Impact of Ki-67 and E-cadherin expression on lymphovascular invasion in upper urinary tract urothelial carcinoma
Bacground/Aim. Upper urinary tract urothelial carcinoma (UUT-UC) constitutes 5% of malignant neoplasms arising from transitional epithelium, but is more invasive than bladder cancer. Lzmphovascular invasion (LVI) is associated with biologically aggressive carcinoma and with occult metastase...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2015-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500101S.pdf |
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| Summary: | Bacground/Aim. Upper urinary tract urothelial carcinoma (UUT-UC) constitutes
5% of malignant neoplasms arising from transitional epithelium, but is more
invasive than bladder cancer. Lzmphovascular invasion (LVI) is associated
with biologically aggressive carcinoma and with occult metastases. The aim of
this study was to investigate the correlation between LVI and
immunohistochemical expression of two frequently routinely applied
immunohistochemical biomarkers, Ki-67 and E-cadherin, in UUT-UC. Methods. The
specimens from 106 patients with UUT-UC who had undergone nephroureterectomy
were analyzed for pathologic parameters and LVI, while Ki-67 and E-cadherin
expression were assessed by immunohistochemistry. Results. Ki-67 was
overexpressed in 38% of the cases, while 45% of tumors demonstrated aberrant
E-cadherin staining. The presence of LVI was significantly associated with
tumor stage, grade, non-papillary growth, nodular invasion pattern, high
Ki-67 labeling index and altered E-cadherin expression. Analyzing logistic
regression models, we have shown that tumor properties such as stage, grade,
growth and invasion pattern (p < 0.001), as well as the expression of Ki-67
and E-cadherin (p < 0.001) significantly predicted the presence of LVI. In
the first model, only solid tumor architecture (p < 0.05) and nodular
invasion pattern (p < 0.05) were significant predictors of LVI. In the second
model, Ki-67 expression was found to improve the prediction of LVI (p <
0.05). Conslusion. Our results suggest that Ki-67 overexpression is an
independent predictor of LVI in UUTUC, indicating the progression of the
disease. E-cadherin staining adds no valuable information to LVI probability
assessment. This emphasizes the importance of Ki-67 staining of UUT-UC
sections in routine pathological practice. Patients with Ki-67
overexpression, especially in solid tumors with nodular invasion, should be
monitored more closely after surgery. [Projekat Ministarstva nauke Republike
Srbije, br. 175092: Etiology, diagnosis, prevention and therapy of endemic
nephropathy and associated tumors of the urothelium - the significance of
genome and proteome study] |
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| ISSN: | 0042-8450 2406-0720 |