LAT1, a neutral amino acid transporter, requires covalent association with the heavy chain of 4F2 cell surface antigen (4F2hc) for its functional form. We investigated the importance of LAT1 and 4F2hc expressions to progression in transitional cell carcinoma of the upper urinary tract. In 124 cases, we examined their expressions using immunohistochemistry and in situ hybridization, and also their relationships to the expression of proliferating cell nuclear antigen (PCNA), clinicopathologic parameters, and clinical outcome. Positive expressions of LAT1 (protein and mRNA), and 4F2hc (protein) were recognized in 79.8%, 89.5%, and 87.9% of samples, respectively. In tumor cells, LAT1 protein was detected as a nodular pattern or membranous pattern (plasma membrane or diffuse cytoplasm plus plasma membrane), while LAT1 mRNA was detected as nodular or diffuse (diffuse cytoplasm) patterns and 4F2hc protein was detected as a diffuse pattern. A correlation with stage and both overall and disease-free survival rates in the univariate analysis, but not with PCNA index, was shown for: LAT1 protein expression, a membranous pattern of LAT1 protein, a diffuse pattern of LAT1 mRNA, a cooperative expression of LAT1 protein (membranous pattern) and 4F2hc protein, and a cooperative expression of LAT1 mRNA (diffuse pattern) and 4F2hc protein. In conclusion, the detection of LAT1 protein would appear to be of value in informing the progression of TCC-UUT.
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