Nuclear factor-κB activation predicts an unfavourable outcome in human upper urinary tract urothelial carcinoma.
OBJECTIVE
to examine the hypothesis that nuclear factor-κB (NF-κB), a transcription factor involved in anti-apoptosis, invasion, and angiogenesis, plays a role in the carcinogenesis of upper urinary tract urothelial carcinoma (UUT-UC) and has prognostic value for survival.


METHODS
in all, 90 patients with UUT-UC [mean (range) age, 64.5 (24-84) years] who underwent surgery at our institution from January 1991 to December 2005 were included. Clinicopathological data were collected retrospectively. We performed immunohistochemical staining for NF-κB (p65) on paraffin-embedded sections of the tumour and corresponding normal tissues. The association between survival and potential prognostic factors was examined.


RESULTS
the median follow-up was 40 months. In all, 55 patients (61.1%) with UUT-UC overexpressed cytoplasmic NF-κB, and nuclear immunoreactivity for NF-κB was detected in 24 patients (26.7%). On univariate analysis, significant prognostic factors for survival were tumour location, stage, grade, lymph node involvement, and nuclear NF-κB expression. On multivariate analysis, nuclear NF-κB positivity was an independent predictor for disease-specific survival [Cox regression hazard ratio (HR) 2.87; P= 0.025] and overall survival (HR 2.24; P= 0.037).


CONCLUSIONS
these results imply a role for nuclear NF-κB expression in the tumorigenesis of UUT-UC. Nuclear NF-κB may serve as a useful independent molecular marker to predict outcome and may represent a promising therapeutic target for patients with UUT-UC.
Yeh
Hsin-Chih
HC
Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Taiwan.
Huang
Chun-Hsiung
CH
Yang
Sheau-Fang
SF
Li
Ching-Chia
CC
Chang
Lin-Li
LL
Lin
Hui-Hui
HH
Ke
Hung-Lung
HL
Wei
Yu-Ching
YC
Wu
Wen-Jeng
WJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D007682:Kidney Pelvis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016328:NF-kappa B / Q000378:metabolism*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014516:Ureteral Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D055815:Young Adult
D014408:Biomarkers, Tumor; D016328:NF-kappa B