腎孟尿管癌におけるp53,Ki-67,E-cadherin,β-cateninの免疫組織学的検討  [in Japanese] IMMUNOHISTOCHEMICAL STUDIES OF p53, Ki-67, E-CADHERIN AND β-CATENIN ON RENAL PELVIC AND URETERAL CANCERS  [in Japanese]

(目的)31例の腎孟尿管癌について臨床病理学的・免疫組織学的に予後と膀胱内再発予測因子について検討を行った.(対象と方法)男性が19名,女性12名で,年齢は43歳から84歳,中央値は69歳であった.観察期間の中央値は79ヵ月であった.腎孟尿管癌組織を用いてp53,Ki-67,E-cadherin,β-cateninの免疫組織学的検討を行った.(結果・結論)31例の疾患特異的5年生存率は77.4%であった.単変量解析では腫瘍数,異型度,浸潤様式,リンパ管侵襲が有意な予後因子であった.さらにそれらの因子についてCoxの比例ハザードモデルによる多変量解析を行うと腫瘍数とリンパ管侵襲が独立した予後予測因子であった.また31例の5年膀胱内非再発率は60.9%であった.単変量解析ではE-cadherinの発現のみが膀胱内非再発率へ影響を及ぼす有意な因子であった.

(Purpose) We reviewed prognosis and bladder recurrence of 31 patients with renal pelvic and ureteral cancer concerning climicopathological and immunohistochemical factors. (Methods) The patients consisted of 19 males and 12 females. The median age was 69 years, ranging from 43 to 84 years. Median follow-up period was 79 months. Immunohistochemistry for p53, Ki-67, E-cadherin and β-catenin was performed on sections from tumor tissue. (Results & conclusions) The overall 5-year cause-specific survival rate was 77.4%. Univariate analysis indicated tumor number, grade, infiltrating pattern, lymphatic involvement to be significant prognostic factors. Moreover, multivariate analysis with Cox's proportional hazard model revealed tumor number and lymphatic involvement to be independent prognostic factors for cause-specific survival rate. The overall 5-year bladder recurrence free rate was 60.9%. Univariate analysis revealed expression of E-cadherin to be a significant factor for bladder recurrence free rate.