Loss of uroplakin III expression is associated with a poor prognosis in patients with urothelial carcinoma of the upper urinary tract

• Published in: BJU international 2006-06, Vol.97 (6), p.1322-1326
• Main Authors: OHTSUKA, YUKIHIRO, KAWAKAMI, SATORU, FUJII, YASUHISA, KOGA, FUMITAKA, SAITO, KAZUTAKA, ANDO, NOBORU, TAKIZAWA, TOUICHIRO, KAGEYAMA, YUKIO, KIHARA, KAZUNORI
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Humans; Immunohistochemistry; Lymph Node Excision; Male; Medical sciences; Membrane Glycoproteins - metabolism; Middle Aged; Multivariate Analysis; Neoplasm Invasiveness - pathology; Neoplasm Proteins - metabolism; Neoplasm Staging; Nephrology. Urinary tract diseases; Prognosis; Survival Analysis; Tumors of the urinary system; Urinary tract. Prostate gland; Urologic Neoplasms - metabolism; Urologic Neoplasms - mortality; Urologic Neoplasms - pathology; Uroplakin III; urothelial carcinoma of upper urinary tract; Urothelium - metabolism; Urothelium - pathology
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2006.06158.x

OBJECTIVE 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. PATIENTS AND METHODS 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. RESULTS In all specimens there was intense UPIII immunoreactivity of umbrella cells of normal urothelium. In tumour samples, UPIII expression was positive in 75% of ≤ pT1 tumours and 40% 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