CSF-1 Overexpression Predicts Poor Prognosis in Upper Tract Urothelial Carcinomas

Abstract

Background. Colony-stimulating factor-1 (CSF-1) is a homodimeric glycoprotein. The main role of CSF-1 is as a hematopoietic growth factor that modulates proliferation, differentiation, and survival of macrophages. Moreover, CSF-1 has also been reported to be aberrantly expressed in several human cancers. However, the precise role of CSF-1 in upper tract urothelial carcinomas (UTUC) has not been studied. In this research, we examined the clinical significance of CSF-1 expression in UTUC. Materials and Methods. One hundred twelve cancer tissue samples of UTUC from patients were included in this study, and the other cohort of 35 UTUC were paired cancer-adjacent normal samples. CSF-1 expression was evaluated by immunohistochemistry, and the association of CSF-1 expression with different clinicopathological variables was analyzed. Results. CSF-1 expression was higher in UTUC than in the normal urothelium (P=0.005). The CSF-1 expression was primarily localized in the nucleus and was significantly correlated with tumor size (P=0.04) and patients who had a high stage (P<0.001), distant metastasis (P=0.006), recurrence (P=0.003), and cancer death (P=0.005). High CSF-1 expression was correlated with poor disease-free survival (P=0.008) and cancer-specific survival (P=0.001). Our results also used univariate and multivariable analyses, which found that high CSF-1 expression was an independent predictor of poor disease-free survival (hazard ratio=2.56; P=0.007) and cancer-specific survival (hazard ratio=5.14; P=0.022). Conclusions. Our findings indicate that the expression of CSF-1 is a potential prognostic marker for predicting patient survival and recurrence in UTUC.