Korean J Urol.  2013 Oct;54(10):671-676.

Effect of Overexpression of Glucose-Regulated Protein 78 and Bcl-2 on Recurrence and Survival in Patients With Ureter Tumors

• Park CH
• Choi MS
• Ha JY
• Kim BH
• Park CH
• Kim CI

Abstract

PURPOSE
The utility of the expression of glucose-regulated protein 78 (GRP78) in the evaluation of prognosis depends on the type of tumor. Hence, we aimed to examine the impact of expression of GRP78 and Bcl-2, which are used in the existing prognostic evaluation of ureter tumors, in the evaluation of recurrence and survival rates of ureter tumors.
MATERIALS AND METHODS
In 53 patients who had undergone radical nephroureterectomy for a ureter tumor from March 2002 to March 2012, age, sex, T stage, nuclear grade, bladder recurrence, and survival rate were analyzed at the time of the patient's surgery depending on the extent of immunohistochemical expression of GRP78 and Bcl-2.
RESULTS
GRP78 was overexpressed in 25 patients (47.2%). When GRP78 was overexpressed, there was a high T stage (p=0.001) and nuclear grade (p=0.007) and a lot of bladder recurrence (40.0%, p=0.034). Bcl-2 was overexpressed in 16 patients (30.1%), and there were no significant associations with any risk factors (p>0.05, respectively). In the multivariate analysis regarding bladder recurrence, the recurrence rate was higher with higher pT stage (p=0.048) and when GRP78 (p=0.033) was overexpressed. In the Kaplan-Meier survival analysis, although the survival rate was significantly lower in the group in which GRP78 was overexpressed (p=0.03), there was no correlation between Bcl-2 overexpression and survival rate (p=0.07).
CONCLUSIONS
Patients with ureter tumors who had overexpression of GRP78 had a high T stage and nuclear grade, a lot of bladder recurrence, and a low survival rate. Therefore, if GRP78 is overexpressed in ureter tumor patients, active postoperative follow-up should be carried out.

Keyword

Bcl-2; GRP78; Urothelial cell carcinoma

MeSH Terms

Follow-Up Studies
Humans
Multivariate Analysis
Prognosis
Recurrence
Risk Factors
Survival Rate
Ureter
Urinary Bladder

Figure

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  FIG. 1 Immunohistochemical stainings for glucose-regulated protein 78 (A) and Bcl-2 (B) show positivity in cytoplasm of tumor cells (×200).

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  FIG. 2 Effect of GRP78 (A) and Bcl-2 (B) overexpression with survival of upper ureter tumor patients from original cohorts. GRP78, glucose-regulated protein 78.

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