Low Expression of Keratin17 is Related to Poor Prognosis in Bladder Cancer
Received 21 October 2020
Accepted for publication 16 December 2020
Published 19 January 2021 Volume 2021:14 Pages 577—587
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Federico Perche
Jiacheng Wu,1,2,* Haifei Xu,1,* Hao Ji,1 Baoqian Zhai,2 Jinfeng Zhu,1 Mingde Gao,3 Haixia Zhu,2 Xiaolin Wang1
1Department of Urology, Tumor Hospital Affiliated to Nantong University, Nantong University, Nantong 226361, People’s Republic of China; 2Cancer Research Center Nantong, Tumor Hospital Affiliated to Nantong University, Nantong University, Nantong 226361, People’s Republic of China; 3Department of Urology, Medical College of Nantong University, Nantong 226019, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Haixia Zhu
Cancer Research Center Nantong, Tumor Hospital Affiliated to Nantong University, Nantong University, No. 30 Tongyang Bei Road, Tongzhou District, Nantong 226361, People’s Republic of China
Tel +86 138 6290 6771
Fax +86 513 8671 2287
Department of Urology, Tumor Hospital Affiliated to Nantong University, Nantong University, No. 30 Tongyang Bei Road, Tongzhou District, Nantong 226361, People’s Republic of China
Tel +86 159 5086 8500
Fax +86 513 8672 9043
Objective: To investigate the association between KRT17 and the prognosis in bladder cancer patients.
Methods: The clinical data of 101 patients with bladder cancer from May 2013 to May 2015 were retrospectively analyzed. At the same time, the expression of KRT17 and its correlation with clinicopathological factors were examined by immunohistochemistry. We search the prognostic value of KRT17 in bladder cancer from the cancer genome map (TCGA) online database. To explore the possible cellular mechanism, gene set enrichment analysis (GSEA) was used. The patients were divided into two groups: high expression of KRT17 and low expression of KRT17. The patients were followed up for 5 years to observe the survival. Kaplan–Meier method and Log rank test were used for univariate survival analysis, and Cox regression analysis was used for multivariate analysis. Finally, a nomogram was constructed on this basis for internal verification.
Results: Among the 101 patients, 46 (45.5%) were in the KRT17 low expression group and 55 (54.5%) in the high KRT17 expression group. After 5 years of follow-up, 79 patients survived with a survival rate of 78.2% and 22 patients died with a mortality rate of 21.8%. Kaplan–Meier survival analysis showed that OS and PFS of patients with high expression of KRT17 were significantly higher than those of patients with low expression of KRT17 (p< 0.001, p=0.005). Cox multivariate analysis showed that KRT17 expression was an independent risk factor for tumor progression (p=0.019). And tumor size, vascular tumor thrombus, and T stage also affected tumor progression (p< 0.05). In the internal validation, the c-index of nomogram was 0.898 (95% CI: 0.854– 0.941).
Conclusion: The decreased expression of KRT17 is associated with poor prognosis in patients with bladder cancer. KRT17 can be used as a novel predictive biomarker to provide a new therapeutic target for bladder cancer patients.
Keywords: keratin17, bladder cancer, overall survival, prognosis, progression-free survival, risk factors, nomograph
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