Absence of GATA3/FOXA1 co-expression predicts poor prognosis in upper tract urothelial carcinoma

TL;DR

This study shows that the absence of GATA3 and FOXA1 together in upper tract urothelial carcinoma is linked to worse patient outcomes and could help predict prognosis.

Contribution

The study identifies GATA3/FOXA1 co-expression as a novel prognostic biomarker for upper tract urothelial carcinoma.

Findings

GATA3 and FOXA1 expression levels are positively correlated in UTUC.

Absence of GATA3/FOXA1 co-expression is associated with tumor extensive necrosis and shorter survival times.

GATA3-/FOXA1- status is a significant predictor of poor cancer-specific survival in UTUC patients.

Abstract

GATA binding protein 3 (GATA3) and forkhead box A1 (FOXA1) have been individually implicated in the progression of upper tract urothelial carcinoma (UTUC). This study aims to evaluate the prognostic value of GATA3/FOXA1 co-expression in UTUC patients.

We collected 108 UTUC pathological tissue samples with complete follow-up data and 24 normal control urothelial tissues. We created a 132-site microarray and performed immunohistochemistry (IHC) to measure GATA3 and FOXA1 expression levels. Kaplan-Meier survival and Cox regression analyses were conducted to assess UTUC prognosis.

GATA3 expression was positively correlated with FOXA1 (P=0.031). Absence of GATA3/FOXA1 co-expression (GATA3-/FOXA1-) was associated with tumor extensive necrosis (P=0.001) after Bonferroni correction for multiple comparisons. GATA3-/FOXA1- was associated with shorter Disease-Free Survival (DFS) (P=0.001) and Cancer-Specific Survival (CSS) (P<0.001) than other combination groups. Multivariate analyses identified extensive necrosis as an independent prognostic factor for CSS (P=0.030).

Our study revealed a positive correlation between GATA3 and FOXA1 expression in UTUC. GATA3-/FOXA1- is linked to tumor extensive necrosis and poor prognosis in UTUC and may serve as a potential biomarker for UTUC patients.

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