Prognostic Significance of Preoperative Serum Lactate Dehydrogenase in Upper Urinary Tract Urothelial Carcinoma
Prognostic Significance of Preoperative Serum Lactate Dehydrogenase in Upper Urinary Tract Urothelial Carcinoma
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术前血清乳酸脱氢酶在上尿路尿路上皮癌中的预后意义
DOI：
10.1016/j.clgc.2016.01.003
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发表时间：
2016-08-01
影响因子：
3.2
通讯作者：
Cao, Yun
中科院分区：
文献类型：
--
作者：
Zhang, Xin-Ke;Zhang, Zhi-Ling;Cao, Yun
Upper urinary tract urothelial carcinoma (UUTUC) is one of the uncommon malignancies. In this study, we retrospectively evaluated the prognostic implication of the preoperative lactate dehydrogenase in 100 UUTUC patients. We found that the preoperative lactate dehydrogenase was an independent prognostic factor for patients with UUTUC. This finding could be of help in clinical practice.Background: Upper urinary tract urothelial carcinoma (UUTUC) is one of the uncommon malignancies lacking of prognostic indicators. Lactate dehydrogenase (LDH) has been demonstrated to correlate with clinical outcomes in human cancers. In this study, we aimed to evaluate the prognostic implication of the preoperative LDH in UUTUC. Patients and Methods: A cohort of 100 UUTUC samples along with the preoperative LDH value was recruited from January 1990 to June 2011. The cutoff value was set at 245 u/L for the upper value of normal limitation. Univariate and multivariate analyses were conducted to determine the association of LDH with overall survival (OS) and disease-free survival (DFS). Results: Kaplan-Meier analysis revealed that high level of LDH (>245 u/L) was significantly associated with poor OS (P < .001) and DFS (P = .002). Multivariate Cox proportional analysis indicated LDH, controlled by vascular invasion, pathological stage, lymph node status, subsequent bladder tumor, tumor grade, tumor necrosis, architecture, and multifocality, was as an independent predictor of OS (hazard ratio, 3.181; 95% confidence interval, 1.223-8.276; P = .018) and DFS (hazard ratio, 3.041; 95% confidence interval, 1.247-7.417; P = .015). Stratified showed that elevated serum LDH was correlated with the worse OS in patients without lymph node metastasis (P = .002) and those at advanced pathological stage (P < .001). Conclusion: The preoperative LDH was an independent prognostic factor for patients with UUTUC and could be used as a risk factor to predict the tumor aggressiveness. (C) 2016 Elsevier Inc. All rights reserved.
