Objective To study the expression of key regulators of iron metabolism,iron death inhibitor and ferririn heavy chain 1(FTH1),in bladder cancinoma and their relationship with immune invasion and prognosis.Methods Sixty patients diagnosed with bladder cancer at Jiamusi Central Hospital from January 2016 to January 2018 were chosen as the subjects of this study.Collected clinical tissue samples from patients and analyzed the protein expression of FTH1 and the infiltration abundance of three types of immune cells[CD8+T cells,CD4+T cells,natural killer(NK)cells]in bladder tumor samples through immunohistochemistry(IHC).Pearson analyzed the correlation between FTH1 and the expression of immune cell marker.Kaplan-Meier(KM)survival curve was used to analyze the relationship between FTH1 and overall survival(OS),disease free survival(DFS)in bladder cancer patients.COX proportional hazards regression model analyzed risk factors affecting the prognosis and survival of bladder cancer patients.Results The positive expression rate of FTH1 protein in bladder cancer tissue was significantly higher than that in normal adjacent tissues(37.50％vs 12.50％),with a statistically significant difference(χ2=36.391,P<0.05).The positive rate of FTH1 in cancer tissues with female gender,non papillary tumor histological subtype,and T1～T2 lesion infiltration degree,American joint committee on cancer(AJCC)stage I～Ⅱ,was lower than that in cancer tissues with male gender,papillary tumor histological subtype,T3～T4 lesion infiltration degree,and AJCC stage Ⅲ～Ⅳ,and the differences were statistically significant(χ2=4.156～13.846,all P<0.05).The five-year cumulative OS and cumulative DFS of the FTH1 high expression group were significantly lower than those of the FTH1 low expression group,and the differences were statistically significant(Log-rank χ2=25.35,33.67,all P<0.0001).The results of the multivariate COX regression analysis indicated that tumor histological subtype and high expression of FTH1 were identified as independent prognostic risk factors for bladder cancer(all P<0.01).Additionally,a positive correlation was observed between high FTH1 expression in bladder cancer and the IHC score of forkhead box protein P3+(Foxp3+)tumor-infiltrating lymphocytes(TILs)(r=0.580,P<0.05),while negative correlations were found between the IHC scores of CD8+TILs CD56+TILs,and CD4+TILs(r=-0.532,-0.533,-0.452,all P<0.05).Conclusion FTH1 as a biomarker potentiates the prediction of bladder cancer prognosis and the immune micro-environmental(IME).

Objective To study the expression of key regulators of iron metabolism,iron death inhibitor and ferririn heavy chain 1(FTH1),in bladder cancinoma and their relationship with immune invasion and prognosis.Methods Sixty patients diagnosed with bladder cancer at Jiamusi Central Hospital from January 2016 to January 2018 were chosen as the subjects of this study.Collected clinical tissue samples from patients and analyzed the protein expression of FTH1 and the infiltration abundance of three types of immune cells[CD8+T cells,CD4+T cells,natural killer(NK)cells]in bladder tumor samples through immunohistochemistry(IHC).Pearson analyzed the correlation between FTH1 and the expression of immune cell marker.Kaplan-Meier(KM)survival curve was used to analyze the relationship between FTH1 and overall survival(OS),disease free survival(DFS)in bladder cancer patients.COX proportional hazards regression model analyzed risk factors affecting the prognosis and survival of bladder cancer patients.Results The positive expression rate of FTH1 protein in bladder cancer tissue was significantly higher than that in normal adjacent tissues(37.50％vs 12.50％),with a statistically significant difference(χ2=36.391,P<0.05).The positive rate of FTH1 in cancer tissues with female gender,non papillary tumor histological subtype,and T1～T2 lesion infiltration degree,American joint committee on cancer(AJCC)stage I～Ⅱ,was lower than that in cancer tissues with male gender,papillary tumor histological subtype,T3～T4 lesion infiltration degree,and AJCC stage Ⅲ～Ⅳ,and the differences were statistically significant(χ2=4.156～13.846,all P<0.05).The five-year cumulative OS and cumulative DFS of the FTH1 high expression group were significantly lower than those of the FTH1 low expression group,and the differences were statistically significant(Log-rank χ2=25.35,33.67,all P<0.0001).The results of the multivariate COX regression analysis indicated that tumor histological subtype and high expression of FTH1 were identified as independent prognostic risk factors for bladder cancer(all P<0.01).Additionally,a positive correlation was observed between high FTH1 expression in bladder cancer and the IHC score of forkhead box protein P3+(Foxp3+)tumor-infiltrating lymphocytes(TILs)(r=0.580,P<0.05),while negative correlations were found between the IHC scores of CD8+TILs CD56+TILs,and CD4+TILs(r=-0.532,-0.533,-0.452,all P<0.05).Conclusion FTH1 as a biomarker potentiates the prediction of bladder cancer prognosis and the immune micro-environmental(IME).