Analysis of various potential prognostic markers and survival data in clear cell renal cell carcinoma

作者:Ebru Tastekin*; Fulya Oz Puyan; Hakan Akdere; Vuslat Yurut Caloglu; Necdet Sut; Nuray Can; Filiz Ozyilmaz
来源:International Brazilian Journal of Urology, 2017, 43(3): 440-454.
DOI:10.1590/S1677-5538.IBJU.2015.0521

摘要

Purpose: Clear cell renal cell cancers frequently harbor Von Hippel-Lindau gene mutations, leading to stabilization of the hypoxia-inducible factors (HIFs) and their target genes. In this study, we investigated the relationship between vascular endothelial growth factor (VEGF), HIF-1 alpha, HIF-2 alpha, p53 positivity, microvessel density, and Ki-67 rates with prognostic histopathologic factors (Fuhrman nuclear grade, stage, and sarcomatoid differentiation) and survival in clear cell renal cell carcinomas. Material and Methods: Seventy-two nephrectomy specimens diagnosed as clear cell renal cell carcinoma between 2000 and 2012 were reevaluated. Immunohistochemically VEGF, HIF-1 alpha, HIF-2 alpha, p53, CD34 (for microvessel density evaluation), and Ki-67 antibodies were applied to the tumor areas. The relationships of these antibodies with prognostic factors and survival rates were evaluated with statistical analyses. Results: Mean survival time was 105.6 months in patients with ccRCC. Patients with high expression of VEGF, HIF-1 alpha and HIF-2 alpha positivity, a high Ki-67 proliferation index, and a high microvessel density evaluation score had a shorter survival time (p<0.05). Conclusions: Our findings supported that with the use of these immunohistochemical markers, prognosis of renal cell carcinoma may be predicted at the first step of patient management. New treatment modalities targeted to HIF-1 alpha and HIF-2 alpha might be planned as well as VEGF-targeted therapies in the management of clear cell renal cell carcinomas.

  • 出版日期2017-6