High Ubiquitin-like Protein 3 Expression Is Associated With Prolonged Recurrence-free Survival in Non-muscle-invasive Bladder Cancer

BACKGROUND/AIM: Current clinicopathological factors inadequately capture the biological heterogeneity of non-muscle-invasive bladder cancer (NMIBC). This study investigated the prognostic significance of ubiquitin-like protein 3 (UBL3), a molecule involved in extracellular vesicle sorting and immune regulation, in NMIBC. MATERIALS AND METHODS: immunohistochemistry (IHC) quantified using digital H-scores (QuPath). A separate internal validation cohort (n=192) was subsequently evaluated by IHC. The primary endpoint was recurrence-free survival (RFS). RESULTS: =0.023), alongside a negative preoperative urine cytology and immediate intravesical chemotherapy, remained independently associated with RFS. CONCLUSION: Elevated UBL3 expression was associated with prolonged RFS in patients with NMIBC following transurethral resection of bladder tumor. While UBL3 has potential as a prognostic biomarker, establishing its definitive clinical utility will require mechanistic investigations and validation across independent, multicenter cohorts.