Predictive value of CK5 and CK20 for prognosis in upper urinary tract urothelial carcinoma

Chuan LIU; Han CHEN; Tonghui WENG; Jiabing LI; Ming WANG

doi:10.16016/j.2097-0927.202110007

您当前的位置：

首页 >

文章列表页 >

Predictive value of CK5 and CK20 for prognosis in upper urinary tract urothelial carcinoma

Clinical Medicine | 更新时间：2026-01-09

- Predictive value of CK5 and CK20 for prognosis in upper urinary tract urothelial carcinoma
- Journal of Army Medical University Vol. 44, Issue 9, Pages: 923-929(2022)
- 作者机构：
  
  400016 重庆，重庆医科大学附属第一医院泌尿外科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.2097-0927.202110007
  CLC： R730.23;R730.7;R737.13
- Received：03 October 2021，
  
  Revised：2021-12-09，
  
  Published：15 May 2022
- 稿件说明：
移动端阅览
Chuan LIU, Han CHEN, Tonghui WENG, et al. Predictive value of CK5 and CK20 for prognosis in upper urinary tract urothelial carcinoma[J]. Journal of Army Medical University, 2022, 44(9): 923-929.
DOI：

Chuan LIU, Han CHEN, Tonghui WENG, et al. Predictive value of CK5 and CK20 for prognosis in upper urinary tract urothelial carcinoma[J]. Journal of Army Medical University, 2022, 44(9): 923-929. DOI： 10.16016/j.2097-0927.202110007.

摘要

目的

观察CK5和CK20在上尿路尿路上皮癌(upper urinary tract urothelial carcinoma，UTUC)肿瘤组织中的表达，探讨CK5和CK20在UTUC预后评估中的价值。

方法

收集我科2012年12月至2018年12月期间收治的101例UTUC患者病例资料。免疫组化法检测患者肿瘤组织中CK5、CK20的表达；χ

检验分析CK5、CK20的表达与肿瘤病理特征的关系；Kaplan-Meier生存曲线分析患者的术后生存情况；COX比例风险回归模型分析CK5、CK20与患者预后的关系。

结果

根据CK5、CK20的免疫组化结果将101例患者分为4组：CK5

CK20

组(30例，占29.7%)、CK5

CK20

组(32例，占31.7%)、CK5

CK20

组(26例，占25.7%)和CK5

CK20

组(13例，占12.9%)。Kaplan-Meier单因素分析及生存曲线均提示CK5

CK20

组总体生存率(overall survival，OS)(

0.001)、肿瘤特异性生存率(cancer-specific survival，CSS)(

0.001)更差；COX单因素及多因素分析显示肿瘤分级、T分期、淋巴结转移及CK5

CK20

亚型(

=0.015，HR=5.663，95%

：1.392~23.050；

=0.007，HR=7.962，95%

：1.763~35.955)是影响UTUC预后的独立危险因素。

结论

联合检测CK5、CK20的表达可预测UTUC患者的预后情况，当二者联合表达为CK5

CK20

时患者预后情况较差，且肿瘤分期更高、更易发生淋巴结转移。

Abstract

Objective

To investigate the expression of CK5 and CK20 in upper urinary tract urothelial carcinoma (UTUC) so as to explore the predictive value of CK5 and CK20 for the disease.

Methods

The clinical data of 101 UTUC patients admitted to our department from December 2012 to December 2018 were collected and retrospectively analyzed. The expression of CK5 and CK20 in tumor tissues was detected by immunohistochemical assay. The associations of CK5 and CK20 expression with the pathological features of tumor were analyzed. Kaplan-Meier survival curve was used to investigate the postoperative survival of the patients

and COX proportional risk regression model was adopted to analyze the relationships of CK5 and CK20 with the prognosis of these patients.

Results

According to the immunohistochemical results

the 101 patients were classified into 4 subtypes: CD5

CD20

(

=30

29.7%)

CD5

CD20

(

=32

31.7%)

CD5

CD20

(

=26

25.7%)

and CD5

CD20

(

=13

12.9%). Kaplan-Meier univariate analysis and survival curve indicated that the overall survival (OS) (

0.001) and cancer-specific survival (CSS) (

0.001) of the patients were significantly worst in the CD5

CD20

group than the other 3 groups. COX univariate and multivariate regression analyses showed that tumor grade

T stage

lymph node metastasis

and CD5

CD20

subtype (for OS:

=5.663

95%

: 1.392~23.050

=0.015; for CSS

=7.962

95%

: 1.763~35.955

=0.007) were independent risk factors for the prognosis of UTUC patients.

Conclusion

Combined detection of CK5 and CK20 expression can predict the prog

nosis of patients with UTUC

and those presenting CD5

CD20

subtype have poorer prognosis

higher tumor stage and more prone to lymph node metastasis.

关键词

Keywords

references

ROUPRÊT M, BABJUK M, BURGER M, et al . European association ofurology guidelines on upper urinary tract urothelial carcinoma: 2020 update[J ] . Eur Urol, 2021, 79(1): 62-79. DOI: 10.1016/j.eururo.2020.05.042.

ROSENBERG J E, HOFFMAN-CENSITS J, POWLES T, et al . Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: a single-arm, multicentre, phase 2 trial[J ] . Lancet, 2016, 387(10031): 1909-1920. DOI: 10.1016/S0140-6736(16)00561-4.

JAN H C, YANG W H, OU C H. Combination of the preoperative systemic immune-inflammation index and monocyte-lymphocyte ratio as a novel prognostic factor in patients with upper-tract urothelial carcinoma[J]. Ann Surg Oncol, 2019, 26(2): 669-684. DOI: 10.1245/s10434-018-6942-3.

KIM J, AKBANI R, CREIGHTON C J, et al . Invasive bladder cancer: genomic insights and therapeutic promise[J ] . Clin Cancer Res, 2015, 21(20): 4514-4524. DOI: 10.1158/1078-0432.CCR-14-1215.

刘鑫, 王一星, 李冠宏, 等. Cytokeratin和CD133在肺腺癌患者外周血中的联合检测及临床病理分析[J]. 第三军医大学学报, 2017, 39(20): 2004-2009. DOI: 10.16016/j.1000-5404.201709141.

LIU X, WANG Y X, LI G H, et al . Combined detecti on and clinical pathological analysis of peripheral blood CK and CD133 in primary lung adenocarcinoma patients[J ] . J Third Mil Med Univ, 2017, 39(20): 2004-2009. DOI: 10.16016/j.1000-5404.201709141.

MAI K T, BALL C G, BELANGER E C. Noninvasive papillary basal-like urothelial carcinoma: a subgroup of urothelial carcinomas with immunohistochemical features of basal urothelial cells associated with a high rate of recurrence and progression[J]. Appl Immunohistochem Mol Morphol, 2016, 24(8): 575-582. DOI: 10.1097/PAI.0000000000000224.

张静琦, 周晓洲, 石家仲, 等. 联合CK5和CK20免疫染色分析鉴别膀胱癌亚型[J]. 临床泌尿外科杂志, 2020, 35(4): 257-263. DOI:10.13201/j.issn.1001-1420.2020.04.002.

ZHANG J Q, ZHOU X Z, SHI J Z, et al . Combination of CK5 and CK20 immunostaining analysis for identifying subtypes of bladder cancer[J ] . J Clin Urol, 2020, 35(4): 257-263. DOI: 10.13201/j.issn.1001-1420.2020.04.002.

WANG Q, GAN X D, LI F, et al . PM2.5 exposure induces more serious apoptosis of cardiomyocytes mediated by Caspase3 through JNK/P53 pathway in hyperlipidemic rats[J ] . Int J Biol Sci, 2019, 15(1): 24-33. DOI: 10.7150/ijbs.28633.

INOUE S, MIZUSHIMA T, FUJITA K, et al . GATA3 immunohistochemistry in urothelial carcinoma of the upper urinary t ract as a urothelial marker and a prognosticator[J ] . Hum Pathol, 2017, 64: 83-90. DOI: 10.1016/j.humpath.2017.04.003.

SCARPINI S, ROUPRÊT M, RENARD-PENNA R, et al . Impact of the expression of Aurora-A, p53, and MIB-1 on the prognosis of urothelial carcinomas of the upper urinary tract[J ] . Urol Oncol, 2012, 30(2): 182-187. DOI: 10.1016/j.urolonc.2009.12.003.

XIONG G Y, LIU J, TANG Q, et al . Prognostic and predictive value of epigenetic biomarkers and clinical factors in upper tract urothelial carcinoma[J ] . Epigenomics, 2015, 7(5): 733-744. DOI: 10.2217/epi.15.34.

MAI K T, BUSCA A, BELANGER E C. Flat intraurothelial neoplasia exhibiting diffuse immunoreactivity for CD44 and cytokeratin 5 (urothelial stem cell/basal cell markers): a variant of intraurothelial neoplasia commonly associated with muscle-invasive urothelial carcinoma[J]. Appl Immunohistochem Mol Morphol, 2017, 25(7): 505-512. DOI: 10.1097/PAI.0000000000000334.

王昭君, 卢鸯鸯, 戴燕燕, 等. CK5/6在浸润性乳腺癌中的表达及预后意义[J]. 医学研究杂志, 2020, 49(12): 99-103. DOI: 10.11969/j.issn.1673-548X.2020.12.024.

WANG Z J, LU Y Y, DAI Y Y, et al . Expression and prognostic significance of CK5/6 in invasive breast cancer[J ] . J Med Res, 2020, 49(12): 99-103. DOI: 1 0.11969/j.issn.1673-548X.2020.12.024.

ECKSTEIN M, WIRTZ R M, GROSS-WEEGE M, et al . mRNA-expression of KRT5 and KRT20 defines distinct prognostic subgroups of muscle-invasive urothelial bladder cancer correlating with histological variants[J ] . Int J Mol Sci, 2018, 19(11): 3396. DOI: 10.3390/ijms19113396.

MA Y F, FAN M Y, DAI L, et al . Expression of p63 and CK5/6 in early-stage lung squamous cell carcinoma is not only an early diagnostic indicator but also correlates with a good prognosis[J ] . Thorac Cancer, 2015, 6(3): 288-295. DOI: 10.1111/1759-7714.12181.

OSMANOV Y I, GAIBOV Z A, KOGAN E A, et al . Comparative morphological characteristics and immunophenotype of urothelial carcinomas of the renal pelvis and bladder[J ] . Arkh Patol, 2018, 80(5): 23-32. DOI: 10.17116/patol20188005123.

PATSCHAN O, SJÖDAHL G, CHEBIL G, et al . A molecular pathologic framework for risk stratification of stage T1 urothelial carcinoma[J ] . Eur Urol, 2015, 68(5): 824-832;discussion835-6. DOI: 10.1016/j.eururo.2015.02.021.

SIKIC D, KECK B, WACH S, et al . Immunoh istochemiocal subtyping using CK20 and CK5 can identify urothelial carcinomas of the upper urinary tract with a poor prognosis[J ] . PLoS One, 2017, 12(6): e0179602. DOI: 10.1371/journal.pone.0179602.

王庆伟, 张涛, 文建国, 等. 上尿路尿路上皮癌预后多因素分析及术后再发膀胱癌危险因素分析[J]. 临床泌尿外科杂志, 2018, 33(5): 385-389. DOI: 10.13201/j.issn.1001-1420.2018.05.012.

WANG Q W, ZHANG T, WEN J G, et al . Analysis of multivariate prognosis of upper urinary tract urothelial carcinoma and risk factors of postoperative bladder cancer[J ] . J Clin Urol, 2018, 33(5): 385-389. DOI: 10.13201/j.issn.1001-1420.2018.05.012.

KEELEY F X Jr, BIBBO M, BAGLEY D H. Ureteroscopic treatment and surveillance of upper urinary tract transitional cell carcinoma[J]. J Urol, 1997, 157(5): 1560-1565.

SIMONE G, PAPALIA R, LORETO A, et al . Independent prognostic value of tumour diameter and tumour necrosis in upper urinary tract urothelial carcinoma[J ] . BJU Int, 2009, 103(8): 1052-1057. DOI:10.1111/j.1464-410X.2008.08134.x.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

A novel estrogen receptor expression stratification (low/moderate/high) based on Chinese population provides more accurate prognosis prediction for HR⁺/HER2^- early breast cancer patients

Immunosuppressive microenvironment of TGIF1-overexpressing gastric cancers and its clinical significance

Impact of molecular heterogeneity of NPM1 mutations on prognosis of acute myeloid leukemia: a clinical report of 86 cases

Association of 5-factor modified frailty index and controlling nutritional status score with overall survival in patients with unresectable hepatocellular carcinoma undergoing interventional therapy

Construction and validation of prediction model for cervical cancer recurrence based on systemic inflammation response index and clinicopathological parameters

Related Author

WANG Chengfang

ZHOU Yuqin

ZHANG Yanling

QI Xiaowei

ZHANG Yi

TONG Huyun

CHEN Xu

ZHANG Wenjie

Related Institution

Department of Breast and Thyroid Surgery， First Affiliated Hospital， Army Medical University （Third Military Medical University）

Department of Gastroenterology， Chongqing Hechuan District People’s Hospital

School of Medicine， Chongqing University

Chongqing Key Laboratory of Precision Prevention and Treatment for Digestive System Tumors， Department of Gastroenterology， Army Medical Center of PLA/Daping Hospital of Third Military Medical University

Department of Hematology, the First Hospital of Lanzhou University

⁰