COL6A1 expression as a potential prognostic biomarker for risk stratification of T1 high grade bladder cancer: Unveiling the aggressive nature of a distinct non-muscle invasive subtype

• Published in: Investigative and clinical urology Vol. 65; no. 1; pp. 94 - 103
• Main Authors: Kim, Kyeong, Byun, Young Joon, Zheng, Chuang-Ming, Moon, Sungmin, Jo, Soo Jeong, Kang, Ho Won, Kim, Won Tae, Choi, Yung Hyun, Moon, Sung-Kwon, Kim, Wun-Jae, Piao, Xuan-Mei, Yun, Seok Joong
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Urological Association 01.01.2024; Korean Urological Association; 대한비뇨의학회
• Subjects: collagen type vi; Humans; Non-Muscle Invasive Bladder Neoplasms; Original; Prognosis; progression-free survival; Risk Assessment; Urinary Bladder; Urinary Bladder Neoplasms - genetics; 비뇨기과학; Collagen type VI; Non-muscle invasive bladder neoplasms; Progression-free survival; Risk assessment
• ISSN: 2466-0493; 2466-054X; 2466-054X
• DOI: 10.4111/icu.20230227

T1 high grade (T1HG) bladder cancer (BC) is a type of non-muscle invasive BC (NMIBC) that is recognized as an aggressive subtype with a heightened propensity for progression. Current risk stratification methods for NMIBC rely on clinicopathological indicators; however, these approaches do not adequately capture the aggressive nature of T1HG BC. Thus, new, more accurate biomarkers for T1HG risk stratification are needed. Here, we enrolled three different patient cohorts and investigated expression of collagen type VI alpha 1 ( ), a key component of the extracellular matrix, at different stages and grades of BC, with a specific focus on T1HG BC. Samples from 298 BC patients were subjected to RNA sequencing and real-time polymerase chain reaction. We found that T1HG BC and muscle invasive BC (MIBC) exhibited comparable expression of , which was significantly higher than that by other NMIBC subtypes. In particular, T1HG patients who later progressed to MIBC had considerably higher expression of than Ta, T1 low grade patients, and patients that did not progress, highlighting the aggressive nature and higher risk of progression associated with T1HG BC. Moreover, Cox and Kaplan-Meier survival analyses revealed a significant association between elevated expression of and poor progression-free survival of T1HG BC patients (multivariate Cox hazard ratio, 16.812; 95% confidence interval, 3.283-86.095; p=0.001 and p=0.0002 [log-rank test]). These findings suggest that may be a promising biomarker for risk stratification of T1HG BC, offering valuable insight into disease prognosis and guidance of personalized treatment decisions.