MRE11蛋白表現與上泌尿道上皮癌預後之相關性

詹鎮豪^1,2,3,4、徐偉齊⁵、李威明^3,4,6、李怡琛⁷、黃阿梅^4,5,8、張玲麗^5,9、林慧惠³、吳文正^1,3,4,5、李經家^1,3、連培因¹⁰、柯宏龍^1,3,4,5

¹高醫附設醫院 泌尿部，²小港醫院 泌尿科，³高雄醫學大學 泌尿科，³高雄醫學大學 泌尿科，⁴高雄醫學大學 臨醫所，⁵高雄醫學大學 醫研所，⁶部立屏東醫院 泌尿科，⁷高雄醫學大學 解剖科，⁸高雄醫學大學 生化所，⁹高雄醫學大學 微免所，¹⁰高雄醫學大學 病理科

MRE11 expression level predicts poor survival in upper tract urothelial carcinomas

Jhen-Hao Jhan ^1,2,3,4, Wei-Chi Hsu ⁵, Wei-Ming Li ^3,4,6,, Yi-Chen Lee ⁷, A-Mei Huang ^4,5,8, Lin-Li Chang ^5,9, Hui-Hui Lin³, Wen-Jeng Wu ^1,3,4,5, Ching-Chia Li ^1,3, Peir-In Liang ¹⁰, Hung-Lung Ke^1,3,4,5

^1.        Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

^2.        Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan

^3.        Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

^4.        Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

^5.        Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

^6.        Department of Urology, Ministry of Health and Welfare Pingtung Hospital, Pingtung, Taiwan.

^7.        Department of Anatomy, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

^8.        Department of Biochemistry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

^9.        Department of Microbiology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

^10.      Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Purpose: Upper tract urothelial carcinoma (UTUC) is a aggressive malignancy with characteristics of high metastasis and poor prognosis. There are some extraordinarily different features of UTUC between Asian and Western countries. Double-strand break repair protein MRE11 is a component of the MRN complex which involved in DNA repair pathway. Emerging studies have focused on the role of MRE11 in human malignancies with conflicting results. We aimed to establish the relationship between MRE11 expression and the oncological outcome of UTUC..

Materials and Methods: This study retrospectively reviewed 150 patients who underwent radical nephroureterectomy(RNU) with pathologically confirmed UTUC. Pathological slides were reviewed and clinical parameters were collected. An immunohistochemical study was performed and the cytoplasmic and nuclear staining results of UTUC were recorded. Expressions of MRE11 were analyzed to identify correlations with various clinicopathological parameters, metastasis-free survival (MFS) and cancer-specific survival (CSS).

Results: MRE11 expression was significantly correlated with patients with high pathological stage (p = 0.001), perineural invasion (p = 0.015) and tumor necrosis (p = 0.034). In univariate analysis, high MRE11 expression was associated with a poor MFS (p = 0.014, 95% CI 1.18, 4.38) and a poor CSS (p = 0.001, 95% CI 2.45, 27.75). In multivariable analysis, high MRE11 expression was associated with a poor CSS (p = 0.019, 95% CI 1.28, 15.65).

Conclusions: MRE11 expression could serve as a potential predictor of prognosis for patients with UTUC.