Endoglin expression in upper urinary tract urothelial carcinoma is associated with intravesical recurrence after radical nephroureterectomy

Int J Urol. 2015 May;22(5):463-7. doi: 10.1111/iju.12719. Epub 2015 Jan 29.

Abstract

Objectives: To evaluate the expression and prognostic significance of endoglin in patients with upper urinary tract urothelial carcinoma.

Methods: zArchival formalin-fixed and paraffin-embedded tissues from 99 cases of primary upper urinary tract urothelial carcinomas treated with nephroureterectomy were retrieved. Tissue microarrays were constructed with triplicate tumor samples and paired non-neoplastic urothelium. Tissue microarrays were analyzed using immunohistochemistry for endoglin, and the associations between clinicopathological parameters and outcome were studied.

Results: Endoglin expression was significantly higher in the endothelium of upper urinary tract urothelial carcinomas than in paired benign urothelium (P < 0.001). Endoglin expression was not associated with pathological T stage or tumor grade, and it was not associated with increased hazard ratios for cancer-specific mortality, tumor recurrence in the lymph node or distant metastasis. However, expression of endoglin was significantly associated with intravesical recurrence, when adjusting for other relevant clinicopathological variables (P = 0.015).

Conclusions: Endoglin is overexpressed in the endothelium of upper urinary tract urothelial carcinomas when compared with normal urothelium, and this overexpression seems to be associated with a higher risk of intravesical recurrence. Therefore, endoglin could be a biomarker for the prediction of intravesical recurrence, as well as a potential therapeutic target.

Keywords: endoglin; immunohistochemistry; intravesical recurrence; nephroureterectomy; upper urinary tract urothelial carcinoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antigens, CD / genetics*
  • Biomarkers, Tumor / genetics
  • Carcinoma, Transitional Cell / genetics
  • Carcinoma, Transitional Cell / surgery*
  • Endoglin
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology*
  • Nephrectomy
  • Phosphorylation
  • Prognosis
  • Receptors, Cell Surface / genetics*
  • Signal Transduction
  • Survival Analysis
  • Urinary Tract / metabolism*
  • Urologic Neoplasms / genetics
  • Urologic Neoplasms / surgery*
  • Urothelium / pathology
  • Urothelium / surgery

Substances

  • Antigens, CD
  • Biomarkers, Tumor
  • ENG protein, human
  • Endoglin
  • Receptors, Cell Surface