Abstract

The identification of upper tract urinary carcinoma (UTUC) prognostic biomarkers is urgently needed to predict tumour progression. This study aimed to identify serum microRNAs (miRNAs) that may be useful as minimally invasive predictive biomarkers of tumour progression and survival in UTUC patients. To this end, 33 UTUC patients who underwent radical nephroureterectomy at the Hospital Clinic of Barcelona were prospectively included. Expression of 800 miRNAs was evaluated in serum samples from these patients using nCounter® miRNA Expression Assays. The study was divided into an initial discovery phase (n=12) and a validation phase (n=21). Cox regression analysis was used for survival analysis. The median follow-up (range) of the series was 42 months (9-100 months). In the discovery phase, 38 differentially expressed miRNAs were identified between progressing and non-progressing UTUC patients (p<0.05). Validation of these 38 miRNAs in an independent set of UTUC patients confirmed the differential expression in 18 of them (p<0.05). Cox Regression analysis showed miR-151b and pathological stage as significant prognostic factors for tumour progression (HR=0.33, p<0.001 and HR=2.62, p=0.006, respectively) and cancer specific survival (HR=0.25, p<0.001 and HR=3.98, p=0.003, respectively). Survival curves revealed that miR-151b is able to discriminate between two groups of UTUC patients with a highly significant different probability of tumour progression (p=0.006) and cancer specific survival (p=0.034). Although the data needs to be externally validated, miRNA analysis in serum appears to be a valuable prognostic tool in UTUC patients. Particularly, differential expression of miR-151b in serum may serve as a minimally invasive prognostic tool in UTUC.

Highlights

  • Radical nephroureterectomy (RNU) is the accepted treatment for localized upper tract urinary carcinoma (UTUC) [1]

  • This study aimed to identify serum microRNAs that may be useful as minimally invasive predictive biomarkers of tumour progression and survival in UTUC patients

  • Pathological stage and tumour grade are the most established prognostic factors associated with tumour progression and patient survival, but they are insufficient to predict the individual outcome of UTUC patients [2]

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Summary

Introduction

Radical nephroureterectomy (RNU) is the accepted treatment for localized upper tract urinary carcinoma (UTUC) [1]. Recent studies show that several miRNAs are differentially expressed in different human cancers, which indicate that miRNAs may have a role in the carcinogenetic processes of numerous tumours [8,9,10,11]. These miRNA differences have been observed in human biofluids [12, 13]. To the best of our knowledge, the prognostic global circulating miRNA patterns from UTUC patients have not been studied as yet

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