Popov Hristo, Ghenev Peter, Stoyanov George S
General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR.
Pathology, Complex Oncology Center, Shumen, BGR.
Cureus. 2023 Sep 10;15(9):e44998. doi: 10.7759/cureus.44998. eCollection 2023 Sep.
Background One of the most characteristic features of non-invasive urothelial carcinoma (UC) is its high recurrence rate. Guanine-adenine-thymine-adenine nucleotide sequence-binding protein 3 (GATA3), as a transcription factor, correlates with urothelial differentiation and has been reported with poor prognosis in high-grade UC and recurrence in breast malignancies. As such, we set out to study the specifics of GATA3 in non-invasive UC, emphasizing on prediction for recurrence. Methods The cohort comprised 163 patients, with a follow-up period of five years, including 109 pTa cases and 54 pT1 cases. Immunohistochemical expression of GATA3 was assessed using a histo score (H-score). Kaplan-Meier test was conducted for the time to recurrence, according to the level of expression of GATA3 and the indicators studied. Receiver operating characteristic (ROC) curve analysis was done to determine the role of accuracy and specificity of predictability of the indicators. Results Recurrence within the follow-up period was noted in 41.72% of cases. No recurrence relationship was established for age and gender. GATA3 expression showed a varying H-score. Using ROC curve analysis, a cut-off value of 155 divided UC expression levels into low and high, with a sensitivity of 72.7% and specificity of 78.7% (area under the curve=0.800, 95% confidence interval: 0.696-0.904, p<0.001), further showing an association between high levels of nuclear expression and risk of local recurrence (p<0.0001). Conclusion Herein we have described the sensitivity of high GATA3 expression in non-invasive UC of the urinary bladder and its relation to local recurrence, independent of gender, age, tumor differentiation, and stage.
背景 非侵袭性尿路上皮癌（UC）最典型的特征之一是其高复发率。鸟嘌呤 - 腺嘌呤 - 胸腺嘧啶 - 腺嘌呤核苷酸序列结合蛋白3（GATA3）作为一种转录因子，与尿路上皮分化相关，并且在高级别UC中预后不良以及在乳腺恶性肿瘤复发方面已有报道。因此，我们着手研究非侵袭性UC中GATA3的具体情况，重点在于预测复发。方法 该队列包括163例患者，随访期为五年，其中包括109例pTa病例和54例pT1病例。使用组织学评分（H评分）评估GATA3的免疫组化表达。根据GATA3的表达水平和所研究的指标，对复发时间进行Kaplan - Meier检验。进行受试者操作特征（ROC）曲线分析以确定指标预测的准确性和特异性的作用。结果 在41.72%的病例中观察到随访期内复发。年龄和性别与复发无相关性。GATA3表达显示出不同的H评分。使用ROC曲线分析，将截断值设为155可将UC表达水平分为低表达和高表达，敏感性为72.7%，特异性为78.7%（曲线下面积 = 0.800，95%置信区间：0.696 - 0.904，p < 0.001），进一步表明高水平核表达与局部复发风险之间存在关联（p < 0.0001）。结论 在此我们描述了膀胱非侵袭性UC中高GATA3表达的敏感性及其与局部复发的关系，这与性别、年龄、肿瘤分化和分期无关。
