MRI Signs of Muscle-invasive Bladder Cancer and the Expression of Transcription Factor E2F3 to Predict Survival

Abstract

Objective: it was to investigate the MRI features of muscle-invasive bladder cancer (MIBC) and the effect of high E2F transcription factor 3 gene (E2F3) expression on the prognosis of bladder cancer (BCa) patients. Methods: 80 patients diagnosed with BCa in the Department of Urology of Tangdu Hospital from January 2021 to January 2023 were enrolled, and underwent MRI scanning. BCa tissue samples and adjacent normal tissue samples were collected as controls. The expression level of E2F3 in MIBC tissues was detected by immunohistochemical staining, and the MRI features of MIBC were analyzed. The accuracy (Acc), sensitivity (Sen), specificity (Spe), false positive rate (FPR), false negative rate (FNR) of MRI, E2F3, and MRI+E2F3 in the diagnosis of MIBC were calculated with the pathological and surgical results as the gold standard. Results: T1WI images showed heterogeneous high signal intensity, irregular thickening adjacent to the bladder wall, no abnormalities in the prostate and bilateral seminal vesicles, and no enlarged pelvic lymph nodes. DWI images showed edema of the bladder wall at the base of the tumor. The Acc (92.5%), Sen (93.75%) and Spe (91.67%) of E2F3 plus MRI in MIBC diagnosis were obviously higher as against E2F3 or MRI alone (P < 0.05). The survival time of patients with high E2F3 expression was clearly lower as against patients with low E2F3 expression (P < 0.05). Conclusion: MRI can effectively display the characteristics of MIBC. E2F3 plus MRI has an excellent diagnostic performance for MIBC with high Sen and Spe. The high expression of E2F3 is closely related to the survival of patients, and can be adopted to predict the prognosis of patients.