Upper urinary tract urothelial carcinoma (UTUC) is an aggressive and lethal disease. For patients with locally advanced UTUC, recurrence of tumor is frequent, and lacks of predictive biologic markers limited the choice of postoperative treatment. Galectin-1 (GAL1) is a β-galactoside-binding protein, participating in many parts of tumorigenesis, including cell proliferation, invasiveness, metastasis, and angiogenesis. However, the role of GAL1 in UTUC has not been fully investigated. The aim of this study was to examine the prognostic impact of GAL1 in patients with UTUC.
The study enrolled 86 UTUC patients who underwent radical nephroureterectomy and bladder cuff excision with final pathologically diagnosed as pT3N0 stage between January 2005 and December 2012. Perioperative characteristics and pathologic features were recorded. Immunohistochemical staining of tumor specimens using anti-GAL1 antibody were performed. UTUC cell line (BFTC-909) was used for in vitro study of tumor invasiveness and migration. Kaplan-Meier analyses and Cox proportional regression models were used for univariate and multivariate survival analyses.
Using 10% expression of GAL1 protein as a cuff-off point, the study population could be classified as GAL1-high (GAL1 > 10%, n = 35) or GAL1-low (GAL1 ≤ 10%; n = 51) group. Basic clinicopathologic characteristics were comparable between two groups. In univariate analysis, high GAL1 expression was significantly associated with a worse recurrence-free survival (RFS; p = 0.028) and cancer-specific survival (CSS; p = 0.025). Multivariate analysis showed GAL1-high is an independent factor for RFS (HR 2.43; 95% CI 1.17-5.05, p = 0.018) and CSS (HR 4.04; 95% CI 1.25-13.03, p = 0.019). In vitro study, we found that knockdown of GAL1 reduced UTUC cancer cell migration and invasion significantly.
Galectin-1 expression is a reliable prognostic factor for locally advanced UTUC. GAL1 inhibition may serve as a potential therapeutic target for patients with UTUC.
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All authors have declared no conflicts of interest.