C5a receptor expression is associated with poor prognosis in urothelial cell carcinoma patients treated with radical cystectomy or nephroureterectomy

Wada,Yoshihiro; Maeda,Yoshihiro; Kubo,Tatsuko; Kikuchi,Ken; Eto,Masatoshi; Imamura,Takahisa

doi:10.3892/ol.2016.5137

C5a receptor expression is associated with poor prognosis in urothelial cell carcinoma patients treated with radical cystectomy or nephroureterectomy

Authors:
- Yoshihiro Wada
- Yoshihiro Maeda
- Tatsuko Kubo
- Ken Kikuchi
- Masatoshi Eto
- Takahisa Imamura
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Affiliations: Department of Urology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan, Department of Molecular Pathology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan, Medical Quality Management Center, Kumamoto University Hospital, Kumamoto 860-8556, Japan
Published online on: September 15, 2016 https://doi.org/10.3892/ol.2016.5137
Pages: 3995-4000

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Abstract

Patients with aggressive urothelial cell carcinoma (UCC) that undergo radical cystectomy or nephroureterectomy exhibit markedly high rates of disease recurrence and mortality. To select appropriate adjuvant thxerapies in addition to radical surgery, the identification of predictive prognostic markers for UCC patients is required. The aim of the present study was to identify such markers, by evaluating the association of UCC complement component 5 (C5) fragment a (C5a)receptor (C5aR) expression, detected using immunohistochemistry, with clinicopathological parameters and survival outcomes of UCC patients. The results revealed that C5aR was expressed in cancer cells, particularly at the invasive front, but not in noncancerous urothelial cells or adjacent cells. The UCC C5aR‑positive rate of patients treated with radical surgeries was 73% (38/52) and the rate was 83% (20/24) at stages I‑II of disease. No correlation between C5aR expression and any of clinicopathological parameters, which included gender, tumor location, World Health Organization grade, T stage, vessel invasion and stage of disease, was identified. However, univariate and multivariate analyses revealed that C5aR‑positive UCC patients exhibited significantly lower overall survival rates [hazard ratio (HR), 3.14; 95% confidence interval (CI), 1.03‑9.60; P=0.035 and HR, 3.92; 95% CI, 1.15‑13.4; P=0.029, respectively] and 5‑year survival rates (0.42 vs. 0.83) compared with C5aR‑negative UCC patients. Furthermore, 5‑year survival and disease‑specific survival rates were lower in patients with C5aR‑positive UCC (0.51; 95% CI, 0.30‑0.71) than patients with C5aR‑negative UCC (0.83; 95% CI, 0.62‑1.00). These results indicate that UCC C5aR expression is predictive of poor patient outcomes and thus may lead to the appropriate selection of adjuvant therapies at earlier UCC stages, which could improve patient prognosis.

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