Abstract
BackgroundThe study investigated the expression and the clinicopathological significance of p53, p27, Ki-67, E-cadherin, and HER2 in upper urinary tract urothelial carcinomas (UTUC) from Tunisian patients. We performed a retrospective study of 66 UTUC. Main clinicopathological features were reported. The expression of p53, p27, Ki-67, E-cadherin, and HER2 was investigated by immunohistochemistry on whole tissue section.ResultsExpression of p53, Ki-67, p27, E-cadherin, and HERE2 was reported in 36.4%, 69.7%, 90.9%, 100%, and 0% of cases, respectively. p53 expression was associated with stage (p = 0.001), positive surgical margin (p = 0.005), and shorter recurrence-free survival (RFS; Log Rank test, p = 0.026). Ki-67 and p27 expression was associated with stage (p < 0.001 and p = 0.001, respectively) and grade (p < 0.001 and p = 0.001, respectively). Using Kaplan-Meier test, the positive surgical margin was associated with shorter RFS compared to free surgical margin (Log Rank test, p = 0.031). Moreover, in univariate Cox regression analysis, surgical margin (p = 0.041; HR 0.325, 95% CI 0.110–0.956) and p53 expression (p = 0.035; HR 0.328, 95% CI 0.116–0.925) were the significant factors associated with RFS.ConclusionsTogether, our findings suggest that positive surgical margin and p53 expression were potential prognostic factors of UTUC since both were associated with shorter RFS in Tunisian patients.
Highlights
The study investigated the expression and the clinicopathological significance of p53, p27, Ki-67, Ecadherin, and human epidermal growth factor receptor type 2 (HER2) in upper urinary tract urothelial carcinomas (UTUC) from Tunisian patients
We explored the clinicopathological value of p53, p27, Ki-67, E-cadherin, and HER2 in UTUC. p53 protein is implicated in genomic stability, cell cycle, and apoptosis. p53 alterations were described in several malignancies and correlated with mediocre prognosis in various cancers [3]
Twenty-nine patients had a history of chronic pyelonephritis and eleven patients had an antecedent bladder tumor at the time of diagnosis
Summary
The study investigated the expression and the clinicopathological significance of p53, p27, Ki-67, Ecadherin, and HER2 in upper urinary tract urothelial carcinomas (UTUC) from Tunisian patients. UTUC are often aggressive with poor prognosis compared to bladder cancer [1]. Due to their anatomical particularities, including a thin muscle layer, proximity to the kidney, and rich lymphatic drainage, tumor invasion affects significantly tumor progression and distant metastasis [1]. To accurately improve the oncological outcomes of patients, previous reports analyzed several prognostication factors and identified novel clinicopathological parameters, including patient age, multifocality, Missaoui et al Journal of the Egyptian National Cancer Institute (2020) 32:36 concomitant in situ carcinoma, tumor architecture and size, and variant histology [1, 2]. The prognostic interest of factors involved in cell cycle and apoptotic pathways, cell proliferation and adhesion, metastasis, and microsatellite instability has been investigated [2]
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