Clinical significance of T-bet, GATA-3, and Bcl-6 transcription factor expression in bladder carcinomaReport as inadecuate

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Journal of Translational Medicine

, 14:144

Personalised medicine


BackgroundThe aim of this study was to investigate the clinical significance of three immune cell-related transcription factors, T-bet, GATA-3 and Bcl-6 in bladder cancer in Tunisian patients.

MethodsExpression of T-bet, GATA-3 and Bcl-6 genes was assessed using RT-qPCR in 65 bladder cancers from patients: 32 being diagnosed as low- and medium-grade, 31 as high-grade, 25 as muscle invasive stage and 39 as non-muscle invasive stage. Gene expression was statistically correlated according to the grade, the stage, tobacco consumption, the BCG response and disease severity.

ResultsT-bet levels in patients with high-grade bladder cancer were significantly elevated compared to patients with low- or medium-grade bladder cancer p = 0.005. In invasive carcinoma T2–T4, the T-bet levels were significantly higher than in superficial non-invasive bladder tumors Tis, Ta, and T1 p = 0.02. However, T-bet is predictive of the response to BCG. Its expression is high in good responders to BCG p = 0.02. In contrast, the expression of GATA-3 and Bcl-6 in non-invasive carcinoma p = 0.008 and p = 0.0003 and in patients with low- and medium-grade cancers p = 0.001 and p < 0.0001 is significantly higher than in invasive bladder tumors and in patients with high-grade bladder carcinoma, respectively. In addition, heavy smokers, whose tumors express low levels of GATA-3 and Bcl-6, are poor responders to BCG p = 0.01 and p = 0.03. Finally, better patient survival correlated with GATA-3 p = 0.04 and Bcl-6 p = 0.04 but not T-bet expression.

ConclusionsOur results suggest that T-bet expression in bladder tumors could be a positive prognostic indicator of BCG therapy, even if high levels are found in high-grade and stage of the disease. However, GATA-3 and Bcl-6 expression could be considered as predictive factors for good patient survival.

KeywordsBladder carcinomas T-bet GATA-3 Bcl-6 Prognosis AbbreviationsBCGbacillus calmette-guerin

Bcl-6B-cell lymphoma 6

GATA-3trans-acting T cell-specific transcription factor 3

TfhT-cell follicular -helper-

T-betT-box transcription factor TBX21

TNMtumor node metastasis

WHOWorld Health Organization

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Author: Islem Ben Bahria-Sediki - Nadhir Yousfi - Catherine Paul - Mohamed Chebil - Mohamed Cherif - Rachida Zermani - Amel Ben A


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