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P0108 Overexpression of DPP4 is a poor prognostic factor for patients with urothelial carcinoma of the upper urinary tract and urinary bladder
Abstracts / 50 (2014) e1–e74
Kerala, India, c Department of Biostatistics, Amrita Institute of Medical Sciences & Research Centre, Kochi, Kerala, India Background: Advances in radiotherapy techniques have improved clinical outcomes, but have also lead to concerns over subsequent acute and late effects. Dysphagia is one such complication that has garnered much attention. This retrospective study, conducted at a tertiary cancer care centre, aimed to analyse swallowing profiles of patients with cancer of anterior two-thirds of tongue, who had undergone surgery and had received adjuvant radiation using either IMRT or 3D CRT, as a surrogate of dose received by dysphagia aspiration-related structures (DARS). Methods: The treatment plans of patients treated using IMRT and 3D CRT, from November 2011 to December 2012, were retrieved from the planning system. The swallowing structures (DARS), namely superior, middle and inferior constrictors, base of tongue, larynx with supraglottis, and length of oesophagus, included in treatment volume with cricopharyngeous muscle, were contoured according to RTOG guidelines. Dose volume histograms were generated for these. Constraint doses were statistically derived. University of Washington Head-and-Neck-related Quality-of-Life questions addressing swallowing was used to evaluate swallowing status of patients. Findings: A statistically significant subjective correlation was found to exist between doses of swallowing structures, especially the constrictor muscles, base of tongue, and the larynx. Statistically derived probable mean dose-constraints correlated clinically with swallowing status of patients. IMRT had a statistically significant advantage over 3D CRT, in terms of V30 (p = 0.051), V50 (p = 0.002), V60 (p = 0.002), and D80 (p = 0.023) for the swallowing structures taken together. The probable limiting dose for dysphagia was 63 Gy for the superior constrictor and base of tongue, and 55 Gy for the larynx. Interpretation: Our study predicted possible mean dose constraints for the superior constrictor, base of tongue, and larynx. Further prospective studies are required to confirm these findings. Dysphagia-optimised IMRT is needed to improve swallowing status and quality of life in these patients.
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or analine, including chemokines, growth factors, and neuropeptide. Different DPP4 expression status has been observed in malignant tumours, including colon, renal, and ovarian carcinoma. Data mining of the published dataset (GSE31684) identified that DPP4 is significantly upregulated in urothelial carcinoma of the urinary bladder. We therefore analysed the association of DPP4 expression and outcome in our well-characterised cohort of urothelial carcinoma. Methods: Laser capture microdissection coupled with real-time qRT-PCR was used to evaluate DPP4 transcript level in 20 urothelial carcinomas of the urinary bladder. DPP4 immunostaining was done on 340 cases of urothelial carcinoma of the upper urinary tract and 295 cases of urothelial carcinoma of the urinary bladder. The expression status of DPP4 was then correlated with various clincopathological factors, disease-specific survival (DSS), and metastasis-free survival (MeFS). Findings: DPP4 mRNA expression was significantly increased in urothelial carcinomas with higher pT status (p < 0.001). In both groups of urothelial carcinomas, increment of DPP4 immunoexpression was significantly associated with advanced pT stage (both p < 0.001), high histological grade (urothelial carcinoma of the upper urinary tract, p = 0.019), lymph node metastasis (urothelial carcinoma of the upper urinary tract, p < 0.001; urothelial carcinoma of the urinary bladder, p = 0.033), vascular invasion (both p < 0.001), perineurial invasion (urothelial carcinoma of the urinary bladder, p = 0.021) and frequent mitosis (urothelial carcinoma of the upper urinary tract, p = 0.003). DPP4 overexpression independently predicted poor DSS (urothelial carcinoma of the upper urinary tract, p = 0.028; urothelial carcinoma of the urinary bladder, p < 0.0001) and MeFS (urothelial carcinoma of the upper urinary tract, p = 0.031; urothelial carcinoma of the urinary bladder, p < 0.0001) in both groups of patients. Interpretation: Our study shows that overexpression of DPP4 is significantly associated with aggressive tumour behaviour and poor outcome. DPP4 may have an important role in tumorigenesis of urothelial carcinoma.
http://dx.doi.org/10.1016/j.ejca.2014.03.152 http://dx.doi.org/10.1016/j.ejca.2014.03.151
P0108 OVEREXPRESSION OF DPP4 IS A POOR PROGNOSTIC FACTOR FOR PATIENTS WITH UROTHELIAL CARCINOMA OF THE UPPER URINARY TRACT AND URINARY BLADDER P-I. Liang a,*, W-J. Wu b,c,d, C-N. Huang b,c, C-C. Li b,c,e, H-L. Ke b,c, W-M. Li b,c, H-C. Yeh b,c,e, C-F. Li f,g,h, Y-Y. Lee f, H-H. Lin c, B-W. Yeh c, S-J. Hwang i . a Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, b Department of Urology, Faculty of Medicine, Kaohsiung Medical University, Taiwan, c Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, d Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan, e Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Taiwan, f Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan, g National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan, h Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan, i Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan Background: Dipeptidyl peptidase-4 (DPP4), also known as CD26, is an enzyme that cleaves a diversity of protein that contains proline
P0109 DIETARY FACTORS INFLUENCING STOMACH CANCER INCIDENCE IN OMANI PATIENTS N.A.Y. Al-Saimi a, H.R. Chitme a,*, M. Al Mandhari b. a Department of Pharmacy, Oman Medical College, Bausher Campus, Muscat, Oman, b College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman Background: Stomach cancer is one of the most common cancers in Oman. The age-standardised incidence of stomach cancer is higher in Oman than in all other GCC nations. In Oman, diet is traditional— high consumption of fish, red meat, and animal fats, especially from camel, and rather low consumption of raw fruits and vegetables. The main objective of this was to evaluate the possible dietary risk factors for stomach cancer in Omani patients. Methods: This small-scale hospital-based cohort and case–control study done by examining the records of patients with stomach cancer and prospectively by using questionnaires for stomach cancer patients and/or close relatives. The questionnaire was developed based on the literature on stomach cancer risk factors. Findings: Fifty-three patients with stomach cancer and 53 normal patients were included. Bread, beef, cheese, soft drinks, and sweet desserts had a significant adverse effect on the incidence and relative risk of stomach cancer (p < 0.05). However, consumption of fresh fruits,
Kerala, India, c Department of Biostatistics, Amrita Institute of Medical Sciences & Research Centre, Kochi, Kerala, India Background: Advances in radiotherapy techniques have improved clinical outcomes, but have also lead to concerns over subsequent acute and late effects. Dysphagia is one such complication that has garnered much attention. This retrospective study, conducted at a tertiary cancer care centre, aimed to analyse swallowing profiles of patients with cancer of anterior two-thirds of tongue, who had undergone surgery and had received adjuvant radiation using either IMRT or 3D CRT, as a surrogate of dose received by dysphagia aspiration-related structures (DARS). Methods: The treatment plans of patients treated using IMRT and 3D CRT, from November 2011 to December 2012, were retrieved from the planning system. The swallowing structures (DARS), namely superior, middle and inferior constrictors, base of tongue, larynx with supraglottis, and length of oesophagus, included in treatment volume with cricopharyngeous muscle, were contoured according to RTOG guidelines. Dose volume histograms were generated for these. Constraint doses were statistically derived. University of Washington Head-and-Neck-related Quality-of-Life questions addressing swallowing was used to evaluate swallowing status of patients. Findings: A statistically significant subjective correlation was found to exist between doses of swallowing structures, especially the constrictor muscles, base of tongue, and the larynx. Statistically derived probable mean dose-constraints correlated clinically with swallowing status of patients. IMRT had a statistically significant advantage over 3D CRT, in terms of V30 (p = 0.051), V50 (p = 0.002), V60 (p = 0.002), and D80 (p = 0.023) for the swallowing structures taken together. The probable limiting dose for dysphagia was 63 Gy for the superior constrictor and base of tongue, and 55 Gy for the larynx. Interpretation: Our study predicted possible mean dose constraints for the superior constrictor, base of tongue, and larynx. Further prospective studies are required to confirm these findings. Dysphagia-optimised IMRT is needed to improve swallowing status and quality of life in these patients.
e39
or analine, including chemokines, growth factors, and neuropeptide. Different DPP4 expression status has been observed in malignant tumours, including colon, renal, and ovarian carcinoma. Data mining of the published dataset (GSE31684) identified that DPP4 is significantly upregulated in urothelial carcinoma of the urinary bladder. We therefore analysed the association of DPP4 expression and outcome in our well-characterised cohort of urothelial carcinoma. Methods: Laser capture microdissection coupled with real-time qRT-PCR was used to evaluate DPP4 transcript level in 20 urothelial carcinomas of the urinary bladder. DPP4 immunostaining was done on 340 cases of urothelial carcinoma of the upper urinary tract and 295 cases of urothelial carcinoma of the urinary bladder. The expression status of DPP4 was then correlated with various clincopathological factors, disease-specific survival (DSS), and metastasis-free survival (MeFS). Findings: DPP4 mRNA expression was significantly increased in urothelial carcinomas with higher pT status (p < 0.001). In both groups of urothelial carcinomas, increment of DPP4 immunoexpression was significantly associated with advanced pT stage (both p < 0.001), high histological grade (urothelial carcinoma of the upper urinary tract, p = 0.019), lymph node metastasis (urothelial carcinoma of the upper urinary tract, p < 0.001; urothelial carcinoma of the urinary bladder, p = 0.033), vascular invasion (both p < 0.001), perineurial invasion (urothelial carcinoma of the urinary bladder, p = 0.021) and frequent mitosis (urothelial carcinoma of the upper urinary tract, p = 0.003). DPP4 overexpression independently predicted poor DSS (urothelial carcinoma of the upper urinary tract, p = 0.028; urothelial carcinoma of the urinary bladder, p < 0.0001) and MeFS (urothelial carcinoma of the upper urinary tract, p = 0.031; urothelial carcinoma of the urinary bladder, p < 0.0001) in both groups of patients. Interpretation: Our study shows that overexpression of DPP4 is significantly associated with aggressive tumour behaviour and poor outcome. DPP4 may have an important role in tumorigenesis of urothelial carcinoma.
http://dx.doi.org/10.1016/j.ejca.2014.03.152 http://dx.doi.org/10.1016/j.ejca.2014.03.151
P0108 OVEREXPRESSION OF DPP4 IS A POOR PROGNOSTIC FACTOR FOR PATIENTS WITH UROTHELIAL CARCINOMA OF THE UPPER URINARY TRACT AND URINARY BLADDER P-I. Liang a,*, W-J. Wu b,c,d, C-N. Huang b,c, C-C. Li b,c,e, H-L. Ke b,c, W-M. Li b,c, H-C. Yeh b,c,e, C-F. Li f,g,h, Y-Y. Lee f, H-H. Lin c, B-W. Yeh c, S-J. Hwang i . a Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, b Department of Urology, Faculty of Medicine, Kaohsiung Medical University, Taiwan, c Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, d Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan, e Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Taiwan, f Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan, g National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan, h Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan, i Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan Background: Dipeptidyl peptidase-4 (DPP4), also known as CD26, is an enzyme that cleaves a diversity of protein that contains proline
P0109 DIETARY FACTORS INFLUENCING STOMACH CANCER INCIDENCE IN OMANI PATIENTS N.A.Y. Al-Saimi a, H.R. Chitme a,*, M. Al Mandhari b. a Department of Pharmacy, Oman Medical College, Bausher Campus, Muscat, Oman, b College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman Background: Stomach cancer is one of the most common cancers in Oman. The age-standardised incidence of stomach cancer is higher in Oman than in all other GCC nations. In Oman, diet is traditional— high consumption of fish, red meat, and animal fats, especially from camel, and rather low consumption of raw fruits and vegetables. The main objective of this was to evaluate the possible dietary risk factors for stomach cancer in Omani patients. Methods: This small-scale hospital-based cohort and case–control study done by examining the records of patients with stomach cancer and prospectively by using questionnaires for stomach cancer patients and/or close relatives. The questionnaire was developed based on the literature on stomach cancer risk factors. Findings: Fifty-three patients with stomach cancer and 53 normal patients were included. Bread, beef, cheese, soft drinks, and sweet desserts had a significant adverse effect on the incidence and relative risk of stomach cancer (p < 0.05). However, consumption of fresh fruits,