Loss of uroplakin III expression is associated with a poor prognosis in patients with urothelial carcinoma of the upper urinary tract
Loss of uroplakin III expression is associated with a poor prognosis in patients with urothelial carcinoma of the upper urinary tract
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DOI：
10.1111/j.1464-410x.2006.06158.x
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发表时间：
2006-06-01
影响因子：
4.5
通讯作者：
Kihara, Kazunori
中科院分区：
文献类型：
--
作者：
Ohtsuka, Yukihiro;Kawakami, Satoru;Kihara, Kazunori
为探讨尿斑蛋白III（uroplakin III，UPIII）的表达与上尿路尿路上皮癌患者预后的关系，对71例上尿路上皮癌患者行根治性肾输尿管切除术、淋巴结清扫术或活检术后的临床病理资料进行回顾性分析。免疫组化法检测手术标本中UPIII的表达。使用Kaplan-Meier图计算癌症特异性生存期。临床病理变量，包括UPIII表达状态，肿瘤分期和分级的预后价值进行了评估，单因素分析，然后用考克斯比例风险模型进行多因素分析。在肿瘤样本中，UPIII表达在≥ pT 2的75%（P = 0.02）、1-2级肿瘤的65%和3级肿瘤的33%（P = 0.009）中呈阳性。在71名患者中，21名在中位随访61个月期间死于该病。UPIII阴性表达者的5年生存率明显低于UPIII阳性表达者（100%vs46%，P < 0.001）。诊断时患者的年龄、组织学分级、性别或肿瘤的多样性均没有显著的预后价值。多因素分析显示，UPIII表达是影响上尿路上皮癌预后的重要因素（P < 0.001），其次是肿瘤分期（P = 0.04）和淋巴结转移（P = 0.05），提示UPIII表达是影响上尿路上皮癌预后的重要因素。
To investigate the association between the expression of uroplakin III (UPIII) and the prognosis of patients with urothelial carcinoma of the upper urinary tract, as uroplakins are urothelium-specific markers of terminal urothelial differentiation.Clinicopathological and follow-up data from 71 patients who had undergone radical nephroureterectomy and lymph node dissection or sampling for urothelial carcinoma of the upper urinary tract were reviewed. The expression of UPIII was evaluated immunohistochemically in surgical specimens. Cancer-specific survival was calculated using Kaplan-Meier plots. Prognostic values of clinicopathological variables including UPIII expression status, tumour stage and grade were evaluated by univariate analyses, followed by multivariate analysis using the Cox proportional-hazard model.In all specimens there was intense UPIII immunoreactivity of umbrella cells of normal urothelium. In tumour samples, UPIII expression was positive in 75% of = pT2 (P = 0.02), and in 65% of grade 1-2 tumours and 33% of grade 3 (P = 0.009). Of the 71 patients, 21 died from the disease during the median follow-up of 61 months. The cancer-specific survival of patients with negative UPIII expression was significantly worse than that of those with positive UPIII expression (5-year cancer-specific survival, 100% vs 46%, P < 0.001). Neither patient age at diagnosis, histological grade, sex, or multiplicity of the tumour had significant prognostic value. Multivariate analysis revealed that UPIII expression was the most powerful prognostic indicator (P < 0.001) followed by tumour stage (P = 0.04) and lymph node metastasis (P = 0.05).The present data suggest that UPIII expression is a powerful prognostic factor in patients with upper urinary tract urothelial carcinoma.