title: Pretreatment serum pseudocholinesterase level as a novel prognostic biomarker for upper tract urothelial carcinoma.
abstract: OBJECTIVE
  Pretreatment serum pseudocholinesterase (PChE) has been reported to be a prognostic predictor in several cancers. However, the prognostic significance of serum PChE level in patients with upper tract urothelial carcinoma (UTUC) remains unknown.
  
  
  METHODS
  A total of 180 patients who underwent radical nephroureterectomy (RNU) for UTUC were included in this retrospective analysis. The associations of pretreatment serum PChE levels with clinicopathological characteristics and clinical outcomes were assessed.
  
  
  RESULTS
  The median (IQR) pretreatment serum PChE level was 6385 (5449-7260) IU/L, and an optimal cutoff value of 5336 IU/L was set according to ROC analysis. Decreased pretreatment serum PChE levels were significantly correlated with older patient age, higher preoperative chronic kidney disease (CKD) stage and pT stage (all P < 0.05). On multivariate analysis, adjusting for preoperative variables, decreased pretreatment serum PChE levels independently predicted higher pT stage (P = 0.011). Moreover, Kaplan-Meier curves suggested that patients with PChE levels <5336 IU/L were predicted to have a shorter overall survival (OS) and cancer-specific survival (CSS) than those with PChE levels ≥5336 IU/L (both P < 0.001). On multivariate analysis, decreased pretreatment serum PChE levels were significantly associated with shorter OS (HR 0.553; 95 %CI 0.322-0.951; P = 0.032) and CSS (HR 0.484; 95 %CI 0.269-0.870; P = 0.015).
  
  
  CONCLUSIONS
  Decreased pretreatment serum PChE level is an independent predictor for higher pT stage, shorter OS and CSS in patients with UTUC. Pretreatment serum PChE levels may act as a simple and effective parameter to predict prognosis for UTUC patients after RNU.
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Shen
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Mi
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Hu
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Liqun
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
authors.forename: Zhisong
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China. yuweif@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China. hanwenke@medmail.com.cn.
authors.forename: Wenke
authors.initials: W
authors.lastname: Han
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002091:Butyrylcholinesterase / Q000097:blood*; D002295:Carcinoma, Transitional Cell / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D014516:Ureteral Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D019459:Urothelium / Q000473:pathology*
chemical_list: D015415:Biomarkers; D002091:Butyrylcholinesterase
keywords: Cancer-specific survival; Overall survival; Prognostic biomarker; Pseudocholinesterase; Upper tract urothelial carcinoma