| Summary: | 碩士 === 中山醫學大學 === 醫學研究所 === 101 === Objective: Deregulation of microRNA have been proposed as one of the most important epigenetic alterations in urothelial carcinogenesis of bladder and upper urinary tract. Dicer, a RNase III endoribonuclease, is an essential regulator in microRNA biogenesis. The objective of this study is to investigate whether immunohistochemical expression of Dicer in urothelial carcinoma associates with conventional clinicopathological features and patient survival .
Methods and Materials: From June 2006 to July 2009, immunohistochemincal staining for Dicer was performed on tissues of upper urinary tract, including renal pelvis and ureter, and urinary bladder from 42 patients with primary urothelial carcinoma in a single medical center. Retrospective chart review of patient’s clinicaopathological characteristics was performed then correlated with the expression of Dice, including IHC intensity and distribution. We also investigated the impact of Dicer expression to overall survival.
Results: A total of 39 patients met the inclusion criteria and were included in the study. There was an increasing trend in proportions of high tumor grade across IHC intensity without statistical significance (Cochran-Armitage trend test, P=0.631). Tumor location was the only clinicopathological variant associated with Dicer IHC intensity (P=0.038). In univariant survival analysis, histological pattern (P=0.046) and Dicer IHC intensity (P=0.026) showed significant impact to overall survival. Besides, Kaplan-Meier plots also revealed the survival difference by high and low Dicer IHC intensity.
Conclusion and Suggestion: High Dicer IHC intensity expression is linked to poor disease state and decreased overall survival in urothelial carcinoma. Although there are no clinical evidences or rationale available currently, our data revealed association between Dicer IHC intensity and tumor location. Further studies is needed to understand the role of Dicer in aspects of microRNA machinery, carcinogenesis modulation, biochemical significance, and even therapeutic value in urothelial carcinoma of urinary tract.
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