide Array Sequence Analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000235:genetics*