*Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
Jpn J Clin Oncol. 2014 May;44(5):486-92. doi: 10.1093/jjco/hyu020. Epub 2014 Mar 18.
Fatty acid synthase has been shown to be highly expressed in various types of cancers with increased tumour aggressiveness. In this study we examined the level of fatty acid synthase expression in surgically resected upper urinary tract urothelial carcinoma specimens and evaluated the relations between fatty acid synthase expression and the patients' pathological features and clinical outcomes.
Sections of paraffin-embedded tumour specimens from 113 patients who underwent surgical treatment for upper urinary tract urothelial carcinoma were immunostained with a polyclonal fatty acid synthase antibody, and a tumour was considered to have high fatty acid synthase expression if >50% of the cancer cells stained with moderate-to-strong intensity. Associations between fatty acid synthase expression and the patients' pathological parameters and survival were analyzed statistically.
During the follow-up time (median: 46.8 months), 61 patients (54.0%) had recurrence and 17 (15.0%) died of upper urinary tract urothelial carcinoma. High fatty acid synthase expression was significantly associated with high tumour grade (P = 0.0273). Patients with high fatty acid synthase expression had significantly worse recurrence-free survival and extravesical-recurrence-free survival than those with low fatty acid synthase expression (P = 0.0171, P = 0.0228, respectively). In multivariate analysis, high fatty acid synthase expression was an independent predictor of shortened recurrence-free survival (P = 0.0220, hazard ratio (HR) = 1.970).
Fatty acid synthase expression in upper urinary tract urothelial carcinoma is an independent predictor for tumour recurrence. Patients with high fatty acid synthase expression in upper urinary tract urothelial carcinoma should be followed carefully and adjuvant therapy for them should be considered.
脂肪酸合酶在具有侵袭性增加的各种类型癌症中表达水平较高。本研究检测了脂肪酸合酶在上尿路尿路上皮癌手术切除标本中的表达水平，并评估了脂肪酸合酶表达与患者病理特征和临床结局之间的关系。
用多克隆脂肪酸合酶抗体对 113 例接受上尿路尿路上皮癌手术治疗的患者肿瘤石蜡包埋标本切片进行免疫染色，如果>50%的癌细胞呈中-强染色，则认为肿瘤具有高脂肪酸合酶表达。统计分析脂肪酸合酶表达与患者病理参数和生存的相关性。
在随访期间（中位数：46.8 个月），61 例（54.0%）患者复发，17 例（15.0%）患者死于上尿路尿路上皮癌。高脂肪酸合酶表达与高肿瘤分级显著相关（P=0.0273）。高脂肪酸合酶表达患者的无复发生存率和膀胱外复发-无复发生存率明显低于低脂肪酸合酶表达患者（P=0.0171，P=0.0228）。多变量分析显示，高脂肪酸合酶表达是无复发生存率缩短的独立预测因子（P=0.0220，风险比（HR）=1.970）。
上尿路尿路上皮癌中脂肪酸合酶的表达是肿瘤复发的独立预测因子。上尿路尿路上皮癌中脂肪酸合酶高表达的患者应密切随访，并考虑辅助治疗。
