Increased expression of sialyl-Lewis A correlates with poor survival in upper urinary tract urothelial cancer patients.
BACKGROUND
We have previously shown that both sialyl-Lewis A (sLe(a)) and sialyl-Lewis X (sLe(x)) antigens are involved in E-selectin-mediated adhesion of some urothelial cancer cells to the endothelium in vitro. The present study was undertaken to determine whether these antigens could serve as prognostic parameters.


METHODS
We immunohistochemically examined the expression of sLe(a) and sLe(x) in 90 human upper urinary tract urothelial tumours.


RESULTS
Fifty-eight (64%) tumours were found to express sLe(a), while sixty-one (68%) expressed sLe(x). The expression between sLe(a) and sLe(x) was correlated positively (p < 0.0001). Neither sLe(a) nor sLe(x) expression was correlated with any other pathological parameter. The cause-specific survival rate was significantly worse in sLe(a)-positive patients than in sLe(a)-negative patients (5-year survival rates 64% and 93%, respectively: p = 0.023), while the survival rates were not statistically different between sLe(x)-positive and sLe(x)-negative patients. By Cox's multivariate analysis, sLe(a) expression as well as lymph node involvement and venous invasion was an independent risk value to predict survival (p < 0.05). In 24 high-risk patients having lymph node metastasis or having both venous invasion and sLe(a) expression, the 5-year survival rate was 29%, while it was 93% in the other 66 patients (p < 0.0001).


CONCLUSIONS
These results indicate that increased expression of sLe(a) antigen as well as lymph node metastasis and venous invasion may be associated with shorter cause-specific survival in upper urinary tract urothelial cancer. The combination of these factors offers a better prediction of prognosis.
Saito
Kazutaka
K
Department of Urology and Reproductive Medicine, Tokyo Medical and Dental University Graduate School, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Fujii
Yasuhisa
Y
Kawakami
Satoru
S
Hayashi
Tetsuo
T
Arisawa
Chizuru
C
Koga
Fumitaka
F
Kageyama
Yukio
Y
Kihara
Kazunori
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D018395:CA-19-9 Antigen; D002295:Carcinoma, Transitional Cell / Q000276:immunology* / Q000473:pathology; D005260:Female; D005732:Gangliosides / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009844:Oligosaccharides / Q000096:biosynthesis; D011379:Prognosis; D000080506:Sialyl Lewis X Antigen; D014571:Urologic Neoplasms / Q000276:immunology* / Q000473:pathology
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D005732:Gangliosides; D009844:Oligosaccharides; D000080506:Sialyl Lewis X Antigen; C064564:sialyl Le(a) ganglioside