浏览全部资源
扫码关注微信
CK5和CK20在上尿路尿路上皮癌预后评估中的价值
Predictive value of CK5 and CK20 for prognosis in upper urinary tract urothelial carcinoma
- 陆军军医大学学报 2022年44卷第9期 页码：923-929
- 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：
[王明，E-mail: wangm1368@163.comWANG Ming, E-mail: wangm1368@163.com
- 基金信息：
DOI：10.16016/j.2097-0927.202110007
中图分类号： R730.23;R730.7;R737.13收稿：2021-10-03，
修回：2021-12-09，
纸质出版：2022-05-15
- 稿件说明：
移动端阅览
刘川, 陈晗, 翁同辉, 等. CK5和CK20在上尿路尿路上皮癌预后评估中的价值[J]. 陆军军医大学学报, 2022,44(9):923-929.
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.
刘川, 陈晗, 翁同辉, 等. CK5和CK20在上尿路尿路上皮癌预后评估中的价值[J]. 陆军军医大学学报, 2022,44(9):923-929. DOI： 10.16016/j.2097-0927.202110007.
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
2
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
2
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
2
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
2
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)(
P
<
0.001)、肿瘤特异性生存率(cancer-specific survival，CSS)(
P
<
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(
P
=0.015，HR=5.663，95%
CI
：1.392~23.050；
P
=0.007，HR=7.962，95%
CI
：1.763~35.955)是影响UTUC预后的独立危险因素。
结论
2
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
2
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
2
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
2
According to the immunohistochemical results
the 101 patients were classified into 4 subtypes: CD5
+
CD20
-
(
n
=30
29.7%)
CD5
+
CD20
+
(
n
=32
31.7%)
CD5
-
CD20
-
(
n
=26
25.7%)
and CD5
-
CD20
+
(
n
=13
12.9%). Kaplan-Meier univariate analysis and survival curve indicated that the overall survival (OS) (
P
<
0.001) and cancer-specific survival (CSS) (
P
<
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:
HR
=5.663
95%
CI
: 1.392~23.050
P
=0.015; for CSS
HR
=7.962
95%
CI
: 1.763~35.955
P
=0.007) were independent risk factors for the prognosis of UTUC patients.
Conclusion
2
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.
0
浏览量
0
下载量
0
CSCD
- 网络PDF下载
- Meta-XML下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 技术支持由北京北大方正电子有限公司提供 京ICP备09064830号-19
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies
