廖丞晞^1,2,3,4 張文馨^2,3 胡佩欣⁶ 吳錫金⁵ 蔡佳紋^2,3 包大靝^2,3,4

¹國軍台中總醫院泌尿外科; ²中國醫藥大學臨床醫學研究所; ³Terry Fox癌症研究室;

⁴國防醫學院臨床醫學研究所; ⁵中國醫藥大學附設醫院泌尿外科; ⁶彰化基督教醫院眼科部

Cheng-Hsi Liao^1,2,3,4 , Wen-Shin Chang^2,3 ,Pei-Shin Hu^3,6, Hsi-Chin Wu⁵, Chia-Wen Tsai^2,3,and Da-Tian Bau^1,2

¹ Department of Urology, Taichung Armed Forces General Hospital, Taichung, Taiwan, R.O.C.;

² Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C.;

³ Terry Fox Cancer Research Laboratory;

⁴ Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, R.O.C.;

⁵ Department of Urology, China Medical University Hospital, Taichung, Taiwan, R.O.C.;

⁶ Department of Ophthalmology, Changhua Christian hospital, Changhua, Taiwan, R.O.C.

 

Purpose: Upper urinary tract urothelial carcinoma is very unique and prevalent in Taiwan and the etiology is largely unrevealed. Glutathione S-Transferase (GST) isoenzymes play an important role in resisting cell apoptosis, and carcinogenesis. We aim to establish the relationship between GST expression and the prognosis of upper urinary tract urothelial carcinoma (UUT-UC) in mid-Taiwan.

Materials and Methods: This pilot study has retrospectively reviewed 46 patients with pathologically confirmed UUT-UC at China Medical University Hospital and Taichung Armed Forces General Hospital, Taichung from 2003 to 2012. As rationally designed, expressions of GSTT1 and GSTP1 have been compared between urothelial carcinoma cells and normal uroepithelial cells by western blot analysis to figure out a novel and reliable biomarker.

Results: Renal pelvis cancer reportedly comprises only 5% of all urothelial tumors, and ureteral cancer is even less common. The reported ratios of ureteral cancer cases to renal pelvis cancer cases range from 1:3 to 1:4. However in Taiwan, the ratio of upper urinary tract urothelial carcinoma (UUT-UC) cancer cases to lower urinary tract urothelial carcinoma (LUT-UC) cases is 3.08:6.72, even in non-endemic areas of blackfoot disease. Malignancies are more common in UUT-UC. Contributing factors in the development of urothelial carcinoma (UC) include genetic characteristics, exposure to toxicants, occupation, and diet. Environmental carcinogens such as tobacco smoke, aromatic amines, and polycyclic hydrocarbons are also known risk factors. The odds ratio [OR] were estimated from the logistic regression model with the generalized estimating equation (GEE) repeated-measures analysis method. In the presence of tumor-pairs GSTT1 expression, invasive showed a significant association (OR = 1.29, 95% confidence interval (CI) = 1.00-1.67; P = 0.0493).

Conclusions: To sum up, in the presence of tumor-pairs GSTT1 expression, invasive showed a significant association in UTUC in mid-Taiwan. Further investigation with larger sample size in addition to genotype-phenotype correlation and intracellular mechanisms are our future work.