Retrospective Evaluation of Risk Factors and Immunohistochemical Findings for Pre-Neoplastic and Neoplastic lesions of Upper Urinary Tract in Patients with Chronic Nephrolithiasis
| Autor: | Fanny Sharadkumar Desai, Lisam Shanjukumar Singh, Jitendra Nongthombam |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Urologic Neoplasms Cancer Research medicine.medical_specialty Pathology Adolescent Epidemiology medicine.medical_treatment Urinary system 030232 urology & nephrology Nephrolithiasis Gastroenterology Immunoenzyme Techniques Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Biomarkers Tumor medicine Carcinoma Humans Child Aged Neoplasm Staging Retrospective Studies Upper urinary tract Carcinoma Transitional Cell business.industry Public Health Environmental and Occupational Health Case-control study Retrospective cohort study Odds ratio Middle Aged Prognosis medicine.disease Nephrectomy Transitional cell carcinoma Oncology Case-Control Studies 030220 oncology & carcinogenesis Chronic Disease Carcinoma Squamous Cell Female business Precancerous Conditions Follow-Up Studies |
| Zdroj: | Asian Pacific Journal of Cancer Prevention. 16:8293-8298 |
| ISSN: | 1513-7368 |
| Popis: | Background Urinary stones are known predisposing factors for upper urinary tract carcinoma (UUTC) which are commonly detected at advanced stage with poor outcome because of rarity and lack of specific criteria for early detection. Aims and objectives The main aim was to evaluate the impact of age, gender andstone characteristics on risk of developing UUTC in patients with chronic nephrolithiasis. We also discuss the role of aberrant angiogenesis (AA) and immunohistochemical expression of p53, p16INK4a, CK20 and Ki-67 in diagnosis of pelvicalyceal neoplastic (NL) and pre-neoplastic lesions (PNL) in these patients. Materials and methods Retrospective analysis of pelvicalyceal urothelial lesions from 88 nephrectomy specimens were carried out in a tertiary care centre from June 2012 to December 2014. Immunohistochemistry (IHC) was performed on 37 selected cases. Computed image analysis was performed to analyse aberrant angiogenesis. Results All UUTC (5.7%) and metaplastic lesions were found to be associated with stones. Some 60% were pure squamous cell carcinoma and 40% were transitional cell carcinoma. Odd ratios for developing NL and PNL lesions in presence of renal stone, impacted stones, multiple and large stag horn stones were 9.39 (95% CI 1.15-76.39, p value 0.05), 6.28 (95% CI 1.59-24.85, p value 0.000) and 7.4 (95% CI, 2.29-23.94, p value 0.001) respectively. When patient age was ≥ 55, the odds ratio for developing NL was 3.43 (95% CI 1.19-9.88, p value 0.019). IHC analysis showed that mean Ki-67 indices were 3.15 ± 3.63 % for non-neoplastic lesions, 10.0±9.45 % for PNL and 28.0± 18.4% for NL. Sensitivity and specificity of CK20, p53, p16INK4a, AA were 76% and 95.9%; 100% and 27.5%; 100% and 26.5%; 92.3 % and 78.8% respectively. Conclusions Age ≥55 years, large stag horn stones, multiple stones and impacted stones are found to be associated with increased risk of NL and PNL in UUT. For flat lesions, a panel of markers, Ki 67 index >10 and presence of aberrant angiogenesis were more useful than individual markers. |
| Databáze: | OpenAIRE |
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