Endothelin-1高表現可以做為泌尿道上皮癌好的預後因子
詹鎮豪1、呂研嫚1、李經家1,2、阮雍順1,3、李威明1,4、柯宏龍1,4、葉信志1,2,4、 黃琮懿1,4、溫聖辰1,4、李香瑩1,2、周以和1,4、吳文正1,2,4、黃俊農1,4
1高雄醫學大學 附設中和紀念醫院 泌尿科
2高雄市立大同醫院
3高雄市立小港醫院
4高雄醫學大學 醫學系
High Endothelin-1 Expression Predicts Good Prognosis in Upper Tract Urothelial Carcinoma
Jhen-Hao Jhan1、Yen-Man Lu1、Ching-Chia Li1,2、Yung-Shun Juan1,3、Wei-Ming Li1,4、 Hung-Lung Ke1,4、Hsin-Chih Yeh1,2,4、Tsung-Yi Huang1,4、Sheng-Chen Wen1,4、 Hsiang-Ying Lee1,2、Yii-Her Chou1,4、Wen-Jeng Wu1,2,4、Chun-Nung Huang1,4
1Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
2 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
3Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
4Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
Purpose:
The survival of upper tract urothelial carcinoma has not changed significantly during the last two decades and there were also no adequate prognostic factors for the disease. In this study, we aim to evaluate the predictive value of endothelin expression on the prognosis of patients with upper tract urothelial carcinoma.
Materials and Methods:
One hundred and fifty-six UTUC patients who underwent radical nephroureterectomy (RNU) with bladder cuff excision were enrolled in the study. ET axis expression was analyzed by immunohistochemistry. The association between retrospectively collected clinical parameters and ET axis expression was examined by using the χ2 test. The Kaplan-Meier method was applied to estimate the effect of ET axis expression on metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS). Hazard ratios of ET axis expression on survival were evaluated by the Cox regression model.
Results:
Endothelin-1 expression was strongly associated with superficial pathologic tumor stage (p=0.002), absence of lymph node involvement (p<0.001), and low pathologic tumor grade (p=0.040). Endothelin-1 overexpression was also associated with significantly better metastasis-free survival (HR=0.40, p=0.047), CSS (HR=0.21, p=0.002), and overall survival (HR=0.35, p=0.021).
Conclusion:
These findings indicate that endothelin expression could be a biomarker that predicts good survival and warrants further examination as anti-cancer treatment target. Studies focusing on the underlying mechanisms are needed to provide novel therapy for upper tract urothelial carcinoma.