Identification and validation of a dysregulated TME-related gene signature for predicting prognosis, and immunological properties in bladder cancer.

Background: During tumor growth, tumor cells interact with their tumor microenvironment (TME) resulting in the development of heterogeneous tumors that promote tumor occurrence and progression. Recently, there has been extensive attention on TME as a possible therapeutic target for cancers. However, an accurate TME-related prediction model is urgently needed to aid in the assessment of patients' prognoses and therapeutic value, and to assist in clinical decision-making. As such, this study aimed to develop and validate a new prognostic model based on TME-associated genes for BC patients. Methods: Transcriptome data and clinical information for BC patients were extracted from The Cancer Genome Atlas (TCGA) database. Gene Expression Omnibus (GEO) and IMvigor210 databases, along with the MSigDB, were utilized to identify genes associated with TMEs (TMRGs). A consensus clustering approach was used to identify molecular clusters associated with TMEs. LASSO Cox regression analysis was conducted to establish a prognostic TMRG-related signature, with verifications being successfully conducted internally and externally. Gene ontology (GO), KEGG, and single-sample gene set enrichment analyses (ssGSEA) were performed to investigate the underlying mechanisms. The potential response to ICB therapy was estimated using the Tumor Immune Dysfunction and Exclusion (TIDE) algorithm and Immunophenoscore (IPS). Additionally, it was found that the expression level of certain genes in the model was significantly correlated with objective responses to anti-PD-1 or anti-PD-L1 treatment in the IMvigor210, GSE111636, GSE176307, or Truce01 (registration number NCT04730219) cohorts. Finally, real-time PCR validation was performed on 10 paired tissue samples, and in vitro cytological experiments were also conducted on BC cell lines. Results: In BC patients, 133 genes differentially expressed that were associated with prognosis in TME. Consensus clustering analysis revealed three distinct clinicopathological characteristics and survival outcomes. A novel prognostic model based on nine TMRGs (including C3orf62, DPYSL2, GZMA, SERPINB3, RHCG, PTPRR, STMN3, TMPRSS4, COMP) was identified, and a TMEscore for OS prediction was constructed, with its reliable predictive performance in BC patients being validated. MultiCox analysis showed that the risk score was an independent prognostic factor. A nomogram was developed to facilitate the clinical viability of TMEscore. Based on GO and KEGG enrichment analyses, biological processes related to ECM and collagen binding were significantly enriched among high-risk individuals. In addition, the low-risk group, characterized by a higher number of infiltrating CD8+ T cells and a lower burden of tumor mutations, demonstrated a longer survival time. Our study also found that TMEscore correlated with drug susceptibility, immune cell infiltration, and the prediction of immunotherapy efficacy. Lastly, we identified SERPINB3 as significantly promoting BC cells migration and invasion through differential expression validation and in vitro phenotypic experiments. Conclusion: Our study developed a prognostic model based on nine TMRGs that accurately and stably predicted survival, guiding individual treatment for patients with BC, and providing new therapeutic strategies for the disease.

ROS-mediated waterlogging memory, induced by priming, mitigates photosynthesis inhibition in tomato under waterlogging stress.

With global climate change, the frequency and intensity of waterlogging events are increasing due to frequent and heavy precipitation. Little is known however about the response of plants to repeated waterlogging stress events. The aim is to clarify physiological regulation mechanisms of tomato plants under repeated waterlogging stress, and whether Trichoderma harzianum can alleviate waterlogging injury. We identified two genotypes of tomato, 'MIX-002' and 'LA4440', as waterlogging tolerant and sensitive genotypes, respectively, based on plant biomass accumulation. The two tomato genotypes were subjected to a waterlogging priming treatment for 2 days (excess water for 1 cm above substrate surface) followed by a recovery stage for 2 days, and then a second waterlogging stress for 5 days (excess water for 1 cm above substrate surface) followed by a second recovery stage for 3 days. Leaf physiological, plant growth parameters, and the expression of five key genes were investigated. We found that the two genotypes responded differently to waterlogging priming and stress in terms of photosynthesis, reactive oxygen species (ROS), and osmotic regulatory mechanisms. Waterlogging stress significantly increased H2O2 content of 'MIX-002', while that of 'LA4440' had no significant change. Under waterlogging stress, photosynthesis of the two genotypes treated with waterlogging priming returned to the control level. However, Trichoderma harzianum treatment during the second recovery stage did not show positive mitigative effects. The plants of 'LA4440' with priming showed lower peroxidase (POD) activity and proline content but higher H2O2 content than that without priming under waterlogging stress. Under waterlogging stress with priming as compared to without priming, SODCC2 was downregulated in two tomatoes, and AGR2 and X92888 were upregulated in 'MIX-002' but downregulated in 'LA4440'. Overall, the two tomato genotypes exhibited distinct photosynthetic, ROS and osmotic regulatory mechanisms responding to the waterlogging stress. Waterlogging priming can induce stress memory by adjusting stomatal conductance, sustaining ROS homeostasis, regulating osmotic regulatory substances and key gene expressions mediated by H2O2, and thus alleviate the damage on tomato photosynthesis when waterlogging reoccurred.

Differences in Physiological Responses of Two Tomato Genotypes to Combined Waterlogging and Cadmium Stresses.

Waterlogging and heavy mental (e.g., cadmium) stress are two primary threats to crop growth. The combination of abiotic stresses was common and frequent, especially in the field condition. Even though the effects of individual waterlogging and cadmium on tomato plants have been widely investigated, the response of tomatoes under combined waterlogging and cadmium stress remains unclear. This study aimed to clarify and compare physiological, biochemical characteristics and plant growth of two tomato genotypes under individual and combined stress. Two tomato genotypes ('MIX-002' and 'LA4440') were treated under control, waterlogging, cadmium stress and their combination. The results showed that chloroplast ultrastructure of tomatoes under individual and combined stress was damaged with disordered stroma and grana lamellae. The H2O2 (hydrogen peroxide) content and O2·- (superoxide anion radical) production rate of plants under all the three stresses was not significantly higher than the control except for 'LA4440' under the combined stress. Antioxidant enzymes actively responded in the two tomato genotypes, as shown by significant increase in SOD activity from 'MIX-002' under waterlogging and combined stress and from 'LA4440' under cadmium. Meanwhile, CAT activity of 'MIX-002' under waterlogging and 'LA4440' under combined stress significantly decreased, and the POD activity of 'MIX-002' under combined stress significantly increased as compared with the respective control. The APX activity of 'MIX-002' and 'LA4440' under combined stress was significantly lower and higher than the respective controls. This indicated that tomato plants were able to secure redox homeostasis and protect plants from oxidative damage through the synergetic regulation of antioxidant enzymes. Plant height and biomass of the two genotypes under individual and combined stress significantly decreased, which could be a direct result from the chloroplast alteration and resource re-allocation. Overall, the effects of combined waterlogging and cadmium stress were not simply the sum of individual effects on two tomato genotypes. Distinct ROS (reactive oxygen species) scavenging systems of two tomato genotypes under stresses suggest a genotype-dependent antioxidant enzymes regulation.

Transcriptomic Profiling of Tomato Leaves Identifies Novel Transcription Factors Responding to Dehydration Stress.

Drought is among the most challenging environmental restrictions to tomatoes (Solanum lycopersi-cum), which causes dehydration of the tissues and results in massive loss of yield. Breeding for dehydration-tolerant tomatoes is a pressing issue as a result of global climate change that leads to increased duration and frequency of droughts. However, the key genes involved in dehydration response and tolerance in tomato are not widely known, and genes that can be targeted for dehydration-tolerant tomato breeding remains to be discovered. Here, we compared phenotypes and transcriptomic profiles of tomato leaves between control and dehydration conditions. We show that dehydration decreased the relative water content of tomato leaves after 2 h of dehydration treatment; however, it promoted the malondialdehyde (MDA) content and ion leakage ratio after 4 h and 12 h of dehydration, respectively. Moreover, dehydration stress triggered oxidative stress as we detected significant increases in H2O2 and O2- levels. Simultaneously, dehydration enhanced the activities of antioxidant enzymes including peroxidase (POD), superoxide dismutase (SOD), catalase (CAT), and phenylalanine ammonia-lyase (PAL). Genome-wide RNA sequencing of tomato leaves treated with or without dehydration (control) identified 8116 and 5670 differentially expressed genes (DEGs) after 2 h and 4 h of dehydration, respectively. These DEGs included genes involved in translation, photosynthesis, stress response, and cytoplasmic translation. We then focused specifically on DEGs annotated as transcription factors (TFs). RNA-seq analysis identified 742 TFs as DEGs by comparing samples dehydrated for 2 h with 0 h control, while among all the DEGs detected after 4 h of dehydration, only 499 of them were TFs. Furthermore, we performed real-time quantitative PCR analyses and validated expression patterns of 31 differentially expressed TFs of NAC, AP2/ERF, MYB, bHLH, bZIP, WRKY, and HB families. In addition, the transcriptomic data revealed that expression levels of six drought-responsive marker genes were upregulated by de-hydration treatment. Collectively, our findings not only provide a solid foundation for further functional characterization of dehydration-responsive TFs in tomatoes but may also benefit the improvement of dehydration/drought tolerance in tomatoes in the future.

The NLR Protein Encoded by the Resistance Gene Ty-2 Is Triggered by the Replication-Associated Protein Rep/C1 of Tomato Yellow Leaf Curl Virus.

The whitefly-transmitted tomato yellow leaf curl virus (TYLCV) is one of the most destructive viral pathogens of cultivated tomato. To combat TYLCV, resistance gene Ty-2 has been introduced into cultivated tomato (Solanum lycopersicum) from wild tomato species Solanum habrochaites by interspecific crossing. Introgression lines with Ty-2 contain a large inversion compared with S. lycopersicum, which causes severe suppression of recombination and has hampered the cloning of Ty-2 so far. Here, we report the fine-mapping and cloning of Ty-2 using crosses between a Ty-2 introgression line and several susceptible S. habrochaites accessions. Ty-2 was shown to encode a nucleotide-binding leucine-rich repeat (NLR) protein. For breeding purposes, a highly specific DNA marker tightly linked to the Ty-2 gene was developed permitting marker-assisted selection. The resistance mediated by Ty-2 was effective against the Israel strain of TYLCV (TYLCV-IL) and tomato yellow leaf curl virus-[China : Shanghai2] (TYLCV-[CN : SH2]), but not against tomato yellow leaf curl Sardinia virus (TYLCSV) and leafhopper-transmitted beet curly top virus (BCTV). By co-infiltration experiments we showed that transient expression of the Rep/C1 protein of TYLCV, but not of TYLCSV triggered a hypersensitive response (HR) in Nicotiana benthamiana plants co-expressing the Ty-2 gene. Our results indicate that the Rep/C1 gene of TYLCV-IL presents the avirulence determinant of Ty-2-mediated resistance.

Long noncoding RNAs, ENST00000598996 and ENST00000524265, are correlated with favorable prognosis and act as potential tumor suppressors in bladder cancer.

Bladder cancer (BC) is a serious malignancy worldwide due to its distant metastasis and high recurrence rates. Increasing evidence has indicated that dysregulated long non­coding RNAs (lncRNAs) are involved in tumorigenesis and progression in multiple malignancies. However, their clinical significances, biological functions and molecular mechanisms in BC remain poorly understood. Hence, the present study investigated the expression profile of lncRNAs and mRNAs in five BC tissues and the corresponding adjacent normal specimens using high­throughput RNA sequencing (RNA­seq). A total of 103 differentially expressed (DE) lncRNAs were identified, including 35 upregulated and 68 downregulated ones in BC tissues. Similarly, a total of 2,756 DE­mRNAs were detected, including 1,467 upregulated and 1,289 downregulated. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses, and lncRNA­miRNA­mRNA network analyses suggested that these dysregulated lncRNAs are potentially implicated in the onset and progression of BC. Subsequently, four lncRNAs (upregulated ENST00000433108; downregulated ENST00000598996, ENST00000524265 and ENST00000398461) and two mRNAs (upregulated CCNB1 and CDK1) in 64 pairs of BC and adjacent normal tissues and four BC cell lines were detected using reverse transcription­quantitative PCR and these results were consistent with the sequencing data. Additionally, Fisher's exact test, Kaplan­Meier plots, and Cox regression analyses were used for elucidating the clinical values of ENST00000598996 and ENST00000524265. Furthermore, a receiver operating characteristic curve was constructed to assess their diagnostic values. The low expression level of ENST00000598996 and ENST00000524265 was correlated with unfavorable clinicopathological parameters, and shorter progression­free and overall survival time, whereas, ENST00000433108 was not associated with either. The in vitro functional experiments also revealed that the overexpression of ENST00000598996 and ENST00000524265 decreased the proliferation, migration, and invasion abilities of BC cells. Collectively, the results of the present study provide a novel landscape of lncRNA and mRNA expression profiles in BC. In addition, the results also indicated that ENST00000598996 and ENST00000524265 may serve as tumor suppressors, potential diagnostic biomarkers and prognostic predictors for patients with BC.

Laparoscopic treatment of a huge seminal vesicle calculus: A case report and review of literature.

A 67-year-old male patient had a history of repeated urinary tract infections for numerous years. X-ray examination revealed a large calcific density in the pelvic cavity, with a diameter of 10.4 cm and a CT value of ~792.9 HU. On MRI of the pelvis, the lesion displayed with extremely low signals. The inside of the stone had a concentric ring shape with a slightly higher signal and the patient was diagnosed with a large left seminal vesicle calculus. Laparoscopic surgery was selected to treat the stone. The patient recovered rapidly and the symptoms, including urgency, urinary frequency, as well as lower abdominal and perineal pain, were obviously improved. The present case study reports on the largest seminal vesicle calculus reported in the current English literature in addition to a brief literature review. Cases of seminal vesicle calculi (SVC) are rare. The present study reports on a case of SVC, which is the largest reported in current English literature, to the best of our knowledge.

Physiological response of tomatoes at drought, heat and their combination followed by recovery.

In nature, crops encounter a combination of abiotic stresses that severely limit yield. Our aim was to dynamically expose the changes of tomatoes' physiological parameters to drought, heat and their combination and thereby clarify the relationship between the responses to single and combined stress. We studied the effect of single and combined drought and heat stresses on the shoot and root of two tomato cultivars (Sufen No.14 as CV1; Jinlingmeiyu as CV2). After being exposed to combined stress for 6 days, the dry weight of shoot and root significantly decreased. The Fq '/Fm ' (quantum yield of photosystem II) was significantly lower in CV1 upon drought and combined stress and in CV2 subjected to combined stress (between days 4 and 6) compared to control. The relative water content during combined stress was significantly lower than control from day 4 to recovery day 2. On days 3 and 6, the water loss rate significantly increased under heat stress and decreased at drought and combined stress, respectively. The combined stress caused severe damages on photosystem II and chloroplast ultrastructure. The root activity after stress recovered even though drought significantly increased the activity from day 2 to day 6. Combined stress result in complex responses during tomato growth. The CV1 was more heat tolerant than CV2, but there was no varietal difference at drought and combined stress. This study contributes to the understanding of the underlying physiological response mechanism of plant to combined stress and crop improvement by providing valuable information for abiotic stress-tolerant tomato breeding.

Application of Whole Genome Resequencing in Mapping of a Tomato Yellow Leaf Curl Virus Resistance Gene.

Tomato yellow leaf curl virus (TYLCV) has significantly impacted the tomato industry around the world, and the use of insecticides and insect nets have not effectively controlled the spread of this pathogen. The tomato line AVTO1227 is highly resistant to TYLCV. In this study, F2 and BC1 populations derived from AVTO1227 and the susceptible line Money maker were used to assess the genetic mechanism underlying TYLCV resistance. We have identified a recessive TYLCV resistance gene, hereby designated as ty-5, which is linked to SlNACI. Genomic DNA pools from resistant and susceptible groups were constructed, and their genomes were resequenced. The ty-5 gene was identified on an interval encompassing the genomic positions 2.22 Mb to 3.19 Mb on tomato chromosome 4. Genotyping using linkage markers further mapped ty-5 within the interval between markers ty5-25 and ty5-29, where only the pelota gene is located. Consequently, pelota was considered as the candidate gene corresponding to ty-5. Two nucleotide transversions within the promoter region and one transversion in exon region of the pelota gene were detected in the parental lines. However, the relative transcript levels of pelota did not significantly differ among the three tomato lines, regardless of TYLCV infection. This study will facilitate marker-assisted breeding for resistance to TYLCV and lay a foundation for the research of the resistance mechanism of ty-5 in tomato.

Genome-wide identification and expression analysis of the BTB domain-containing protein gene family in tomato.

BTB (broad-complex, tramtrack, and bric-a-brac) family proteins are characterized by the presence of a protein-protein interaction BTB domain. BTB proteins have diverse functions, including transcriptional regulation, protein degradation, chromatin remodeling, and cytoskeletal regulation. However, little is known about this gene family in tomato (Solanum lycopersicum), the most important model plant for crop species. In this study, 38 BTB genes were identified based on tomato whole-genome sequence. Phylogenetic analysis of BTB proteins in tomato revealed that SlBTB proteins could be divided into at least 4 subfamilies. The SlBTB proteins contains 1-3 BTB domains, and several other types of functional domains, including KCTD (Potassium channel tetramerization domain-containing), the MATH (meprin and TRAF homology), ANK (Ankyrin repeats), NPR1 (nonexpressor of pathogenesis-related proteins1), NPH3 (Nonphototropic Hypocotyl 3), TAZ zinc finger, C-terminal Kelch, Skp1 and Arm (Armadillo/beta-catenin-like repeat) domains are also found in some tomato BTB proteins. Moreover, their expression patterns in tissues/stages, in response to different abiotic stress treatments and hormones were also investigated. This study provides the first comprehensive analysis of BTB gene family in the tomato genome. The data will undoubtedly be useful for better understanding the potential functions of BTB genes, and their possible roles in mediating hormone cross-talk and abiotic stress in tomato as well as in some other relative species.

Preoperative hemoglobin-platelet ratio can significantly predict progression and mortality outcomes in patients with T1G3 bladder cancer undergoing transurethral resection of bladder tumor.

OBJECTIVE: To investigate the prognostic role of hematological biomarkers, especially hemoglobin-platelet ratio (HPR) in the oncological outcomes in stage 1 and grade 3 (T1G3) bladder cancer. MATERIALS AND METHODS: We identified 457 T1G3 bladder cancer patients who underwent transurethral resection of the bladder (TURB) between 2009 and 2014. Based on hematological parameters (hemoglobin-platelet ratio (HPR), hemoglobin, and platelet counts), recurrence-free survival (RFS), progression-free survival (PFS), and overall survival (OS) and cancer-specific survival (CSS) were analyzed by using Kaplan-Meier analysis. Multivariate Cox regression model was adopted to identify the predictors of oncological outcomes. RESULTS: Kaplan-Meier survival analysis showed that low HPR (< 0.615), low hemoglobin (< 125g/l) and elevated platelet counts (> 240 × 103/µl) were correlated with poor OS. Low HPR, but not low hemoglobin and high platelet counts, is associated with worse PFS. Low HPR and low hemoglobin, but not elevated platelet counts, are associated with worse CSS. However, no significant difference was observed in RFS according to any of these hematological markers. On multivariate analysis, low HPR (HR = 1.27, 95% CI = 0.81-1.75, P = 0.030), low hemoglobin (HR = 1.20, 95% CI = 0.79-1.84, P = 0.028) and elevated platelet counts (HR = 1.07, 95% CI = 0.72-1.32, P = 0.038) were significantly associated with OS. Low hemoglobin (HR = 1.08, 95% CI = 0.68-1.82, P = 0.041) was significantly linked with CSS. Particularly, low HPR was identified as an independent predictor of PFS (HR = 1.16, 95% CI = 0.97-1.49, P = 0.033) and CSS (HR = 1.14, 95% CI = 0.87-1.78, P = 0.029). CONCLUSIONS: Preoperative HPR can be taken into account as a factor predictive of oncological outcomes for T1G3 bladder cancer, particularly disease progression and mortality outcomes.

Genome-wide identification of circRNAs involved in tomato fruit coloration.

Circular RNAs (circRNAs) are an emerging class of non-coding RNAs in plants. Our aim is to identify the circRNAs with different expression levels between tomato fruits from two cultivars ('Jinling Fenyu' and 'Jinling Moyu') at two different developmental stages. Following high-throughput sequencing, 3796 circRNAs were identified, and 243 circRNAs were shared in the four samples. As compared with the fruit at mature green stage, the expression levels of 273 and 89 circRNAs were significantly altered in the fruit at turning stage from 'Jinling Fenyu' and 'Jinling Moyu', respectively. Moreover, the parental genes of the circRNAs with significantly different expression level were mainly involved in metabolic, cellular and single-organism process and played roles in catalytic activity and binding based on GO (Gene Ontology) analysis. The results suggested that circRNAs were widespread in tomato and were generated from different chromosomes and diverse genomic regions. Some circRNAs were specific in tomato fruits at different developmental stages, which enriches the number of circRNAs in plants involved in fruit coloration and ripening. This study provides the first genome-wide profile of circRNAs involved in tomato fruit coloration and lays a foundation for studying the potential biological functions of circRNAs involved in fruit ripening.

Drought stress had a predominant effect over heat stress on three tomato cultivars subjected to combined stress.

BACKGROUND: Abiotic stresses due to environmental factors could adversely affect the growth and development of crops. Among the abiotic stresses, drought and heat stress are two critical threats to crop growth and sustainable agriculture worldwide. Considering global climate change, incidence of combined drought and heat stress is likely to increase. The aim of this study was to shed light on plant growth performance and leaf physiology of three tomatoes cultivars ('Arvento', 'LA1994' and 'LA2093') under control, drought, heat and combined stress. RESULTS: Shoot fresh and dry weight, leaf area and relative water content of all cultivars significantly decreased under drought and combined stress as compared to control. The net photosynthesis and starch content were significantly lower under drought and combined stress than control in the three cultivars. Stomata and pore length of the three cultivars significantly decreased under drought and combined stress as compared to control. The tomato 'Arvento' was more affected by heat stress than 'LA1994' and 'LA2093' due to significant decreases in shoot dry weight, chlorophyll a and carotenoid content, starch content and NPQ (non-photochemical quenching) only in 'Arvento' under heat treatment. By comparison, the two heat-tolerant tomatoes were more affected by drought stress compared to 'Arvento' as shown by small stomatal and pore area, decreased sucrose content, ΦPSII (quantum yield of photosystem II), ETR (electron transport rate) and qL (fraction of open PSII centers) in 'LA1994' and 'LA2093'. The three cultivars showed similar response when subjected to the combination of drought and heat stress as shown by most physiological parameters, even though only 'LA1994' and 'LA2093' showed decreased Fv/Fm (maximum potential quantum efficiency of photosystem II), ΦPSII, ETR and qL under combined stress. CONCLUSIONS: The cultivars differing in heat sensitivity did not show difference in the combined stress sensitivity, indicating that selection for tomatoes with combined stress tolerance might not be correlated with the single stress tolerance. In this study, drought stress had a predominant effect on tomato over heat stress, which explained why simultaneous application of heat and drought revealed similar physiological responses to the drought stress. These results will uncover the difference and linkage between the physiological response of tomatoes to drought, heat and combined stress and be important for the selection and breeding of tolerant tomato cultivars under single and combine stress.

Expression of circular RNA circASXL1 correlates with TNM classification and predicts overall survival in bladder cancer.

Circular RNAs (circRNAs) as a family of non-coding RNAs are increasingly recognized regarding their biogenesis, regulatory roles in gene expression and clinic significance in developmental diseases and cancers. In this study, we aim to identify circRNAs that may be associated with clinicopathological characteristics of patients with bladder cancer. The circRNAs databases CircBase and circ2 Traits were used to seek circRNAs reported to bladder cancer. The expression levels of the circRNA of interest in paired samples of tumor tissue and adjacent normal mucosa from 61 patients with bladder cancer were detected by real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and statistically analyzed. Database search shows that circASXL1 (circBase ID: hsa_circ_0001136) transcribed from the ASXL1 gene locus is among the circRNAs with altered expressions in bladder cancer. Results showed that the expression level of circASXL1 was significantly higher in bladder cancer tissues compared to that in adjacent noncancerous tissues (P<0.001). To be noticed, chi-square tests support that the expression of circASXL1 significantly correlates with tumor grade (P=0.025), tumor stage (P=0.019), lymph node invasion (P=0.011) and distant metastasis (P=0.032). The area under ROC curve (AUC) is 0.770 for circASXL1 in predicting tumor invasion (T2-T4 tumors). Kaplan-Meier survival analysis indicates that tumors of high circASXL1 expression are associated with shorter overall survival compared to tumors of low circASXL1 expression. Further, multivariate analysis reveals that circASXL1 is an independent prognostic factor for overall survival for patients with bladder cancer. Expression of circASXL1 in bladder tumor correlates with TNM classification and may independently predict overall survival for patients with bladder cancer.