Low levels of cathepsin D are associated with a poor prognosis in endometrial cancer.

Total cytosolic cathepsin D (Cat D) levels were estimated by an immunoradiometric assay in a series of 156 consecutive patients with surgical stages I-III primary endometrial adenocarcinoma. Simultaneously, the tissue content of both oestrogen (ER) and progesterone (PR) receptors, and p185HER-2/neu, DNA content (ploidy), and the fraction of S-phase cells (S-phase) were also estimated. Tumoral Cat D content ranged from 0 to 243 pmol mg(-1) protein (median 44 pmol mg(-1) protein) and was not associated with any of the established clinicopathological and biological prognostic variables, with the exception of a weak positive correlation with the tumoral p185HER-2/neu levels. Univariable analysis performed on a subset of 97 patients, followed for a minimum of 2 years or until death, showed that patient age at diagnosis, high histological grade, advanced surgical stage, vascular invasion, positive peritoneal cytology, low levels of Cat D, negative ER and PR status, aneuploidy, and high S-phase were predictive of the presence of persistent or recurrent disease. However, multivariable analysis revealed that only histological grade, surgical stage, Cat D and PR were significantly associated with the patient's outcome. From these findings, we conclude that Cat D is an independent prognostic factor in endometrial adenocarcinoma, its low levels being associated with a worse clinical outcome.

[Incidence of upper urothelial tumor in the Autonomous Community of La Rioja in 1976-1991]. / Incidencia del tumor de urotelio alto en la Comunidad Autónoma de La Rioja en el período 1976-1991.

Study of the incidence rate of upper urothelium tumours between 1976 and 1991 among the population of the autonomous community La Rioja. A study by age, sex and time intervals, totalling 32 cases, is conducted. A greater incidence in males, and between 1987-1991 in terms of time, is observed. With regard to location of the upper urothelium tumour, a significant difference is found between right and left ureters and right and left renal pelvis. In 14 cases, an associated vesical carcinoma was noted (RR = 5338.9 with 95% CI from 2668.5 to 10681.4).