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Simple Summary: At present, the immunotherapy and immune microenvironment of bladder cancer have attracted more and more attention from clinicians and researchers. In this study, the high expression of SULF2 by RNA sequencing of tissues from 90 bladder cancer patients was associated with poor prognosis in patients. We further found that a high expression of SULF2 can promote the polarization of macrophages to M2. In mechanistic studies, we found that SULF2 can promote the secretion of IL-8 through Wnt/β-catenin. IL-8 promotes the transcription of CD163 and CD206 in the microenvironment, ultimately leading to the polarization of macrophages to M2 macrophages. This study elucidates the effect of SULF2 on the polarization of macrophages in the tumor microenvironment. Sulfatase 2 (SULF2) affects the occurrence and development of cancer by regulating HSPG-binding factors. However, the mechanism of SULF2 in bladder cancer (BCa) is unknown. To determine this, we analyzed the RNA sequencing of 90 patients with BCa. The results showed that the expression of SULF2 was closely related to the prognosis of BCa. Moreover, in vivo and in vitro experiments revealed that SULF2 promotes tumor proliferation and invasion. Furthermore, using a mouse orthotopic BCa model and flow cytometric analysis, we identified that SULF2 affects the polarization of macrophages. Mechanism studies clarified that SULF2 promoted the release of HSPG-binding factors, such as IL-8, in the microenvironment through β-catenin. Meanwhile, IL-8 activated the JAK2/STAT3 pathway of macrophages to promote the expression of CD163 and CD206, thereby regulating the polarization of macrophages to the M2-type. Conclusively, these results indicate that SULF2 plays an important role in regulating the microenvironment of BCa and promotes the polarization of macrophages to the M2-type by secreting IL-8, which further deepens the malignant progression of BCa. [ABSTRACT FROM AUTHOR]

Simple Summary: It is necessary to explore a reliable predictive biomarker for immunotherapeutic strategies in bladder cancer. As an important member of tumor-infiltrating immune cells, cytotoxic T cells are the ultimate effectors of cancer rejection because of their specificity against cancer cells and cytolytic capabilities. Based on RNA expression data, we found that among T cytotoxic pathway-related genes, CD8A is a novel protective gene in bladder cancer. CD8A expression is highly associated with tumor microenvironment characteristics and tumor mutation burden, which partially explain CD8A as a prognostic and immunotherapy predictive biomarker in bladder cancer. In addition, we performed the radiogenomics in bladder cancer based on the RNA-sequence data and MRI-based radiomics features in our center. In this way, an MRI-based radiomics signature has the potential to preoperatively predict the expression of CD8A, thereby contributing to the preoperative prediction of prognosis and immunotherapeutic susceptibility in bladder cancer. As an important member of T cytotoxic pathway-related genes, CD8a molecule (CD8A) may be a useful biomarker of immunotherapeutic response and immune cell infiltration. We aimed to investigate the clinical predictive value of CD8A in prognosis and tumor microenvironment (TME) and preoperatively predict the expression of CD8A using radiogenomics in bladder cancer (BCa). Among 12 T cytotoxic pathway-related genes, CD8A was a novel protective gene and had the highest correlations with T cells and Macrophages M1 in BCa. In advanced cancer patients treated with immunotherapy, low CD8A expression was associated with immunotherapeutic failure and poor survival outcomes. CD8A expression was highly related to tumor mutation burden, critical immune checkpoint genes and several types of tumor-infiltrating immune cells, predicting effective response to immunotherapy. The preoperative MRI radiomics features and RNA-sequence data of 111 BCa samples were used to develop a radiomics signature that achieved good performance in the prediction of CD8A expression in both the training (area under curve (AUC): 0.857) and validation sets (AUC: 0.844). CD8A is a novel indicator for predicting the prognosis and immunotherapeutic response in BCa. A radiomics signature has the potential to preoperatively predict the expression of CD8A in BCa patients. [ABSTRACT FROM AUTHOR]

Purpose. The long noncoding RNA LUCAT1 (lung cancer-associated transcript 1) has been reported to be highly expressed in bladder cancer samples, but its role and molecular mechanisms need to be elucidated. Methods. Bioinformatics methods show that miR-181c-5p is a target of LUCAT1. Here, we aimed to reveal whether LUCAT1 participates in the development of bladder cancer via targeting miR-181c-5p. The expression levels of LUCAT1 and miR-181c-5p were detected by RT-PCR technology in bladder cells and tissues. The effects of the LUCAT1/miR-181c-5p axis on cell proliferation, migration, invasion, and apoptosis were tested by CCK-8, wound healing, Transwell chambers, and flow cytometry assays. The expressions of apoptosis/migration-related proteins were detected by western blotting assays. Results. The results demonstrated that LUCAT1 was overexpressed in bladder cancer tissue and cells, while miR-181c-5p showed a low expression pattern as compared to normal bladder cells and tissues. Cell proliferation, migration, and invasion capacities were significantly impaired, and cell apoptosis was enhanced when LUCAT1 was silenced in UM-UC-3 and T24 cell lines, but this effect was abolished by miR-181c-5p downregulation. In addition, miR-181c-5p downregulation impaired LUCAT1 downregulation which mediated the decreased expressions of Bcl2 and N-cadherin and the increased expressions of Bax and E-cadherin. Moreover, we found that KRAS was a direct target of miR-181c-5p and was under the positive regulation of LUCAT1. Conclusion. Collectively, this study reveals that knockdown of LUCAT1 inhibits the migration and invasion of bladder cancer cells in a miR-181c-5p-dependent manner, which may be related to KRAS downregulation. [ABSTRACT FROM AUTHOR]

Introduction. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been proven to be significant prognostic factors in many cancers. We aimed to retrospectively investigate the prognostic value of NLR and PLR in patients with bladder cancer undergoing radical cystectomy. Materials and Methods. The study comprised patients from 2010 to 2018 who were diagnosed with bladder cancer and received radical cystectomy. Clinical and pathological parameters were collected. Receiver operating characteristic curves of NLR and PLR were plotted for overall survival (OS) and cancer-specific survival (CSS). The best cutoff value of NLR and PLR were determined using X-tile software. The prognostic value of NLR and PLR for OS and CSS was analyzed using the Kaplan–Meier method and Cox regression models. Results. A total of 223 patients were enrolled with a medium follow-up period of 57 months. Receiver operating characteristic curves showed that PLR was superior to NLR as a prognostic factor in patients with bladder cancer undergoing radical cystectomy. Univariate analysis revealed that NLR (p=0.032 and p=0.041) and PLR (p=0.003 and p=0.003) were significantly associated with both OS and CSS, respectively. Multivariate analysis identified only PLR as independent prognostic factors for OS (p=0.046) and CSS (p=0.039), respectively. Conclusions. The present findings suggested that compared with NLR, PLR was a superior prognostic factor of OS and CSS in bladder cancer patients indicated to radical cystectomy. [ABSTRACT FROM AUTHOR]