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Thomas Flaig, MD


Researchers Explore How Sexual Diversity May Impact Bladder Cancer

By: Lauren Velentzas
Posted: Thursday, August 24, 2023

In a recent study in BMC Medical Genomics, Zou et al, of Guangxi Medical University, China, used single-cell RNA sequencing to better understand how sexual differences may impact the incidence and prognosis of bladder cancer and other bladder-related disorders. The investigators believe their study lays the foundation for understanding epidemiologic differences in urinary tract infection and bladder cancer.

“In general, females have a more robust immune response than males, resulting in different responses to many diseases between males and females,” the investigators noted. “In [the] female bladder, we found more B-cell and T-cell–activated signals and a higher expression of immunoglobulin genes.”

Using sequencing and clinical data from The Cancer Genome Atlas Program, the investigators collected single-cell RNA sequencing data of three male and three female healthy bladders. After quality control, 27,437 cells were obtained for analysis, and the researchers identified eight cell types. The investigators examined the cell type–based expression patterns of bladder cancer–related genes in both female and male bladders, and they found them predominantly expressed in urothelial cells regardless of sex. This suggests that this cell type may be the most closely associated with bladder cancer, and it may be the first cell population to transform into tumor cells.

It was also found that male urothelial cells had higher growth activity than female cells. However, more active ribosome biogenesis is also associated with tumorigenesis, and this may have some relation to bladder cancer being three to four times more common in men than in women.

Nevertheless, female patients face their own challenges. “In our study, we found that seven collagen genes associated with a poor prognosis of bladder cancer were elevated in fibroblasts in the female bladder,” the study authors said. “When bladder cancer occurs, these upregulated collagen genes may further mediate tumor cell infiltration into surrounding tissues and invasion into muscle tissue, resulting in a poor prognosis and increased mortality,” they added.

Disclosure: The study authors reported no conflicts of interest.

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