Urinary incontinence is a prevalent condition among athletes that is not openly discussed. However, it causes regular changes in their physical performance and daily life. More research is needed to increase awareness of UI and to design interventions.
Anxiety, depression, and their interaction are associated with changes in pain disability at one-year follow-up. These findings encourage the pretreatment screening of anxiety and depression as independent symptoms in patients with CLBP in order to design more tailored and effective multidisciplinary treatments.
TAMs evaluation using CD163 is a good indicator of BCG treatment failure. Moreover, elevated infiltration of CD163(+) macrophages, predominantly in stroma areas but not in the tumor, may be a useful indicator of BCG treatment outcome, possibly owing to its immunosuppressive phenotype.
Objective
To evaluate the predictive value of genetic polymorphisms in the context of bacille Calmette‐Guérin (BCG) immunotherapy outcome and create a predictive profile that may allow discrimination of the risk of recurrence.
Patients and Methods
In a dataset of 204 patients treated with BCG, we evaluated 42 genetic polymorphisms in 38 genes involved in the BCG mechanism of action, using Sequenom MassARRAY® technology. Stepwise multivariate Cox regression was used for data mining.
Results
In agreement with previous studies we found that gender, age, tumour multiplicity and treatment scheme were associated with BCG failure. Using stepwise multivariate Cox regression analysis we propose the first predictive profile of BCG immunotherapy outcome and a risk score based on polymorphisms in immune system molecules [single nucleotide polymorphisms in tumour necrosis factor α (TNFA)‐1031T/C (rs1799964), interleukin 2 receptor α (IL2RA) rs2104286 T/C, IL17A‐197G/A (rs2275913), IL17RA‐809A/G (rs4819554), IL18R1 rs3771171 T/C, intercellular adhesion molecule 1 (ICAM‐1) K469E (rs5498), Fas ligand (FASL)‐844T/C (rs763110) and TNF‐related apoptosis‐inducing ligand receptor 1 (TRAILR1)‐397T/G (rs79037040)] in association with clinicopathological variables. This risk score allows the categorisation of patients into risk groups: patients within the low‐risk group have a 90% chance of successful treatment, whereas patients in the high‐risk group present a 75% chance of recurrence after BCG treatment.
Conclusion
We have established the first predictive score of BCG immunotherapy outcome combining clinicopathological characteristics and a panel of genetic polymorphisms. Further studies using an independent cohort are warranted. Moreover, the inclusion of other biomarkers may help to improve the proposed model.
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