1. Department of Pathology, Chi Mei Medical Center, Liouying, Taiwan;
2. Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology;
3. Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan;
4. National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan;
5. Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan;
6. Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
7. Department of Urology, Faculty of Medicine, Kaohsiung Medical University;
8. Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University;
9. Department of Urology, Kaohsiung Municipal Ta-Tung Hospital;
10. Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University;
11. Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan;
12. Department of Internal Medicine, Chi Mei Medical Center, Chiali, Taiwan.
Object: To identify associations between 17β-hydroxysteroid dehydrogenase type 2 (HSD17B2) expression and clinicopathological variables and prognoses in patients with urothelial carcinoma of the urinary tract.
Materials and Methods: We analyzed one public transcriptome dataset (GSE31684) from the Gene Expression Omnibus. HSD17B2 showed the highest log2-transformed fold-change in expression, and it was therefore further analyzed. We enrolled 340 upper urinary tract and 295 urinary bladder tissue samples that were obtained from patients with urothelial carcinoma between 1996 and 2004 to evaluate the expression of HSD17B2 using immunohistochemistry. The endpoints were disease-specific survival and metastasis-free survival. Univariate and multivariate analyses were performed to assess the relationships between HSD17B2, survival and clinicopathological parameters.
Results: High expression of HSD17B2 was significantly associated with better clinicopathological parameters, including the following parameters in urothelial carcinoma of upper urinary tracts: Ta (non-invasive papillary carcinoma) and T1 (invaded subepithelial connective tissue) disease, without nodal metastasis, without vascular invasion, without perineal invasion and with a low histological grade, and the following parameters specifically in urothelial carcinoma of the urinary bladder: Ta (noninvasive papillary carcinoma) and T1 (invaded into the lamina propria but not into the muscularis propria) disease, without nodal metastasis (all P<0.05). Additionally, HSD17B2 high expression predicted a better prognosis, including improved disease-specific survival and metastasis-free survival in urothelial carcinomas of the urinary tract system.
Conclusions: High expression of HSD17B2 is associated with a better prognosis and is therefore a prognostic biomarker that can be used to predict favorable survival in patients with urothelial carcinoma of the urinary tract system.
Keywords: 17β-hydroxysteroid dehydrogenase type 2, Urothelial carcinoma, Prognosis.