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Yao Q, Zhang X, Wang Y, Wang C, Chen J, Chen D. A promising natural killer cell-based model and a nomogram for the prognostic prediction of clear-cell renal cell carcinoma. Eur J Med Res 2024; 29:73. [PMID: 38268058 PMCID: PMC10807100 DOI: 10.1186/s40001-024-01659-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Clear-cell renal cell carcinoma (ccRCC) is one of prevalent kidney malignancies with an unfavorable prognosis. There is a need for a robust model to predict ccRCC patient survival and guide treatment decisions. METHODS RNA-seq data and clinical information of ccRCC were obtained from the TCGA and ICGC databases. Expression profiles of genes related to natural killer (NK) cells were collected from the Immunology Database and Analysis Portal database. Key NK cell-related genes were identified using consensus clustering algorithms to classify patients into distinct clusters. A NK cell-related risk model was then developed using Least Absolute Shrinkage and Selection Operator (LASSO) Cox regression to predict ccRCC patient prognosis. The relationship between the NK cell-related risk score and overall survival, clinical features, tumor immune characteristics, as well as response to commonly used immunotherapies and chemotherapy, was explored. Finally, the NK cell-related risk score was validated using decision tree and nomogram analyses. RESULTS ccRCC patients were stratified into 3 molecular clusters based on expression of NK cell-related genes. Significant differences were observed among the clusters in terms of prognosis, clinical characteristics, immune infiltration, and therapeutic response. Furthermore, six NK cell-related genes (DPYSL3, SLPI, SLC44A4, ZNF521, LIMCH1, and AHR) were identified to construct a prognostic model for ccRCC prediction. The high-risk group exhibited poor survival outcomes, lower immune cell infiltration, and decreased sensitivity to conventional chemotherapies and immunotherapies. Importantly, the quantitative real-time polymerase chain reaction (qRT-PCR) confirmed significantly high DPYSL3 expression and low SLC44A4 expression in ACHN cells. Finally, the decision tree and nomogram consistently show the dramatic prediction performance of the risk score on the survival outcome of the ccRCC patients. CONCLUSIONS The six-gene model based on NK cell-related gene expression was validated and found to accurately mirror immune microenvironment and predict clinical outcomes, contributing to enhanced risk stratification and therapy response for ccRCC patients.
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Affiliation(s)
- Qinfan Yao
- Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou, 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang Province, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou, China
| | - Xiuyuan Zhang
- Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou, 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang Province, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou, China
| | - Yucheng Wang
- Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou, 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang Province, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou, China
| | - Cuili Wang
- Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou, 310003, China
- Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang Province, China
- Institute of Nephropathy, Zhejiang University, Hangzhou, China
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou, China
| | - Jianghua Chen
- Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou, 310003, China.
- Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang Province, China.
- Institute of Nephropathy, Zhejiang University, Hangzhou, China.
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou, China.
| | - Dajin Chen
- Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou, 310003, China.
- Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang Province, China.
- Institute of Nephropathy, Zhejiang University, Hangzhou, China.
- Zhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou, China.
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Wang J, Zuo Z, Yu Z, Chen Z, Meng X, Ma Z, Niu J, Guo R, Tran LJ, Zhang J, Jiang T, Ye F, Ma B, Sun Z. Single-cell transcriptome analysis revealing the intratumoral heterogeneity of ccRCC and validation of MT2A in pathogenesis. Funct Integr Genomics 2023; 23:300. [PMID: 37713131 DOI: 10.1007/s10142-023-01225-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023]
Abstract
Clear-cell renal cell carcinoma (ccRCC) appears as the most common type of kidney cancer, the carcinogenesis of which has not been fully elucidated. Tumor heterogeneity plays a crucial role in cancer progression, which could be largely deciphered by the implement of scRNA-seq. The bulk and single-cell RNA expression profile is obtained from TCGA and study conducted by Young et al. We utilized UMAP, TSNE, and clustering algorithm Louvain for dimensionality reduction and FindAllMarkers function for determining the DEGs. Monocle2 was utilized to perform pseudo-time series analysis. SCENIC was implemented for transcription factor analysis of each cell subgroup. A series of WB, CFA, CCK-8, and EDU analysis was utilized for the validation of the role of MT2A in ccRCC carcinogenesis. We observed higher infiltration of T/NK and B cells in tumorous tissues, indicating the role of immune cells in ccRCC carcinogenesis. Transcription factor analysis revealed the activation of EOMES and ETS1 in CD8 + T cells, while CAFs were divided into myo-CAFs and i-CAFs, with i-CAFs showing distinct enrichment of ATF3, JUND, JUNB, EGR1, and XBP1. Through cell trajectory analysis, we discerned three distinct stages of cellular evolution, where State2 symbolizes normal renal tubular cells that underwent transitions into State1 and State3 as the CNV score ascended. Functional enrichment examination revealed an amplification of interferon gamma and inflammatory response pathways within tumor cells. The consensus clustering algorithm yielded two molecular subtypes, with cluster 2 being associated with advanced tumor stages and an abundance of infiltrated immune cells. We identified 17 prognostic genes through Cox and LASSO regression models and used them to construct a prognostic model, the efficacy of which was verified in multiple cohorts. Furthermore, we investigated the role of MT2A, one of our hub genes, in ccRCC carcinogenesis, and found it to regulate proliferation and migration of malignant cells. We depicted a detailed single-cell landscape of ccRCC, with special focus on CAFs, endothelial cells, and renal tubular cells. A prognostic model of high stability and accuracy was constructed based on the DEGs. MT2A was found to be actively implicated in ccRCC carcinogenesis, regulating proliferation and migration of the malignant cells.
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Affiliation(s)
- Jie Wang
- Department of Urology, The Second People's Hospital of Meishan City, Meishan, 620500, Sichuan, China
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Zili Zuo
- Department of Urology, The Second People's Hospital of Meishan City, Meishan, 620500, Sichuan, China
| | - Zongze Yu
- Department of Urology, The Second People's Hospital of Meishan City, Meishan, 620500, Sichuan, China
| | - Zhigui Chen
- Department of Urology, The Second People's Hospital of Meishan City, Meishan, 620500, Sichuan, China
| | - Xiangdi Meng
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Zhaosen Ma
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Jiqiang Niu
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Rui Guo
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Lisa Jia Tran
- Department of General, Visceral, and Transplant Surgery, Ludwig Maximilians University Munich, 81377, Munich, Germany
| | - Jing Zhang
- Division of Basic Biomedical Sciences, The University of South Dakota Sanford School of Medicine, Vermillion, SD, 57069, USA
| | - Tianxiao Jiang
- Division of Basic Biomedical Sciences, The University of South Dakota Sanford School of Medicine, Vermillion, SD, 57069, USA
| | - Fangdie Ye
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China.
| | - Baoluo Ma
- Department of Urology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
| | - Zhou Sun
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000, Jilin, China.
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Liu Z, Jin C, Zhang Y, Jiang Y, Wang J, Zheng L. Identification of BRAF, CCND1, and MYC mutations in a patient with multiple primary malignant tumors: a case report and review of the literature. World J Surg Oncol 2023; 21:158. [PMID: 37221610 DOI: 10.1186/s12957-023-03036-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/11/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Multiple primary malignant tumors (MPMTs), usually associated with worse malignant behavior and prognosis comparing to a single primary tumor, and have recently been found to have an increasing incidence globally. However, the pathogenesis of MPMTs remains to be clarified. Here, we report a unique case of the coexistence of malignant melanoma (MM), papillary thyroid carcinoma (PTC), and clear-cell renal cell carcinoma (ccRCC) along with our perceptions on its pathogenesis. CASE PRESENTATION The case reported is of a 59-year-old male patient with unilateral nasal obstruction as well as a renal occupying lesion. Positron emission tomography-computed tomography (PET-CT) revealed a palpable mass of 32 × 30 mm on the posterior and left walls of the nasopharynx. In addition, an isodense nodule was observed in the right superior renal pole, approximately 25 mm in diameter, as well as a slightly hypodense shadow in the right leaf of the thyroid, approximately 13 mm in diameter. Nasal endoscopy and magnetic resonance imaging (MRI) confirmed the existence of a nasopharyngeal neoplasm. Afterward, biopsies of the nasopharyngeal neoplasm, thyroid gland and kidney were performed, and the patient was diagnosed with MM, PTC, and ccRCC according to the pathological and immunohistochemical results. Moreover, mutation of BRAFV600E was detected in bilateral thyroid tissues, and amplification of both CCND1 and MYC oncogenes were detected in the nasopharyngeal melanoma. After chemotherapy, the patient is now in good overall condition. CONCLUSIONS This is the first reported case of a patient with the co-existence of MM, PTC and ccRCC undergoing chemotherapy with a favorable prognosis. Herein, we suggest that such a combination may be non-random, as for mutation of BRAFV600E might account for the co-occurrence of PTC and MM, while mutations of CCND1 and MYC cause the coexistence of MM and ccRCC. This finding may provide valuable guidance on the diagnosis and treatment of such disease, as well as the prevention of developing a second or third tumor for patients with a single primary.
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Affiliation(s)
- Zheyu Liu
- Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Cheng Jin
- Department of Otorhinolaryngology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
| | - Yi Zhang
- Department of Otorhinolaryngology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China.
| | - Yongquan Jiang
- Department of Otorhinolaryngology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
| | - Jingshuo Wang
- Department of Otorhinolaryngology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
| | - Luying Zheng
- Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, People's Republic of China
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Migliorelli A, Caranti A, Manuelli M, Bianchini C, Ciorba A, Pelucchi S. Clear-Cell Renal Cell Carcinoma Metastasis into Pterygomaxillary Fossa - A Case Report. Ann Maxillofac Surg 2023; 13:95-97. [PMID: 37711533 PMCID: PMC10499279 DOI: 10.4103/ams.ams_135_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/10/2022] [Accepted: 01/02/2023] [Indexed: 09/16/2023] Open
Abstract
Rationale The aim of this study is to describe a rare case of clear-cell renal cell carcinoma (ccRCC) metastasis to the pterygomaxillary fossa. Patient Concerns A 54-year-old woman was referred to the Department of Otolaryngology due to right facial pain for the past six weeks. Diagnosis ccRCC metastasis to the pterygomaxillary fossa. Treatment The patient was treated by immunotherapy (Ipilimumab + Nivolumab) after multidisciplinary team evaluation. Outcomes After 18 months, the patient is in good overall condition and the size of the skull base lesion has significantly reduced. Take-Away Lessons ccRCC metastasis to the skull base and adjacent sites occur rarely. Most commonly, the presenting symptoms of these lesions are headache and diplopia for skull base metastases and epistaxis in case of sinusal involvement, according to the literature. When total resection of the metastasis is not feasible, tumour-targeted therapy may be used, as in the presented case. A multidisciplinary evaluation is recommended for the correct assessment and management of these patients.
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Affiliation(s)
- Andrea Migliorelli
- Department of Neurosciences and Rehabilitation, ENT and Audiology Unit, University Hospital of Ferrara, Ferrara, Italy
| | - Alberto Caranti
- Department of Neurosciences and Rehabilitation, ENT and Audiology Unit, University Hospital of Ferrara, Ferrara, Italy
| | - Marianna Manuelli
- Department of Neurosciences and Rehabilitation, ENT and Audiology Unit, University Hospital of Ferrara, Ferrara, Italy
| | - Chiara Bianchini
- Department of Neurosciences and Rehabilitation, ENT and Audiology Unit, University Hospital of Ferrara, Ferrara, Italy
| | - Andrea Ciorba
- Department of Neurosciences and Rehabilitation, ENT and Audiology Unit, University Hospital of Ferrara, Ferrara, Italy
| | - Stefano Pelucchi
- Department of Neurosciences and Rehabilitation, ENT and Audiology Unit, University Hospital of Ferrara, Ferrara, Italy
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Feng C, Li Y, Li K, Lyu Y, Zhu W, Jiang H, Wen H. PFKFB4 is overexpressed in clear-cell renal cell carcinoma promoting pentose phosphate pathway that mediates Sunitinib resistance. J Exp Clin Cancer Res 2021; 40:308. [PMID: 34593007 PMCID: PMC8482632 DOI: 10.1186/s13046-021-02103-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/12/2021] [Indexed: 01/16/2023]
Abstract
Background Kinases play critical role in clear-cell renal cell carcinoma (ccRCC). We aim to exploit novel kinase that is both protumorigenic and drugable in ccRCC. Methods Reproduction of public datasets with validation using microarray was performed to identify candidate gene. Functionality was studied using multi-omics with validation in vitro and in vivo. Results 6-Phosphofructo-2-Kinase/Fructose-2,6-Biphosphatase 4 (PFKFB4) was differentially expressed showing significantly higher expression in tumor than in normal kidney. PFKFB4 overexpression was associated with advanced tumor grade, stage and worsened prognosis. PFKFB4-knockdown significantly impaired fitness in cell proliferation, migration and wound healing. Despite being recurrently deleted on 3p, PFKFN4 mRNA remained actively transcribed by HIF1α. Metabolomics showed overexpressed PFKFB4 showed enriched metabolites in pentose phosphate pathway (PPP). Phosphoproteomics and immunoprecipitation showed PFKFB4 also phosphorylated NCOA3 which interacted with FBP1 to counteract overactive PPP flux, forming a regulatory loop. PFKFB4-knockdown overcame resistance to Sunitinib in vitro and in vivo both in xenograft and tail-vein injection murine models. Conclusion We concluded PFKFB4 was associated with PPP activity and the fine-tuning of which was mediated by its phosphorylation of NCOA3. Targeting PFKFB4 held promise to combat resistance to Sunitinib. Supplementary Information The online version contains supplementary material available at 10.1186/s13046-021-02103-5.
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Affiliation(s)
- Chenchen Feng
- Department of Urology, Huashan Hospital, Fudan University, 12 Middle Urumqi Rd, 200040, Shanghai, PR China.,Institute of Urology, Fudan University, 200040, Shanghai, PR China
| | - Yuqing Li
- Department of Urology, Huashan Hospital, Fudan University, 12 Middle Urumqi Rd, 200040, Shanghai, PR China.,Institute of Urology, Fudan University, 200040, Shanghai, PR China
| | - Kunping Li
- Department of Urology, Huashan Hospital, Fudan University, 12 Middle Urumqi Rd, 200040, Shanghai, PR China.,Institute of Urology, Fudan University, 200040, Shanghai, PR China
| | - Yinfeng Lyu
- Department of Urology, Huashan Hospital, Fudan University, 12 Middle Urumqi Rd, 200040, Shanghai, PR China.,Institute of Urology, Fudan University, 200040, Shanghai, PR China
| | - Wenhui Zhu
- Department of Urology, Huashan Hospital, Fudan University, 12 Middle Urumqi Rd, 200040, Shanghai, PR China.,Institute of Urology, Fudan University, 200040, Shanghai, PR China
| | - Haowen Jiang
- Department of Urology, Huashan Hospital, Fudan University, 12 Middle Urumqi Rd, 200040, Shanghai, PR China. .,Institute of Urology, Fudan University, 200040, Shanghai, PR China.
| | - Hui Wen
- Department of Urology, Huashan Hospital, Fudan University, 12 Middle Urumqi Rd, 200040, Shanghai, PR China. .,Institute of Urology, Fudan University, 200040, Shanghai, PR China.
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Xu ZB, Gan MF, Yu HY, Mo LC, Xia YH, Yu QX, Zheng JM. The Significance of INHBE Expression in the Cancer Cells of Clear-Cell Renal Cell Carcinoma. Urol Int 2021; 106:376-386. [PMID: 34515260 DOI: 10.1159/000518161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/22/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Activins and inhibins are structurally related dimeric glycoprotein hormones belonging to the transforming growth factor-β superfamily but whether they are also involved in malignancy is far from clear. No study has reported the expression of INHBE in kidney cancer. The purpose of this study was to examine the expressions of INHBE in the tumor tissue of patients with clear-cell renal cell carcinoma (ccRCC) and to explore the pathologic significance. METHODS The INHBE mRNA expression in the tumor tissue of ccRCC patients was analyzed by using RNA sequencing data from the TCGA database. To examine the expression of inhibin βE protein, 241 ccRCC patients were recruited and immunohistochemistry was performed on the tumor tissue of these patients along with 39 normal renal samples. The association between the inhibin βE expression level and patient's clinicopathological indices was evaluated. RESULTS In the normal renal tissue, inhibin βE was found to be expressed mainly by renal tubular epithelial cells. In the tumor tissue, inhibin βE was expressed mainly in cancer cells. The expressions of INHBE mRNA and protein in the tumor tissue of ccRCC patients increased significantly compared with those in normal renal samples. There was a significant correlation between the level of inhibin βE in the tumor tissue and tumor grade. Patients with a lower inhibin βE expression in the tumor tissue were found to have a longer overall survival and disease-specific survival. CONCLUSIONS INHBE might be involved in the pathogenesis of ccRCC and function as a tumor promoter.
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Affiliation(s)
- Zi-Bin Xu
- Department of Urology, Taizhou Hospital, Wenzhou Medical University, Linhai, China
| | - Mei-Fu Gan
- Department of Pathology, Taizhou Hospital, Wenzhou Medical University, Linhai, China
| | - Hong-Yuan Yu
- Department of Urology, Taizhou Hospital, Wenzhou Medical University, Linhai, China
| | - Li-Cai Mo
- Department of Urology, Taizhou Hospital, Wenzhou Medical University, Linhai, China
| | - Yu-Hui Xia
- Department of Pathology, Taizhou Hospital, Wenzhou Medical University, Linhai, China
| | - Qing-Xin Yu
- Department of Pathology, Taizhou Hospital, Wenzhou Medical University, Linhai, China
| | - Jing-Min Zheng
- Department of Urology, Taizhou Hospital, Wenzhou Medical University, Linhai, China.,Department of Pathology, Taizhou Hospital, Wenzhou Medical University, Linhai, China
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Wang J, Chen M, Dang C, Zhang H, Wang X, Yin J, Jia R, Zhang Y. The Early Diagnostic and Prognostic Value of BIRC5 in Clear-Cell Renal Cell Carcinoma Based on the Cancer Genome Atlas Data. Urol Int 2021; 106:344-351. [PMID: 34265766 DOI: 10.1159/000517310] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/05/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of this study was to investigate the role of BIRC5 for early diagnosis and prognosis in clear-cell renal cell carcinoma (ccRCC) by studying the expression of BIRC5 and the correlation between BIRC5 expression and clinicopathological parameters and prognosis in ccRCC. METHODS The BIRC5 expression in ccRCC tissues and normal kidney tissues was measured using the Cancer Genome Atlas database and the Human Protein Atlas database. The correlation between BIRC5 expression and clinicopathological parameters and prognosis in ccRCC was analyzed using UALCAN, the Kaplan-Meier plotter, GEPIA, and SurvExpress. Thirteen-paired ccRCC plasma samples were used to verify the BIRC5 early diagnosis value of ccRCC. RESULTS The BIRC5 expression is significantly higher in ccRCC than in normal kidney tissues, and is correlated with the clinical stage and pathological grade of ccRCC (p < 0.05). The result of analyzing the relationship between BIRC5 expression and outcomes in ccRCC indicates that a high BIRC5 expression is an independent prognostic factor affecting the overall survival and disease-free survival of ccRCC (p < 0.05). Compared with normal kidney tissues, the immunohistochemical test shows that BIRC5 is significantly upregulated in ccRCC tissues. mRNA expression levels of BIRC5 were significantly higher in the ccRCC plasma than normal (p < 0.05). CONCLUSIONS The high expression of BIRC5 is an important indicator for the prognosis of ccRCC, which makes BIRC5 an effective biomarker for predicting the prognosis of patients in ccRCC. BIRC5 may be a great potential biomarker for early diagnosis of ccRCC.
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Affiliation(s)
- Jingyuan Wang
- Department of Clinical Lab Diagnosis, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Min Chen
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Chengxue Dang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hao Zhang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xin Wang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jianhao Yin
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Rui Jia
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yong Zhang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Haeberle L, Busch M, Kirchner J, Fluegen G, Antoch G, Knoefel WT, Esposito I. Pancreatic ductal adenocarcinoma concomitant with pancreatic metastases of clear-cell renal cell carcinoma: a case report. J Med Case Rep 2021; 15:314. [PMID: 34059139 PMCID: PMC8168005 DOI: 10.1186/s13256-021-02768-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/01/2021] [Indexed: 11/10/2022] Open
Abstract
Background Metastatic spread to the pancreas is a rare event. Renal cell carcinoma represents one possible site of origin of pancreatic metastases. Renal cell carcinoma often metastasizes late and exclusively to the pancreas, suggesting a special role of renal cell carcinoma among primaries metastasizing to the pancreas. Even rarer, renal cell carcinoma may occur simultaneously with pancreatic ductal adenocarcinoma. Case presentation We present the case of a 78-year-old male Caucasian patient with a history of clear-cell renal cell carcinoma treated with oncological left nephrectomy 20 years before. The patient was diagnosed with pancreatic ductal adenocarcinoma by fine-needle aspiration cytology. At our institution, he received neoadjuvant therapy with folic acid, fluorouracil, irinotecan, oxaliplatin for borderline-resectable pancreatic ductal adenocarcinoma, and subsequently underwent total pancreatectomy. Upon resection, pancreatic ductal adenocarcinoma as well as two metachronous metastases of clear-cell renal cell carcinoma occurring simultaneously and cospatially with pancreatic ductal adenocarcinoma were diagnosed in the pancreatic body. Conclusions Renal cell carcinoma metastases of the pancreas are rare and often occur decades after the initial diagnosis of renal cell carcinoma. The combination of renal cell carcinoma metastases and pancreatic ductal adenocarcinoma is even rarer. However, the possibility should be considered by clinicians, radiologists, and pathologists. The special role of renal cell carcinoma as a site of origin of pancreatic metastasis should be further elucidated.
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Affiliation(s)
- Lena Haeberle
- Institute of Pathology, Heinrich Heine University and University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Melanie Busch
- Institute of Pathology, Heinrich Heine University and University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Julian Kirchner
- Department of Diagnostic and Interventional Radiology, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - Georg Fluegen
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - Wolfram Trudo Knoefel
- Department of General, Visceral and Pediatric Surgery, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - Irene Esposito
- Institute of Pathology, Heinrich Heine University and University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
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9
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Wang L, Li Y, Lyu Y, Wen H, Feng C. Association between copy-number alteration of +20q, -14q and -18p and cross-sensitivity to tyrosine kinase inhibitors in clear-cell renal cell carcinoma. Cancer Cell Int 2020; 20:482. [PMID: 33041663 PMCID: PMC7541266 DOI: 10.1186/s12935-020-01585-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 09/29/2020] [Indexed: 12/30/2022] Open
Abstract
Background We aim to explore association between copy number alteration (CNA) and sensitivity to common tyrosine kinase inhibitors (TKIs) used in clear-cell renal cell carcinoma (ccRCC) treatment. Methods CNA with related sensitivity profiles were extracted from the Genomics of Drug Sensitivity in Cancer (GDSC) dataset and was cross-referenced with common CNA in ccRCC in the Cancer Genome Atlas (TCGA) dataset. Functional annotation was profiled using GSEA and NET-GE. Target genes within cytobands of interest were screened in silico and validated in vitro using proliferation assays in A498 and 786-O ccRCC cells. Results Four TKIs (Sunitinib, Cabozantinib, Axitinib and Sorafenib) that were clinically used in ccRCC were selected. In silico analysis showed gain of 20q (+20q) occurred in ~ 23% of cases and was associated with resistance to all four TKIs; loss of 14q (−14q) occurred in ~ 39% of cases and was associated with resistance to Sunitinib and Sorafenib; loss of 18p (−18p) occurred in ~ 39% of cases and was associated with sensitivity to Sunitinib and Sorafenib. All 3 CNAs were associated with worsened prognosis, respectively. Candidate target genes included of RBL1 on 20q, KLHL33 on 14q and ARHGAP28 on18q. In vitro validation showed RBL1 overexpression induced resistance to Sunitinib and Cabozantinib; KLHL33 silencing induced resistance to Sunitinib; ARHGAP28 silencing induced sensitivity to Cabozantinib. Functional annotation indicated FoxO signaling, hypoxic response and Wnt pathway, and Rho-related cellular adhesion were mechanistically associated with +20q, −14q and −18p, respectively. Conclusion Common CNAs in ccRCC are associated with cancer-intrinsic cross-sensitivity to common TKIs. Further validation and functional analyses are therefore needed.
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Affiliation(s)
- Liang Wang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300052 People's Republic of China
| | - Yuqing Li
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, 200040 People's Republic of China
| | - Yinfeng Lyu
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, 200040 People's Republic of China
| | - Hui Wen
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, 200040 People's Republic of China
| | - Chenchen Feng
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, 200040 People's Republic of China
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Gao J, Xu Q, Fu Y, He K, Zhang C, Zhang Q, Shi J, Zhao X, Wang F, Guo H. Comprehensive evaluation of 68Ga-PSMA-11 PET/CT parameters for discriminating pathological characteristics in primary clear-cell renal cell carcinoma. Eur J Nucl Med Mol Imaging 2020; 48:561-569. [PMID: 32623502 DOI: 10.1007/s00259-020-04916-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 06/07/2020] [Indexed: 01/25/2023]
Abstract
PURPOSE To evaluate parameters derived from 68Ga-PSMA-11 PET/CT images for discriminating pathological characteristics in primary clear-cell renal cell carcinoma (ccRCC). METHODS The study retrospectively examined data for 36 ccRCC patients with preoperative 68Ga-PSMA-11 PET/CT scan and surgical specimens. Radiological parameters including maximal tumor diameter, mean CT value, and maximal standard uptake value (SUVmax) were derived from PET/CT images. Pathological characteristics included WHO/ISUP grade and adverse pathology (tumor necrosis or sarcomatoid or rhabdoid feature). Values of radiological parameters were compared within subgroups of pathological characteristics. Receiver operating characteristic (ROC) curve analysis was used for the effectiveness of radiological parameters in differentiating pathological characteristics, estimating area under the ROC curve (AUC) and 95% confidence intervals (CIs). RESULTS The WHO/ISUP grade distribution for 36 tumors was grade 1, 9 (25.0%); grade 2, 12 (33.3%); grade 3, 9 (25.0%); and grade 4, 6 (16.7%). Adverse pathology was positive for 15 (41.7%). Radiological tumor diameter and SUVmax significantly differed by WHO/ISUP grade, pT stage, and adverse pathology (all P < 0.05), with no difference by CT value. Tumor diameter demonstrated sensitivity 86% and specificity 88% for pT stage, with cutoff 6.70 and AUC 0.91 (95% CI, 0.79-1.00, P < 0.001). SUVmax could effectively differentiate WHO/ISUP grade (3-4 vs. 1-2) and adverse pathology (positive vs. negative), with AUC 0.89 (95% CI, 0.81-0.98, P < 0.001), cutoff 16.4, sensitivity 100%, and specificity 71% and AUC 0.92 (95% CI, 0.85-0.99, P < 0.001), cutoff 18.5, sensitivity 94%, and specificity 87%, respectively. CONCLUSION 68Ga-PSMA-11 PET/CT could effectively identify aggressive pathological features of ccRCC.
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Affiliation(s)
- Jie Gao
- Department of Urology, Nanjing Drum Tower Hospital, Institute of Urology Nanjing University, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Qinfeng Xu
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yao Fu
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Kuiqiang He
- Department of Urology, Nanjing Drum Tower Hospital, Institute of Urology Nanjing University, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Chengwei Zhang
- Department of Urology, Nanjing Drum Tower Hospital, Institute of Urology Nanjing University, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Qing Zhang
- Department of Urology, Nanjing Drum Tower Hospital, Institute of Urology Nanjing University, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Jiong Shi
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Xiaozhi Zhao
- Department of Urology, Nanjing Drum Tower Hospital, Institute of Urology Nanjing University, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China.
| | - Feng Wang
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Hongqian Guo
- Department of Urology, Nanjing Drum Tower Hospital, Institute of Urology Nanjing University, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China.
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Thana M, Wood LA. What Do International Guidelines Say About First-line Therapy for Clear-cell Metastatic Renal Cell Carcinoma? Eur Urol Focus 2019; 6:48-52. [PMID: 31629680 DOI: 10.1016/j.euf.2019.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/20/2019] [Indexed: 11/18/2022]
Abstract
Treatment options for clear-cell metastatic renal cell carcinoma (mRCC) have increased significantly. Clinical practice guidelines aim to aid with decision-making about treatment selection through evidence-based recommendations. In this article, recommendations on first-line treatment for clear-cell mRCC in guidelines from three international organizations are reviewed and summarized. Future guideline development should focus on dynamic updates based on practice-changing data and guidance regarding therapy selection. PATIENT SUMMARY: International guidelines for first-line treatment of metastatic renal cell carcinoma are reviewed in this article. The main differences between guidelines appear to be how quickly the newest evidence is included.
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Affiliation(s)
- Myuran Thana
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
| | - Lori Anne Wood
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
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Hasanov E, Tidwell RSS, Fernandez P, Park L, McMichael C, Tannir NM, Jonasch E. Phase II Study of Carfilzomib in Patients With Refractory Renal Cell Carcinoma. Clin Genitourin Cancer 2019; 17:451-456. [PMID: 31439537 DOI: 10.1016/j.clgc.2019.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/28/2019] [Accepted: 07/15/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND A von Hippel Lindau (VHL) mutation or functional inactivation occurs in the a large proportion of patients with clear-cell renal cell carcinoma (ccRCC), which results in the dysregulation of a number of key cellular functions. A high throughput screen and candidate compound assessment revealed that agents with proteasome inhibition properties were able to stabilize point-mutated VHL and restore some of its functions. PATIENTS AND METHODS Nine patients with histologically confirmed metastatic ccRCC with disease progression during at least 1 previous systemic therapy were treated with carfilzomib at a dose of 20 mg/m2 over 30 minutes via intravenous (I.V.) infusion on days 1 and 2 and a dose of 56 mg/m2 over 30 minutes via I.V. infusion on days 8, 9, 15, and 16 of each 4-week cycle. RESULTS The study was stopped after 9 patients were enrolled because of futility. Of the 9 patients treated in the study, all patients had disease progression within 4 months, with a median time of 1.8 months (95% confidence interval, 0.8-3.6 months). No patient showed a response according to Response Evaluation Criteria In Solid Tumors. Three patients showed a best response of stable disease. The most common side effects were musculoskeletal pain, elevated creatinine level, anemia, hyperkalemia, leukopenia, lymphopenia, and fatigue. CONCLUSION Although the negative safety and efficacy results of this study do not favor the use of carfilzomib for the treatment of ccRCC, previous studies have shown selected patients achieved partial or complete response to this class of agent. Further preclinical investigations to evaluate the molecular characteristics of the patients who respond to proteasome inhibitors will better characterize the underlying mechanism of response, and might allow for the selection of an appropriate patient population in future studies.
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Affiliation(s)
| | - Rebecca S S Tidwell
- Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Pablo Fernandez
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Lauren Park
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Charla McMichael
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Nizar M Tannir
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Eric Jonasch
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
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13
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Casuscelli J, Becerra MF, Seier K, Manley BJ, Benfante N, Redzematovic A, Stief CG, Hsieh JJ, Tickoo SK, Reuter VE, Coleman JA, Russo P, Ostrovnaya I, Hakimi AA. Chromophobe Renal Cell Carcinoma: Results From a Large Single-Institution Series. Clin Genitourin Cancer 2019; 17:373-379.e4. [PMID: 31326335 DOI: 10.1016/j.clgc.2019.06.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 06/15/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND The purpose of the study was to evaluate clinical features and prognostic factors in a large single institutional cohort of chromophobe renal cell carcinoma (ChRCC) patients for identification of tumors with the highest metastatic potential. PATIENTS AND METHODS Clinicopathological parameters of all patients with ChRCC diagnosed and surgically treated at Memorial Sloan Kettering Cancer Center between 1990 and 2016 were identified and compared with patients treated for clear-cell renal cell carcinoma (ccRCC) in the same study period using Wilcoxon test for continuous variables and Fisher exact test for categorical variables. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan-Meier method, log rank test, and Cox proportional hazards regression. RESULTS Four hundred ninety-six patients with ChRCC (10-year RFS, 91.7% and OS, 82.1%) and 3312 patients with ccRCC (10-year RFS, 79.4% and OS, 63.6%) were included in the analysis. Patients with ChRCC were younger (median 59 vs. 61 years; P = .0015), less frequently male (54.8% vs. 66.3%; P < .0001), showed more favorable T stages (T1-2 in 78% vs. 67%; P < .0001) and less frequent sarcomatoid differentiation (1.2 % vs. 4%; P = .0008) and showed lower rates of metastatic development compared with ccRCC patients. Larger tumor size, sarcomatoid differentiation, and higher T-stage are significantly associated with adverse RFS and OS in chromophobe tumors. CONCLUSION ChRCC is more commonly diagnosed in female and younger patients and is associated with a more favorable clinical outcome and a lower propensity for metastatic development than ccRCC. Larger tumors and sarcomatoid differentiation of ChRCC might be considered as risk factors for metastatic development.
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Affiliation(s)
- Jozefina Casuscelli
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Urology, Ludwig-Maximilians University, Munich, Germany
| | - Maria F Becerra
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kenneth Seier
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brandon J Manley
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Nicole Benfante
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Almedina Redzematovic
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Christian G Stief
- Department of Urology, Ludwig-Maximilians University, Munich, Germany
| | - James J Hsieh
- Molecular Oncology, Department of Medicine, Siteman Cancer Center, Washington University, St Louis, MO
| | - Satish K Tickoo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Victor E Reuter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jonathan A Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Paul Russo
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Irina Ostrovnaya
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Ari Hakimi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
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Laba P, Wang J, Zhang J. Low level of isocitrate dehydrogenase 1 predicts unfavorable postoperative outcomes in patients with clear cell renal cell carcinoma. BMC Cancer 2018; 18:852. [PMID: 30153799 PMCID: PMC6114787 DOI: 10.1186/s12885-018-4747-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 08/14/2018] [Indexed: 12/16/2022] Open
Abstract
Background The purpose of this study was to investigate the role of isocitrate dehydrogenase 1 (IDH1) expression on prognosis of patients with clear cell renal cell carcinoma (ccRCC) following nephrectomy. Methods We retrospectively enrolled 358 ccRCC patients undergoing nephrectomy in Renji Hospital. Clinicopathologic features, overall survival (OS) and recurrence-free survival (RFS) of ccRCC patents were all collected. IDH1 expression level was assessed by immunohistochemistry and its association with clinicopathologic features and outcomes were also evaluated. Kaplan-Meier method with the log-rank test was applied to compare survival curves. Multivariate cox regression models were applied to analyze the prognostic value of each factor on OS and RFS of ccRCC patients. Moreover, two nomograms with factors selected by multivariate analysis were constructed to evaluate the prognosis of ccRCC patients, and the calibration plots were built to assess the predictive accuracy of nomograms. Results Our data indicated that IDH1 expression level was down-regulated in ccRCC tissues, and it negatively correlated with tumor Fuhrman grade (p = 0.025). Low IDH1 expression was associated with worse OS and RFS for cccRCC patients (OS, p = 0.004; RFS, p = 0.03). In addition, IDH1 could significantly stratify patients’ OS and RFS in intermediate/high risk patients (UISS score ≥ 4) (p = 0.049 and p = 0.004, respectively). Furthermore, incorporating IDH1 with other prognostic factors could predict ccRCC patients’ OS and RFS (OS, c-index = 0.779; RFS, c-index = 0.798) and perform better than TNM and SSIGN system. Conclusions Low IDH1 expression level might be an adverse prognostic biomarker for clinical outcomes of ccRCC patients, and two nomograms with IDH1 are potential effective prognostic models for ccRCC.
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Affiliation(s)
- Pingcuo Laba
- Department of Urology, Shigatse People's Hospital, Shigatse, 85700, China
| | - Jianfeng Wang
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No.160, Pujian Road, Shanghai, 200127, China
| | - Jin Zhang
- Department of Urology, Shigatse People's Hospital, Shigatse, 85700, China. .,Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No.160, Pujian Road, Shanghai, 200127, China.
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15
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Feng C, Ding G, Ding Q, Wen H. Overexpression of low density lipoprotein receptor-related protein 1 (LRP1) is associated with worsened prognosis and decreased cancer immunity in clear-cell renal cell carcinoma. Biochem Biophys Res Commun 2018; 503:1537-43. [PMID: 30033103 DOI: 10.1016/j.bbrc.2018.07.076] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 07/16/2018] [Indexed: 12/12/2022]
Abstract
AIM Clear-cell renal cell carcinoma (ccRCC) is characterized with underlying genetic disorders and the role of low density lipoprotein receptor-related protein 1 (LRP1) in ccRCC is unknown. METHOD An in silico exploratory analysis using multiple public genetic datasets was used to establish association between LRP1 expression and clinicopathological parameters. Associations of interest were validated using 155 ccRCC samples using immunohistochemistry. RESULTS LRP1 was overexpressed in tumor compared with normal kidney tissue. Increased LRP1 expression in ccRCC was associated with advanced stage, grade and worsened overall survival and progression-free survival. Functional annotation indicated an immune-modulatory role of LRP1 in ccRCC. LRP1 expression was significantly correlated with expressions of PBRM1, SETD2, and KDM5C. Positive correlations between LRP1 and pro-angiogenic factors ERAP1, SCG2, STAB1, and RUNX1 were observed. LRP1 expression was positively correlated with PD-L2 level. Negative correlations between LRP1 and anti-angiogenic factors EMCN and IL18 were observed. LRP1 expression was not associated with microvessel density (MVD) yet was negatively correlated with tumor-infiltrating lymphocytes (TIL). CONCLUSION LRP1 is associated with worsened prognosis in ccRCC and is related to cancer immune modulation. LRP1-targeted therapy can be of therapeutic potential.
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16
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Verbiest A, Couchy G, Job S, Caruana L, Lerut E, Oyen R, de Reyniès A, Tosco L, Joniau S, Van Poppel H, Van Raemdonck D, Van Den Eynde K, Wozniak A, Zucman-Rossi J, Beuselinck B. Molecular Subtypes of Clear-cell Renal Cell Carcinoma are Prognostic for Outcome After Complete Metastasectomy. Eur Urol 2018; 74:474-80. [PMID: 29463434 DOI: 10.1016/j.eururo.2018.01.042] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 01/30/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Metastasectomy is routinely performed in selected patients with metastatic clear-cell renal cell carcinoma (ccRCC) as an alternative to systemic therapy. In the absence of randomized trials, the benefit and best way of patient selection remain unclear. Earlier, we described four molecular ccRCC-subtypes (ccrcc1-4) that have a prognostic and predictive value upon first-line sunitinib or pazopanib. OBJECTIVE Assess the prognostic value of ccrcc1-4 subtypes after complete metastasectomy. (1) Compare outcomes of good-prognosis ccrccc2&3-tumors with intermediate/poor-prognosis ccrcc1&4-tumors. (2) Compare outcomes of the four subtypes separately. DESIGN, SETTING, AND PARTICIPANTS Single-center retrospective study (1995-2017), assessing 43 ccRCC patients undergoing complete metastasectomy without systemic treatment. INTERVENTION Molecular subtype determined with established 35-gene expression classifier. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Median disease-free survival (DFS), time to systemic therapy, cancer-specific (CSS) and overall survival (OS) from metastasectomy, estimated with Kaplan-Meier method and tested against other predictors with multivariable Cox regression. RESULTS AND LIMITATIONS Median DFS was 23 mo for ccrcc2&3-tumors versus 9 mo for ccrcc1&4-tumors (p=0.011, hazard ratio [HR]=2.6). Median time to systemic therapy was 92 mo versus 28 mo (p=0.003, HR=3.3). Median CSS was 133 mo versus 50 mo (p<0.001, HR=2.7). Median OS was 127 mo versus 50 mo (p=0.011, HR=2.5). The classification remained independent upon multivariable analysis. Outcomes remained significantly different when comparing four subtypes separately. The intrinsic heterogeneity of expression profiles is a limitation of this approach. CONCLUSION Even after clinical patient selection, patients with a ccrcc1- or ccrcc4-tumor are at a higher risk of relapse after complete metastasectomy. Patients with a ccrcc2- or ccrcc3-tumor usually experience a long DFS. These results need validation in a larger cohort to establish the subtypes as prognostic marker. PATIENT SUMMARY Metastasectomy is recommended for some patients with metastatic clear-cell kidney cancer; however, we do not know who will benefit the most. We show that molecular subtypes increase the possibility to predict which patients are at risk for early relapse after metastasectomy and who may benefit more from other treatment options.
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Komanski CB, Rubino SM, Meyer JC, Greven CM. Choroidal Melanoma Mimicker: A Case of Metastatic Clear-Cell Renal Cell Carcinoma. Ocul Oncol Pathol 2018; 3:279-282. [PMID: 29344481 DOI: 10.1159/000462975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/03/2017] [Indexed: 11/19/2022] Open
Abstract
Choroidal melanoma is the most common primary intraocular malignancy, yet metastatic disease remains the most common malignancy of the eye. Differentiating these entities is essential as treatment, systemic associations, and prognosis vary dramatically between the two. Established diagnostic criteria are accurate for the diagnosis of uveal melanoma. Yet, metastatic disease may be misdiagnosed as a uveal melanoma in rare cases. We report a case of metastatic clear-cell renal cell carcinoma masquerading as uveal melanoma. A 73-year-old Caucasian man with a history of renal cell carcinoma presented with a 15 × 12 × 7 mm homogenous, pigmented, and acoustically hollow mass without hemorrhage or exudation. The patient was initially treated with plaque radiotherapy with good tumor regression. However, the patient developed pain and vision loss due to total exudative retinal detachment. Subsequent enucleation allowed histopathologic confirmation of clear-cell renal cell carcinoma. Nine years following enucleation, the patient remains in complete remission without evidence of other systemic metastases. Renal cell carcinoma should be considered when evaluating patients with probable uveal melanoma. Delayed-onset ocular metastasis from renal cell carcinoma exhibits an atypical clinical course with the possibility of durable remission following enucleation.
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Affiliation(s)
- Chris B Komanski
- Department of Ophthalmology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Shaina M Rubino
- Department of Ophthalmology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Jacob C Meyer
- Department of Ophthalmology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Craig M Greven
- Department of Ophthalmology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
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Zhao B, Liu L, Mao J, Liu K, Fan W, Liu J, Zhang Z, Li Q. Sinomenine hydrochloride attenuates the proliferation, migration, invasiveness, angiogenesis and epithelial-mesenchymal transition of clear-cell renal cell carcinoma cells via targeting Smad in vitro. Biomed Pharmacother 2017; 96:1036-1044. [PMID: 29198924 DOI: 10.1016/j.biopha.2017.11.123] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/16/2017] [Accepted: 11/27/2017] [Indexed: 01/06/2023] Open
Abstract
New strategies for the treatment of clear-cell renal cell carcinoma (ccRCC) are urgently needed. Recently, accumulating evidence has demonstrated that sinomenine hydrochloride (SH), extracted from the plant sinomenium acutum, has potent anti-cancer activity in multiple human malignant solid tumors. However, the underlying molecular mechanism by which SH treatment exerts its antagonizing tumorigenic effects has not been clearly elucidated. In this study, we showed that SH treatment exerted profound effects on cell growth in ccRCC in a dose- and time-dependent manner in vitro. Furthermore, treatment with SH significantly suppressed the migration, invasiveness and angiogenesis of ccRCC cells in vitro. Mechanistically, we revealed that SH treatment blocked epithelial-mesenchymal transition (EMT) through the downregulation of the expression of the transcription factors Snail1 and Twist in ccRCC cells. Additionally, the depletion of p-Smad2 and p-Smad3 was required for SH treatment to inhibit EMT effectively. Taken together, these findings indicate an anti-cancer role for SH in ccRCC cells and reveal a potential molecular mechanism by which Smad / EMT axis functions in ccRCC, as its hyperactivation has been associated with cell proliferation, migration, invasiveness and angiogenesis in this cancer type. These observations suggest that SH can act as an efficacious adjuvant chemotherapeutic candidate that targets the Smad/EMT axis in patients with ccRCC.
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Affiliation(s)
- Bin Zhao
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, China
| | - Lei Liu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, China
| | - Jun Mao
- The Key Laboratory of Tumor Stem Cell Research of Liaoning Province, Dalian Medical University, Dalian 116044, China
| | - Kun Liu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, China
| | - Weiwang Fan
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, China
| | - Jiheng Liu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, China
| | - Zhiwei Zhang
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, China.
| | - Quanlin Li
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, China.
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Xi Y, Yuan Q, Zhang Y, Madhuranthakam AJ, Fulkerson M, Margulis V, Brugarolas J, Kapur P, Cadeddu JA, Pedrosa I. Statistical clustering of parametric maps from dynamic contrast enhanced MRI and an associated decision tree model for non-invasive tumour grading of T1b solid clear cell renal cell carcinoma. Eur Radiol 2017; 28:124-132. [PMID: 28681074 DOI: 10.1007/s00330-017-4925-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/27/2017] [Accepted: 06/05/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To apply a statistical clustering algorithm to combine information from dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) into a single tumour map to distinguish high-grade from low-grade T1b clear cell renal cell carcinoma (ccRCC). METHODS This prospective, Institutional Review Board -approved, Health Insurance Portability and Accountability Act -compliant study included 18 patients with solid T1b ccRCC who underwent pre-surgical DCE MRI. After statistical clustering of the parametric maps of the transfer constant between the intravascular and extravascular space (K trans ), rate constant (K ep ) and initial area under the concentration curve (iAUC) with a fuzzy c-means (FCM) algorithm, each tumour was segmented into three regions (low/medium/high active areas). Percentages of each region and tumour size were compared to tumour grade at histopathology. A decision-tree model was constructed to select the best parameter(s) to predict high-grade ccRCC. RESULTS Seven high-grade and 11 low-grade T1b ccRCCs were included. High-grade histology was associated with higher percent high active areas (p = 0.0154) and this was the only feature selected by the decision tree model, which had a diagnostic performance of 78% accuracy, 86% sensitivity, 73% specificity, 67% positive predictive value and 89% negative predictive value. CONCLUSIONS The FCM integrates multiple DCE-derived parameter maps and identifies tumour regions with unique pharmacokinetic characteristics. Using this approach, a decision tree model using criteria beyond size to predict tumour grade in T1b ccRCCs is proposed. KEY POINTS • Tumour size did not correlate with tumour grade in T1b ccRCC. • Tumour heterogeneity can be analysed using statistical clustering via DCE-MRI parameters. • High-grade ccRCC has a larger percentage of high active area than low-grade ccRCCs. • A decision-tree model offers a simple way to differentiate high/low-grade ccRCCs.
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Affiliation(s)
- Yin Xi
- Department of Radiology, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, 75235-9085, USA
| | - Qing Yuan
- Department of Radiology, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, 75235-9085, USA
| | - Yue Zhang
- Department of Radiology, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, 75235-9085, USA
| | - Ananth J Madhuranthakam
- Department of Radiology, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, 75235-9085, USA.,Advanced Imaging Research Center, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA
| | - Michael Fulkerson
- Department of Radiology, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, 75235-9085, USA
| | - Vitaly Margulis
- Department of Urology, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA.,Kidney Cancer Program, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA
| | - James Brugarolas
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA.,Department of Internal Medicine, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA
| | - Payal Kapur
- Department of Urology, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA.,Kidney Cancer Program, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA.,Department of Pathology, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, Texas, USA
| | - Jeffrey A Cadeddu
- Department of Urology, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA.,Kidney Cancer Program, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA
| | - Ivan Pedrosa
- Department of Radiology, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, 75235-9085, USA. .,Advanced Imaging Research Center, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA. .,Kidney Cancer Program, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, 2201 Inwood Road, Dallas, TX, USA.
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20
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Damjanovic SS, Ilic BB, Beleslin Cokic BB, Antic JA, Bankovic JZ, Milicevic IT, Rodic GS, Ilic DS, Todorovic VN, Puskas N, Tulic CD. Tuberous sclerosis complex protein 1 expression is affected by VHL Gene alterations and HIF-1α production in sporadic clear-cell renal cell carcinoma. Exp Mol Pathol 2016; 101:323-331. [PMID: 27845047 DOI: 10.1016/j.yexmp.2016.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 11/10/2016] [Indexed: 12/14/2022]
Abstract
Alterations in von Hippel-Lindau gene (VHL) do not determine deregulation of hypoxia-inducible factors (HIFs) in clear-cell renal carcinoma (ccRCC). Their effects on tuberous sclerosis proteins (TSC1/2) and heat shock protein 90 (Hsp90) expressions in sporadic ccRCC are unknown. Therefore, we analyze the impact of VHL alterations and HIF-α production on the expression of TSC proteins and Hsp90 in these tumors. Alterations in VHL gene region exhibited 37/47 (78.7%) tumors. Monoallelic inactivation (intragenic mutation or LOH) was found in 10 (21.3%) and biallelic inactivation (intragenic mutation plus LOH) in 27 (57.4%) ccRCCs. Tumorous expression of HIF-α mRNAs, HIF-α, Hsp90 and TSC2 were VHL independent; TSC2 was underexpressed in all tumors by immunostaining (P<0.001). Immunoblotting revealed that TSC1 production was lower in tumors with monoallelic VHL inactivation than in control (P=0.01) and tissues with biallelic VHL inactivation (P=0.019), while tumors lacking HIF-1α (16/47) concurrently overexpressed HIF-2α and underexpressed TSC1 in comparison to controls (P=0.01 for both) and HIF-1α positive tumors (P=0.015 and P=0.050). Significant portion of variability (56.4%) in tumor diameter was explained by oscillations in nuclear grade, and TSC1 and HIF-2α expression in VHL altered tumors. In conclusion, while TSC2 is broadly downregulated in sporadic ccRCC, TSC1 expression is reduced in two subsets of these tumors, those with monoallelic VHL gene inactivation and those with concurrent low HIF-1α and high HIF-2α expression. Hence, the involvement of nuclear grade, TSC1 and HIF-2α in the progression of VHL altered tumors, implies the interplay between pVHL and TSC1.
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Affiliation(s)
- Svetozar S Damjanovic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Medical School, University of Belgrade, Department for Neuroendocrine Tumors and Hereditary Cancer Syndromes, Dr Subotica 13, Belgrade, Serbia.
| | - Bojana B Ilic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Medical School, University of Belgrade, Department for Neuroendocrine Tumors and Hereditary Cancer Syndromes, Dr Subotica 13, Belgrade, Serbia
| | - Bojana B Beleslin Cokic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Medical School, University of Belgrade, Department for Neuroendocrine Tumors and Hereditary Cancer Syndromes, Dr Subotica 13, Belgrade, Serbia
| | - Jadranka A Antic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Medical School, University of Belgrade, Department for Neuroendocrine Tumors and Hereditary Cancer Syndromes, Dr Subotica 13, Belgrade, Serbia
| | - Jovana Z Bankovic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Medical School, University of Belgrade, Department for Neuroendocrine Tumors and Hereditary Cancer Syndromes, Dr Subotica 13, Belgrade, Serbia
| | - Ivana T Milicevic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Medical School, University of Belgrade, Department for Neuroendocrine Tumors and Hereditary Cancer Syndromes, Dr Subotica 13, Belgrade, Serbia
| | - Gordana S Rodic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Medical School, University of Belgrade, Department for Neuroendocrine Tumors and Hereditary Cancer Syndromes, Dr Subotica 13, Belgrade, Serbia
| | - Dusan S Ilic
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Medical School, University of Belgrade, Department for Neuroendocrine Tumors and Hereditary Cancer Syndromes, Dr Subotica 13, Belgrade, Serbia
| | - Vera N Todorovic
- Institute for Histology and Embryology, School of Medicine of Military Medical Academy, University of Defense, Belgrade, Serbia
| | - Nela Puskas
- Institute of Histology and Embryology, Medical School, University of Belgrade, Belgrade, Serbia
| | - Cane D Tulic
- Clinic for Urology, Medical School, University of Belgrade, Belgrade, Serbia
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21
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Zhang W, Ni M, Su Y, Wang H, Zhu S, Zhao A, Li G. MicroRNAs in Serum Exosomes as Potential Biomarkers in Clear-cell Renal Cell Carcinoma. Eur Urol Focus 2016; 4:412-419. [PMID: 28753793 DOI: 10.1016/j.euf.2016.09.007] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 08/30/2016] [Accepted: 09/28/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Circulating microRNAs (miRNAs) in exosomes are emerging as clinically useful tools for cancer detection. However, little is known about their diagnostic impact in clear-cell renal cell carcinoma (ccRCC). OBJECTIVE To investigate whether miRNAs in serum exosomes can serve as biomarkers in ccRCC. DESIGN, SETTING, AND PARTICIPANTS Serum samples were obtained from 82 patients with ccRCC and 80 healthy volunteers. Exosomes were extracted and purified to selectively capture exosomes positive for tumor-associated epithelial cell adhesion molecule (EpCAM) via a magnetic bead technique. Total RNA was extracted and expression levels of miR-210, miR-1233, and miR-15a miRNAs were quantified and normalized to U6 levels. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Expression levels were compared using a Mann-Whitney U-test, Friedman test, or Wilcoxon test. Receiver operating characteristic (ROC) curves were plotted to assess the diagnostic value of exosomal miRNAs for differentiation between ccRCC patients and controls. RESULTS AND LIMITATIONS Expression levels of exosomal miR-210 and miR-1233 were significantly higher in ccRCC patients than in healthy individuals (both p<0.01). No significant difference was observed for exosomal miR-15a. Exosomal miR-210 and miR-1233 expression levels in different TNM stages were significantly higher than in the controls (all p<0.01). Exosomal miR-210 and miR-1233 expression levels were significantly lower in postoperative than in preoperative samples (both p<0.01). ROC analysis demonstrated that exosomal expression levels distinguished ccRCC patients from healthy individuals with 70% sensitivity and 62.2% specificity for miR-210, and 81% sensitivity and 76% specificity for miR-1233. The retrospective design and lack of other tumor subtypes are limitations of the study. CONCLUSIONS Serum exosomal miRNAs might represent potential diagnostic biomarkers in ccRCC in the future. PATIENT SUMMARY Circulating levels of exosomal microRNAs miR-210 and miR-1233 have potential as biomarkers for diagnostic and monitoring purposes in renal cancer in the future. These molecules can be measured in serum in so-called liquid biopsy.
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Affiliation(s)
- Wei Zhang
- Department of Urology, Zhejiang Cancer Hospital, Hang Zhou, China
| | - Maowei Ni
- Institute of Cancer Research, Zhejiang Cancer Hospital, Hang Zhou, China
| | - Ying Su
- Department of Pathology, Zhejiang Cancer Hospital, Hang Zhou, China
| | - Hua Wang
- Department of Urology, Zhejiang Cancer Hospital, Hang Zhou, China
| | - Shaoxin Zhu
- Department of Urology, Zhejiang Cancer Hospital, Hang Zhou, China
| | - An Zhao
- Department of Urology, Zhejiang Cancer Hospital, Hang Zhou, China; Institute of Cancer Research, Zhejiang Cancer Hospital, Hang Zhou, China.
| | - Guorong Li
- Department of Urology, North Hospital, CHU Saint-Etienne, University of Jean-Monnet, Saint-Etienne, France; Inserm U1059, Saint-Etienne, France.
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22
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NguyenHoang S, Liu Y, Xu L, Chang Y, Zhou L, Liu Z, Lin Z, Xu J. High mucin-7 expression is an independent predictor of adverse clinical outcomes in patients with clear-cell renal cell carcinoma. Tumour Biol 2016; 37:15193-15201. [PMID: 27683054 DOI: 10.1007/s13277-016-5375-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 09/09/2016] [Indexed: 12/21/2022] Open
Abstract
Mucin-7 is a member of the secreted mucins family. Mucins might play a crucial role during tumor development and its aberrant expression was observed in several types of tumor. Our study aims to evaluate the prognostic significance of Mucin-7 expression in postoperative clear-cell renal cell carcinoma (ccRCC) patients. In this retrospective study, we enrolled 392 patients with ccRCC undergoing nephrectomy between 2008 and 2009 in a single center. The median follow-up was 73 months (range 39-74 months). Mucin-7 expression was evaluated by immunohistochemistry protocol on ccRCC specimens. Kaplan-Meier survival analysis was conducted to compare survival curves. Univariate and multivariate Cox regression models were applied to assess the impact of prognostic factors in overall survival (OS) and recurrence-free survival (RFS). A nomogram was then constructed based on the independent prognosticators identified on multivariate analysis. The results displayed that Mucin-7 expression was significantly associated with tumor size (p = 0.034), pT stage (p = 0.004), TNM stage (p = 0.008), and necrosis (p = 0.043). Patients with high Mucin-7 expression had significant worse outcomes in both OS (p < 0.001) and RFS (p < 0.001) compared to those with low Mucin-7 expression. MUC7 expression was considered as an independent predictive factor for OS (HR 2.286; 95 %CI 1.167-4.475; p = 0.016) and RFS (HR 2.055; 95 %CI 1.086-3.887; p = 0.027). A nomogram integrating Mucin-7 expression and other independent prognosticators was constructed. In summary, the high Mucin-7 expression is a potential prognosticator of adverse clinical outcome in ccRCC patients after surgery.
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Affiliation(s)
- SonTung NguyenHoang
- Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Yidong Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Le Xu
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yuan Chang
- Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Lin Zhou
- Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Zheng Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Zongming Lin
- Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
| | - Jiejie Xu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China.
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23
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Lai CY, Xu Y, Yu GS, Wu X, Li YF, Pan B, Heng BL, Xue YJ, Su ZX. Engrailed-2 might play an anti-oncogenic role in clear-cell renal cell carcinoma. J Mol Histol 2016; 47:229-37. [PMID: 26948025 DOI: 10.1007/s10735-016-9665-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/01/2016] [Indexed: 12/13/2022]
Abstract
Our preliminary study indicated that Engrailed-2 (EN2) is downregulated but also ectopically expressed in clear-cell renal cell carcinoma (CCRCC), and the absence of EN2 expression was associated with poor histological grade. However, the specific roles of EN2 in CCRCC have yet to be elucidated. In the present study, we examined the effects of inhibiting EN2 expression by human renal tubular epithelial cells (HK-2) and overexpressing EN2 by human clear-cell renal cells (786-O). Results showed that EN2 inhibition accelerated HK-2 cell proliferation, shortened the cell cycle, reduced apoptosis, and acted more invasively. By contrast, EN2 overexpression in 786-O cells decelerated the proliferative ability of 786-O, increased the percentage of cell apoptosis, and weakened the invasive ability. Overall, the results demonstrated that EN2 might play an anti-oncogenic role in oncogenesis and development of CCRCC, thereby maintaining the normal growth of human renal tubular epithelial cells.
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Affiliation(s)
- Cai-Yong Lai
- Department of Urology, The First Affiliated Hospital of Jinan University, No. 613 Huang Pu Rd, Guangzhou, 510630, China
- Department of Urology, The First Affiliated Hospital of Gannan Medical College, Ganzhou, 341000, China
| | - Yin Xu
- Department of Urology, The First Affiliated Hospital of Jinan University, No. 613 Huang Pu Rd, Guangzhou, 510630, China
| | - Gan-Shen Yu
- Department of Urology, The First Affiliated Hospital of Jinan University, No. 613 Huang Pu Rd, Guangzhou, 510630, China
| | - Xun Wu
- Department of Urology, The First Affiliated Hospital of Jinan University, No. 613 Huang Pu Rd, Guangzhou, 510630, China
| | - Yun-Fei Li
- Department of Urology, The First Affiliated Hospital of Jinan University, No. 613 Huang Pu Rd, Guangzhou, 510630, China
| | - Bin Pan
- Department of Urology, The First Affiliated Hospital of Jinan University, No. 613 Huang Pu Rd, Guangzhou, 510630, China
| | - Bao-Li Heng
- Department of Urology, The First Affiliated Hospital of Jinan University, No. 613 Huang Pu Rd, Guangzhou, 510630, China
| | - Yi-Jun Xue
- Department of Urology, The First Affiliated Hospital of Gannan Medical College, Ganzhou, 341000, China
| | - Ze-Xuan Su
- Department of Urology, The First Affiliated Hospital of Jinan University, No. 613 Huang Pu Rd, Guangzhou, 510630, China.
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Wang Z, Xu L, Chang Y, Zhou L, Fu H, Zhang W, Yang Y, Xu J. IL-33 is associated with unfavorable postoperative survival of patients with clear-cell renal cell carcinoma. Tumour Biol 2016; 37:11127-34. [PMID: 26926076 DOI: 10.1007/s13277-016-4879-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 01/15/2016] [Indexed: 12/19/2022] Open
Abstract
The aim of this study was to evaluate the potential prognostic significance of interleukin-33 (IL-33) in patients with clear-cell renal cell carcinoma (ccRCC) after surgical resection. In this retrospective research, we enrolled 203 patients with ccRCC undergoing nephrectomy between 2003 and 2004 in a single institution. We recorded clinicopathologic features, overall survival (OS), and recurrence-free survival (RFS) and assessed IL-33 expression by immunohistochemical staining. On such bases, the correlations between IL-33 expression and clinicopathologic features and prognosis were evaluated. A high expression of IL-33 was significantly associated with advanced TNM stage and Fuhrman grade (p = 0.017 and p < 0.001, respectively) in patients with ccRCC. Moreover, multivariate analysis identified IL-33 as an independent prognostic factor of OS for patients with ccRCC after surgery (hazard ratio = 2.050; 95 % CI 1.223-3.447; p = 0.006). The incorporation of IL-33 into the TNM stage and Fuhrman grade might help to refine individual risk stratification. The IL-33 expression may serve as an independent negative predictor of survival for patients with ccRCC after surgery.
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Affiliation(s)
- Zewei Wang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Le Xu
- Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yuan Chang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Lin Zhou
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Hangcheng Fu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Weijuan Zhang
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yuanfeng Yang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Jiejie Xu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China.
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Abstract
Background Mutation rates are consistently varied in cancer genome and play an important role in tumorigenesis, however, little has been known about their function potential and impact on the distribution of functional mutations. In this study, we investigated genomic features which affect mutation pattern and the function importance of mutation pattern in cancer. Methods Somatic mutations of clear-cell renal cell carcinoma, liver cancer, lung cancer and melanoma and single nucleotide polymorphisms (SNPs) were intersected with 54 distinct genomic features. Somatic mutation and SNP densities were then computed for each feature type. We constructed 2856 1-Mb windows, in which each row (1-Mb window) contains somatic mutation, SNP densities and 54 feature vectors. Correlation analyses were conducted between somatic mutation, SNP densities and each feature vector. We also built two random forest models, namely somatic mutation model (CSM) and SNP model to predict somatic mutation and SNP densities on a 1-Kb scale. The relation of CSM and SNP scores was further analyzed with the distributions of deleterious coding variants predicted by SIFT and Mutation Assessor, non-coding functional variants evaluated with FunSeq 2 and GWAVA and disease-causing variants from HGMD and ClinVar databases. Results We observed a wide range of genomic features which affect local mutation rates, such as replication time, transcription levels, histone marks and regulatory elements. Repressive histone marks, replication time and promoter contributed most to the CSM models, while, recombination rate and chromatin organizations were most important for the SNP model. We showed low mutated regions preferentially have higher densities of deleterious coding mutations, higher average scores of non-coding variants, higher fraction of functional regions and higher enrichment of disease-causing variants as compared to high mutated regions. Conclusions Somatic mutation densities vary largely across cancer genome, mutation frequency is a major indication of function and influence on the distribution of functional mutations in cancer. Electronic supplementary material The online version of this article (doi:10.1186/s12935-016-0278-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chuance Du
- Department of Urology, Ganzhou Hospital Affiliated to Nanchang University, Ganzhou, Jiangxi province China
| | - Xiaoyuan Wu
- Department of Rehabilitation, Ganzhou Hospital Affiliated to Nanchang University, Nan Chang, Jiangxi province China
| | - Jia Li
- Department of Thyroid and Breast, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072 China
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Yang Y, Zhai C, Chang Y, Zhou L, Shi T, Tan C, Xu L, Xu J. High expression of chemokine CCL2 is associated with recurrence after surgery in clear-cell renal cell carcinoma. Urol Oncol 2015; 34:238.e19-26. [PMID: 26749463 DOI: 10.1016/j.urolonc.2015.11.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 11/21/2015] [Accepted: 11/29/2015] [Indexed: 01/07/2023]
Abstract
PURPOSE Chemokine (C-C motif) ligand 2 (CCL2) is known to recruit monocytes and macrophages to sites of inflammation. Recent studies suggest CCL2 is overexpressed in multiple cancer types and may play a role in the tumor progression. The aim of this study was to assess the association between CCL2 expression and the risk of recurrence after surgery in patients with clear-cell renal cell carcinoma (ccRCC). METHODS This study included 268 ccRCC patients who underwent nephrectomy at a single institute between 2001 and 2004. Clinicopathologic variables and recurrence-free survival (RFS) were recorded. CCL2 expression levels were evaluated by immunohistochemical staining in tumor tissues. Kaplan-Meier method was applied to compare survival curves. Cox regression models were fitted to analyze the effect of prognostic factors on recurrence-free survival (RFS). Harrell's concordance index was calculated to assess predictive accuracy. RESULTS High CCL2 expression was associated with a greater risk of recurrence in ccRCC patients (P<0.001). Multivariate analysis confirmed that CCL2 expression was an independent prognostic factor for RFS (P = 0.045). The predictive accuracy of the Leibovich prognostic score was improved when CCL2 expression was added (0.76 vs. 0.71, P<0.001). Notably, the improvement in prediction was more pronounced in patients with low-risk disease. A nomogram integrating CCL2 expression and pathologic factors was then constructed, which predicted 5- and 10-year RFS well for ccRCC patients. CONCLUSIONS High chemokine CCL2 expression is an independent predictor of recurrence in ccRCC patients. Evaluation of CCL2 could help guide postsurgical management for ccRCC patients.
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Affiliation(s)
- Yuanfeng Yang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Changwen Zhai
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuan Chang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lin Zhou
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tianming Shi
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Cheng Tan
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Le Xu
- Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Jiejie Xu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China.
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27
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Liu Y, Liu H, Liu W, Zhang W, An H, Xu J. β1,6-N-acetylglucosaminyltransferase V predicts recurrence and survival of patients with clear-cell renal cell carcinoma after surgical resection. World J Urol 2015; 33:1791-9. [PMID: 25630622 DOI: 10.1007/s00345-014-1451-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 11/18/2014] [Indexed: 12/16/2022] Open
Abstract
PURPOSE β1,6-N-acetylglucosaminyltransferase V (MGAT5), which is required for the biosynthesis of β1,6GlcNAc-branched N-linked glycans attached to cell surface and secreted glycoproteins, accounts for oncogenic growth signal transduction during the development and progression of various malignancies. Our present study aimed to evaluate the impact of MGAT5 expression on recurrence and survival of patients with clear-cell renal cell carcinoma (ccRCC) following surgery. METHODS We retrospectively enrolled 265 patients (196 in the training cohort and 69 in the validation cohort) with ccRCC undergoing nephrectomy at a single institution. Clinicopathologic features, overall survival (OS) and recurrence-free survival (RFS) were recorded. MGAT5 intensities were assessed by immunohistochemistry in specimens of patients. Kaplan-Meier method was applied to compare survival curves. Cox regression models were used to analyze the impact of prognostic factors on OS and RFS. Concordance index (C-index) was calculated to assess predictive accuracy. RESULTS In both cohorts, MGAT5 expression positively correlated with metastatic and advanced TNM stage. High MGAT5 expression indicated poor survival (P < 0.001 in training set and P < 0.001 in validation set) and early recurrence (P < 0.001 in training set and P = 0.004 in validation set) of patients with ccRCC. After multivariate Cox regression analysis, MGAT5 expression was identified as an independent adverse prognostic factor for survival and recurrence. The predictive accuracy of TNM, UISS and SSIGN prognostic models was improved when MGAT5 expression was added. CONCLUSIONS MGAT5 expression is a potential independent adverse prognostic biomarker for recurrence and survival of patients with ccRCC after nephrectomy.
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MESH Headings
- Biomarkers, Tumor/biosynthesis
- Biomarkers, Tumor/genetics
- Carcinoma, Renal Cell/enzymology
- Carcinoma, Renal Cell/genetics
- Carcinoma, Renal Cell/surgery
- China/epidemiology
- DNA, Neoplasm/genetics
- Disease-Free Survival
- Female
- Follow-Up Studies
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- Incidence
- Kidney Neoplasms/enzymology
- Kidney Neoplasms/genetics
- Kidney Neoplasms/surgery
- Male
- Middle Aged
- N-Acetylgalactosaminyltransferases/biosynthesis
- N-Acetylgalactosaminyltransferases/genetics
- Neoplasm Recurrence, Local/enzymology
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/genetics
- Nephrectomy
- Postoperative Period
- Retrospective Studies
- Survival Rate/trends
- Polypeptide N-acetylgalactosaminyltransferase
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Affiliation(s)
- Yidong Liu
- Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Haiou Liu
- Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Weisi Liu
- Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Weijuan Zhang
- Department of Immunology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, 200032, China
| | - Huimin An
- Department of Urology, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, 200032, China
| | - Jiejie Xu
- Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China.
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28
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He C, Zhao X, Jiang H, Zhong Z, Xu R. Demethylation of miR-10b plays a suppressive role in ccRCC cells. Int J Clin Exp Pathol 2015; 8:10595-10604. [PMID: 26617769 PMCID: PMC4637584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 08/21/2015] [Indexed: 06/05/2023]
Abstract
MicroRNAs have been implicated in cancer cells proliferation, migration and invasion, including clear-cell renal cell carcinoma (ccRCC). DNA methylation, a major epigenetic change associated with cancer, may lead to transcriptional silencing of tumor suppressor genes, including miRNAs, which may be a possible mechanism in carcinogenesis. In this study, we aim to investigate the role of miR-10b in ccRCC and its possible epigenetic mechanism. By qPCR and MSP, we found that miR-10b was significantly decreased in ccRCC tissues and cells, and exhibited heavy methylation on promoter. Upregulation of miR-10b by transfecting with lentivirus highly expressed miR-10b or by exogenous demethylation agents was capable of inhibiting cell proliferation, migration and invasion measured by CCK-8 cell proliferation assay, scratch assay, transwell assay, and flow cytometric analysis of the cell cycle. Our results suggest that miR-10b plays a tumor-suppressive role in ccRCC. Demethylation of miR-10b may be therapeutically beneficial for ccRCC treatment.
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Affiliation(s)
- Cheng He
- Department of Urology, The Second Xiangya Hospital, Central South University Changsha 410011, Hunan, China
| | - Xiaokun Zhao
- Department of Urology, The Second Xiangya Hospital, Central South University Changsha 410011, Hunan, China
| | - Hongyi Jiang
- Department of Urology, The Second Xiangya Hospital, Central South University Changsha 410011, Hunan, China
| | - Zhaohui Zhong
- Department of Urology, The Second Xiangya Hospital, Central South University Changsha 410011, Hunan, China
| | - Ran Xu
- Department of Urology, The Second Xiangya Hospital, Central South University Changsha 410011, Hunan, China
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29
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Liu Z, Liu Y, Xu L, An H, Chang Y, Yang Y, Zhang W, Xu J. P2X7 receptor predicts postoperative cancer-specific survival of patients with clear-cell renal cell carcinoma. Cancer Sci 2015; 106:1224-31. [PMID: 26179886 PMCID: PMC4582993 DOI: 10.1111/cas.12736] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 06/15/2015] [Accepted: 07/06/2015] [Indexed: 12/23/2022] Open
Abstract
The P2X7 receptor, an ATP-gated plasma membrane ion channel, is involved in inflammation, apoptosis and cell proliferation, and thereby plays a crucial role during oncogenic transformation in various malignancies. This study aims to evaluate the impact of P2X7 receptor expression on postoperative cancer-specific survival of patients with clear-cell renal cell carcinoma (ccRCC). A total of 273 patients with ccRCC undergoing nephrectomy at a single institution were retrospectively enrolled in this study, among which 86 patients died of this disease and six patients died of other causes. Clinicopathologic features and cancer-specific survival (CSS) were recorded. P2X7 expression was assessed by immunohistochemistry in clinical specimens. Kaplan–Meier method with log rank test was performed to compare survival curves. Cox regression models were used to evaluate the prognostic values of variables on CSS. Concordance index was calculated to assess prognostic accuracy of prognostic models. Median follow-up period was 90 months (range, 11–120 months). Intratumoral P2X7 expression was significantly lower than peritumoral tissues (P < 0.001). Moreover, high intratumoral P2X7 expression, which was significantly associated with shorten CSS (P < 0.001), high TNM stage (P = 0.038), Fuhrman grade (P = 0.035), SSIGN (stage, size, grade, and necrosis) score (P = 0.021) and University of California Integrated Staging System (UISS) score (P = 0.007), was indicated to be an independent prognostic factor for CSS (hazard ratio [HR], 1.693; P = 0.034). The prognostic accuracy of TNM stage, UISS and SSIGN scoring models was improved when intratumoral P2X7 expression was added. Intratumoral P2X7 expression is a potential independent adverse prognostic indicator for postoperative CSS of patients with ccRCC.
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Affiliation(s)
- Zheng Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yidong Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Le Xu
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huimin An
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuan Chang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuanfeng Yang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Weijuan Zhang
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Jiejie Xu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
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30
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Pan D, Xu L, Liu H, Zhang W, Liu W, Liu Y, Fu Q, Xu J. High expression of interleukin-11 is an independent indicator of poor prognosis in clear-cell renal cell carcinoma. Cancer Sci 2015; 106:592-7. [PMID: 25702890 PMCID: PMC4452160 DOI: 10.1111/cas.12638] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 02/05/2015] [Accepted: 02/12/2015] [Indexed: 01/16/2023] Open
Abstract
Interleukin-11 (IL-11), a member of the IL-6 family of cytokines, exerts pleiotropic oncogenic activities by stimulating angiogenesis and metastasis in many cancer types. The present study aims to evaluate the impact of IL-11 expression on recurrence and mortality of patients with clear-cell renal cell carcinoma (ccRCC). We retrospectively enrolled 193 ccRCC patients undergoing nephrectomy at a single center. Clinicopathologic features, recurrence-free survival (RFS) and overall survival (OS) were recorded. IL-11 intensity was assessed by immunohistochemistry in tumor specimens. The Kaplan–Meier method was applied to compare survival curves. Cox regression models were used to analyze the impact of prognostic factors on RFS and OS. The concordance index (C-index) was calculated to assess predictive accuracy. High IL-11 expression is associated with increased risk of recurrence and poor survival for ccRCC patients (P < 0.001 and P < 0.001, respectively), especially those with early-stage disease (TNM stage I + II). Multivariate analyses confirmed that IL-11 expression was an independent prognostic factor for RFS and OS (P = 0.006 and P = 0.008, respectively). The predictive accuracy of well-established prognostic models was improved when IL-11 expression was integrated. In conclusion, high IL-11 expression is an independent predictor of poor prognosis in ccRCC patients. It may help identify patients who could benefit from additional treatments and closer follow up.
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Affiliation(s)
- Deng Pan
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Le Xu
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Haiou Liu
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Weijuan Zhang
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Weisi Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yidong Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Qiang Fu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Jiejie Xu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
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