PMID- 37784106 OWN - NLM STAT- MEDLINE DCOM- 20231004 LR - 20231119 IS - 1479-5876 (Electronic) IS - 1479-5876 (Linking) VI - 21 IP - 1 DP - 2023 Oct 2 TI - Preoperative fluorescence in situ hybridization analysis as a predictor of tumor recurrence in patients with non-muscle invasive bladder cancer: a bi-institutional study. PG - 685 LID - 10.1186/s12967-023-04528-2 [doi] LID - 685 AB - BACKGROUND: Non-muscle invasive bladder cancer (NMIBC) is known for its elevated recurrence rate, necessitating an enhancement in the current risk stratification for recurrence. The urine-based fluorescence in situ hybridization (FISH) assay has emerged as a noninvasive auxiliary tool for detecting bladder cancer. The aim of this study was to explore the potential relationship between the preoperative FISH assay and recurrence, and to develop a FISH-clinical nomogram for predicting the recurrence-free survival (RFS) in NMIBC patients. METHODS: In total, 332 eligible patients were enrolled from two hospitals. The SYSMH cohort was randomly assigned to the training set (n = 168) and the validation set I (n = 72) at a ratio of 7:3, while the SYSUTH cohort was allocated to the validation set II (n = 92). The correlation between the preoperative FISH assay and recurrence was determined through the Cox regression analysis. The least absolute shrinkage and selection operator (LASSO) Cox regression algorithm was used for model construction. The performance of the model was assessed by its discrimination, calibration, and clinical usefulness. RESULTS: We uncovered that chromosome 7 aneuploidy, p16 locus loss, number of the positive FISH sites, and the FISH test result were significantly associated with tumor recurrence. Then, a FISH-clinical nomogram incorporating the FISH test result, T stage, associated CIS, tumor grade, and tumor status was developed. It showed favorable calibration and discrimination with a C-index of 0.683 (95%CI, 0.611-0.756) in the training set, which was confirmed in the validation set I and validation set II with C-indexes of 0.665 (95%CI, 0.565-0.765) and 0.778 (95%CI, 0.665-0.891), respectively. Decision curve analysis revealed the clinical usefulness of the nomogram. Moreover, our proposed nomogram significantly outperformed the guideline-recommended EORTC and CUETO scoring models. CONCLUSION: Our study confirmed the prognostic value of the preoperative FISH assay and proposed a FISH-clinical nomogram to predict RFS in NMIBC patients. Our nomogram can serve as a more precise tool for recurrence risk stratification, which may optimize disease management in bladder cancer and improve patient prognosis. CI - (c) 2023. BioMed Central Ltd., part of Springer Nature. FAU - Zheng, Junjiong AU - Zheng J AD - Department of Urology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Urological Diseases, 107 Yan Jiang West Road, Guangzhou, People's Republic of China. FAU - Lu, Sihong AU - Lu S AD - Department of Urology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Urological Diseases, 107 Yan Jiang West Road, Guangzhou, People's Republic of China. FAU - Huang, Yi AU - Huang Y AD - Department of Urology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Urological Diseases, 107 Yan Jiang West Road, Guangzhou, People's Republic of China. FAU - Chen, Xu AU - Chen X AD - Department of Urology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Urological Diseases, 107 Yan Jiang West Road, Guangzhou, People's Republic of China. FAU - Zhang, Jie AU - Zhang J AD - Department of Urology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Urological Diseases, 107 Yan Jiang West Road, Guangzhou, People's Republic of China. FAU - Yao, Yuhui AU - Yao Y AD - Department of Urology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Urological Diseases, 107 Yan Jiang West Road, Guangzhou, People's Republic of China. FAU - Cai, Jinhua AU - Cai J AD - Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, People's Republic of China. FAU - Wu, Jieying AU - Wu J AD - Department of Urology, the Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, People's Republic of China. wujying@mail.sysu.edu.cn. FAU - Kong, Jianqiu AU - Kong J AD - Department of Urology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Urological Diseases, 107 Yan Jiang West Road, Guangzhou, People's Republic of China. kongjq5@mail.sysu.edu.cn. FAU - Lin, Tianxin AU - Lin T AD - Department of Urology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Urological Diseases, 107 Yan Jiang West Road, Guangzhou, People's Republic of China. lintx@mail.sysu.edu.cn. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20231002 PL - England TA - J Transl Med JT - Journal of translational medicine JID - 101190741 SB - IM MH - Humans MH - Neoplasm Recurrence, Local/genetics/pathology MH - In Situ Hybridization, Fluorescence MH - *Non-Muscle Invasive Bladder Neoplasms MH - *Urinary Bladder Neoplasms/genetics/surgery/pathology MH - Prognosis MH - Retrospective Studies PMC - PMC10546664 OTO - NOTNLM OT - Fluorescence in situ hybridization OT - Nomogram OT - Non-muscle invasive bladder cancer OT - Recurrence COIS- The authors declare that they have no competing interests. EDAT- 2023/10/03 00:42 MHDA- 2023/10/04 06:43 PMCR- 2023/10/02 CRDT- 2023/10/02 23:48 PHST- 2023/04/21 00:00 [received] PHST- 2023/09/15 00:00 [accepted] PHST- 2023/08/22 00:00 [revised] PHST- 2023/10/04 06:43 [medline] PHST- 2023/10/03 00:42 [pubmed] PHST- 2023/10/02 23:48 [entrez] PHST- 2023/10/02 00:00 [pmc-release] AID - 10.1186/s12967-023-04528-2 [pii] AID - 4528 [pii] AID - 10.1186/s12967-023-04528-2 [doi] PST - epublish SO - J Transl Med. 2023 Oct 2;21(1):685. doi: 10.1186/s12967-023-04528-2.