Comparison of the Prognostic Value of Ki-67 and Programmed Cell Death Ligand-1 in Patients with Upper Tract Urothelial Carcinoma

• Main Authors: Mu-Yao Tsai, Ping-Chia Chiang, Chien-Hsu Chen, Ming-Tse Sung, Shun-Chen Huang, Jau-Ling Suen, Eing-Mei Tsai, Po-Hui Chiang
• Format: Article
• Language: English
• Published: MDPI AG 2021-08-01
• Series: Journal of Clinical Medicine
• Subjects: combined positive score; Ki-67; programmed cell death ligand-1; radical nephroureterectomy; upper tract urothelial carcinoma
• Online Access: https://www.mdpi.com/2077-0383/10/16/3728

We retrospectively enrolled 102 patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy to examine the prognostic value of Ki-67 and programmed cell death ligand-1 (PD-L1). Then, we performed PD-L1 and Ki-67 immunohistochemical staining on whole tissue sections. The cut-off value of PD-L1 positivity was a combined positive score (CPS) ≥10 and the Ki-67 overexpression was 20%. Among the 102 patients, 16.7% and 48.0% showed positive PD-L1 expression and Ki-67 overexpression, respectively. A CPS ≥10 was significantly associated with a higher pathological T stage (<i>p</i> = 0.049). In addition, Ki-67 overexpression was significantly associated with a pathological T stage ≥ 2 (<i>p</i> = 0.027) and tumour necrosis (<i>p</i> = 0.016). In the multivariable analysis, a positive PD-L1 expression was significantly correlated with worse cancer-specific survival (HR = 3.66, 95% CI =1.37−9.77, <i>p</i> = 0.01). However, there was no predictive value using a combination of PD-L1 expression and Ki-67 overexpression as a prognostic predictor. Compared with Ki-67 overexpression, a positive PD-L1 expression with CPS ≥ 10 was a stronger independent prognostic factor for CSS in patients with UTUC.