Prognostic Study Of Classification And Immunohistochemical Markers Of Upper Urinary Tract Urothelial Carcinoma

Objective:To detect the expression of connexin 49(Nectin-4),forked box transcription factor A1(FOXA1),Trophoblastic antigen 2(Trop2)and fibroblast growth factor receptor3(FGFR3)in upper urinary tract urothelial carcinoma(UTUC),to study their relationship with clinical features and prognosis,and to evaluate them as new molecular markers and molecular targets.Method:According to the classification standard issued by WHO in 2014 and TNM staging standard of UTUC in 2017,the specimens were divided into high-grade tumor group and low-grade tumor group.Papillary tumor group and invasive tumor group;T1,T2,T3 and T4;According to whether the patients had recurrence and/or metastasis after operation,they were divided into two groups: the group with recurrence and metastasis after operation and the group without recurrence and metastasis after operation.According to the clinical characteristics of patients: gender is divided into male group and female group;age is divided into high age group(≥70 years old)and low age group(< 70 years old);body mass index(BMI)is divided into overweight group(≥24.0)and normal weight group(< 24.0).Immunohistochemistry(IHC)was used to detect the expressions of Nectin-4,FOXA1,Trop2 and FGFR3 in 81 UTUC tissues.Chi-square test was used to analyze the relationship between the expression levels of Nectin-4,FOXA1,Trop2 and FGFR3 and the clinical indexes of UTUC patients,Kaplan-Meier survival analysis and Log-rank test were used to analyze the relationship between the expression levels of Nectin-4,FOXA1,Trop2 and FGFR3 and the Overall survival rate(OS)of UTUC patients.Fitting univariate and multivariate Cox proportional hazard models to evaluate the relationship between the prognosis of patients with UTUC and Nectin-4,FOXA1,Trop2 and FGFR3.Results:1.The expression rates of Nectin-4 and FOXA1 in UTUC in high-grade tumor group,invasive group,postoperative recurrence and metastasis group and high clinical staging group were higher than those in the corresponding groups,with statistical differences(P < 0.05).The expression rates of Trop2 in UTUC in high-grade tumor group,invasive group and postoperative recurrence and metastasis group were higher than those in the corresponding groups,with statistical significance(P < 0.05).Survival analysis showed that the postoperative survival rate of patients with positive expression of Nectin-4,FOXA1 and Trop2 was lower than that of patients with negative expression(P < 0.05),but it was not an independent risk factor for prognosis(P > 0.05).2.There was no statistical significance between the expression of FGFR3 and clinical features(P > 0.05).Survival analysis showed that there was no significant difference between FGFR3 expression and patient survival rate(P > 0.05).Conclusion:1.Nectin-4,FOXA1 and Trop2 may be involved in the occurrence and development of UTUC,and their expressions may affect the prognosis of patients with UTUC,but they cannot be used as independent predictors.2.FGFR3 may not be involved in the occurrence and development of UTUC and is not related to the prognosis of patients with UTUC.3.The specific participation mechanism needs further study.