Utility of EFEMP1 in the Prediction of Oncologic Outcomes of Urothelial Carcinoma
Urothelial carcinoma (UC) of the upper tract (UTUC) and urinary bladder (UBUC) is a heterogeneous malignancy. Through transcriptomic profiling of the Gene Expression Omnibus UBUC dataset (GSE31684), we discovered that epidermal growth factor-containing fibulin-like extracellularmatrix protein 1 (EFE...
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Published in | Genes Vol. 12; no. 6; p. 872 |
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Abstract | Urothelial carcinoma (UC) of the upper tract (UTUC) and urinary bladder (UBUC) is a heterogeneous malignancy. Through transcriptomic profiling of the Gene Expression Omnibus UBUC dataset (GSE31684), we discovered that epidermal growth factor-containing fibulin-like extracellularmatrix protein 1 (EFEMP1) was the most upregulated gene during metastatic development. EFEMP1 is an important component of basement membranes and acts as an enzyme regulator in extracellular matrix biology. Initially, evaluation of EFEMP1 mRNA expression in 50 UBUCs showed significantly upregulated levels in high stage UC. We further validated the clinical significance of EFEMP1 in 340 UTUC and 295 UBUC using immunohistochemistry, evaluated by H-score. High EFEMP1 immunoexpression significantly correlated with high pathologic stage, high histological grade, lymph node metastasis, vascular invasion, perineural invasion and high mitosis (all p < 0.05). After adjusting for established clinicopathological factors, EFEMP1 expression status retained its prognostic impact on disease-specific survival and metastasis-free survival in UTUC and UBUC (all p < 0.01). Furthermore, Ingenuity Pathway Analysis showed that actin cytoskeleton signaling, tumor microenvironment pathway and mitochondrial dysfunction were significantly enriched by EFEMP1 dysregulation. In conclusion, high EFEMP1 expression was associated with adverse pathological features in UC and independently predicted worse outcomes, suggesting its roles in clinical decision-making and risk stratification. |
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AbstractList | Urothelial carcinoma (UC) of the upper tract (UTUC) and urinary bladder (UBUC) is a heterogeneous malignancy. Through transcriptomic profiling of the Gene Expression Omnibus UBUC dataset (GSE31684), we discovered that epidermal growth factor-containing fibulin-like extracellularmatrix protein 1 (EFEMP1) was the most upregulated gene during metastatic development. EFEMP1 is an important component of basement membranes and acts as an enzyme regulator in extracellular matrix biology. Initially, evaluation of EFEMP1 mRNA expression in 50 UBUCs showed significantly upregulated levels in high stage UC. We further validated the clinical significance of EFEMP1 in 340 UTUC and 295 UBUC using immunohistochemistry, evaluated by H-score. High EFEMP1 immunoexpression significantly correlated with high pathologic stage, high histological grade, lymph node metastasis, vascular invasion, perineural invasion and high mitosis (all p < 0.05). After adjusting for established clinicopathological factors, EFEMP1 expression status retained its prognostic impact on disease-specific survival and metastasis-free survival in UTUC and UBUC (all p < 0.01). Furthermore, Ingenuity Pathway Analysis showed that actin cytoskeleton signaling, tumor microenvironment pathway and mitochondrial dysfunction were significantly enriched by EFEMP1 dysregulation. In conclusion, high EFEMP1 expression was associated with adverse pathological features in UC and independently predicted worse outcomes, suggesting its roles in clinical decision-making and risk stratification. Urothelial carcinoma (UC) of the upper tract (UTUC) and urinary bladder (UBUC) is a heterogeneous malignancy. Through transcriptomic profiling of the Gene Expression Omnibus UBUC dataset (GSE31684), we discovered that epidermal growth factor-containing fibulin-like extracellularmatrix protein 1 ( EFEMP1 ) was the most upregulated gene during metastatic development. EFEMP1 is an important component of basement membranes and acts as an enzyme regulator in extracellular matrix biology. Initially, evaluation of EFEMP1 mRNA expression in 50 UBUCs showed significantly upregulated levels in high stage UC. We further validated the clinical significance of EFEMP1 in 340 UTUC and 295 UBUC using immunohistochemistry, evaluated by H-score. High EFEMP1 immunoexpression significantly correlated with high pathologic stage, high histological grade, lymph node metastasis, vascular invasion, perineural invasion and high mitosis (all p < 0.05). After adjusting for established clinicopathological factors, EFEMP1 expression status retained its prognostic impact on disease-specific survival and metastasis-free survival in UTUC and UBUC (all p < 0.01). Furthermore, Ingenuity Pathway Analysis showed that actin cytoskeleton signaling, tumor microenvironment pathway and mitochondrial dysfunction were significantly enriched by EFEMP1 dysregulation. In conclusion, high EFEMP1 expression was associated with adverse pathological features in UC and independently predicted worse outcomes, suggesting its roles in clinical decision-making and risk stratification. |
Author | Li, Chien-Feng Wu, Wen-Jeng Ke, Hung-Lung Li, Wei-Ming Chan, Ti-Chun Chen, Tzu-Ju Li, Wan-Shan Wei, Yu-Ching |
AuthorAffiliation | 1 Department of Clinical Pathology, Chi Mei Medical Center, Tainan 710, Taiwan; a108n2@mail.chimei.org.tw (T.-J.C.); a80818@mail.chimei.org.tw (W.-S.L.); cfli@mail.chimei.org.tw (C.-F.L.) 2 Department of Medical Technology, Chung Hwa University of Medical Technology, Tainan 717, Taiwan 4 Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan; 090807@nhri.edu.tw 11 Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan 3 Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan 8 Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan 7 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; hlke@kmu.edu.tw (H.-L.K.); wejewu@kmu.edu.tw (W.-J.W.) 12 Department of Urology, Ministry of Health and Welfare, Pingtung Hospital, Pingtung 900, Taiwan 5 National Institute of Cancer Research, National Health Research Institut |
AuthorAffiliation_xml | – name: 1 Department of Clinical Pathology, Chi Mei Medical Center, Tainan 710, Taiwan; a108n2@mail.chimei.org.tw (T.-J.C.); a80818@mail.chimei.org.tw (W.-S.L.); cfli@mail.chimei.org.tw (C.-F.L.) – name: 3 Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan – name: 7 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; hlke@kmu.edu.tw (H.-L.K.); wejewu@kmu.edu.tw (W.-J.W.) – name: 4 Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan; 090807@nhri.edu.tw – name: 12 Department of Urology, Ministry of Health and Welfare, Pingtung Hospital, Pingtung 900, Taiwan – name: 2 Department of Medical Technology, Chung Hwa University of Medical Technology, Tainan 717, Taiwan – name: 5 National Institute of Cancer Research, National Health Research Institutes, Tainan 704, Taiwan – name: 9 Department of Pathology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; ycwei@kmu.edu.tw – name: 11 Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan – name: 10 Department of Pathology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 801, Taiwan – name: 6 Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung 804, Taiwan – name: 8 Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan |
Author_xml | – sequence: 1 givenname: Tzu-Ju surname: Chen fullname: Chen, Tzu-Ju – sequence: 2 givenname: Ti-Chun surname: Chan fullname: Chan, Ti-Chun – sequence: 3 givenname: Wan-Shan surname: Li fullname: Li, Wan-Shan – sequence: 4 givenname: Chien-Feng orcidid: 0000-0002-9527-7576 surname: Li fullname: Li, Chien-Feng – sequence: 5 givenname: Hung-Lung orcidid: 0000-0002-4208-3858 surname: Ke fullname: Ke, Hung-Lung – sequence: 6 givenname: Yu-Ching surname: Wei fullname: Wei, Yu-Ching – sequence: 7 givenname: Wen-Jeng surname: Wu fullname: Wu, Wen-Jeng – sequence: 8 givenname: Wei-Ming surname: Li fullname: Li, Wei-Ming |
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Snippet | Urothelial carcinoma (UC) of the upper tract (UTUC) and urinary bladder (UBUC) is a heterogeneous malignancy. Through transcriptomic profiling of the Gene... |
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SubjectTerms | Actin Antibodies Basement membranes Bladder cancer Cancer therapies Chemotherapy Clinical outcomes Cytoskeleton Data mining Datasets Decision making Disease EFEMP1 Epidermal growth factor Extracellular matrix Gene expression Immunohistochemistry Lymph nodes Lymphatic system Malignancy Medical prognosis Metastases Metastasis Mitochondria Mitosis Patients prognosis Proteins Software Statistical analysis Surgery Survival Survival analysis Tumor microenvironment Tumors upper tract urothelial carcinoma Urinary bladder Urogenital system Urothelial carcinoma |
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Title | Utility of EFEMP1 in the Prediction of Oncologic Outcomes of Urothelial Carcinoma |
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