Expression of Caveolin-1 (CAV1), PAX2 and Survivin (SURV) in Clear Cell Renal Cell Carcinoma (CRCC): No Evidence for Prognostic Significance
D Kankaya, S Kiremitci, O Tulunay, S Baltaci. Medical School of Ankara University, Ankara, Turkey
Background: CRCC is the most common and aggressive subtype of RCC involving the adult kidney. Molecular markers have the potential to predict reliably, the biological behavior of these tumors and could serve as therapeutic targets.
Design: Immunohistochemistry was performed on 100 cases of CRCC using antibodies against CAV-1, PAX2, and SURV. Tumors were grouped by nuclear grade as low-grade (LNG; NG1,2) or high-grade (HNG; NG3,4), and by pathological stage as localized (LC; pT1,2), or locally invasive (IS; pT3,4). Clinically the tumors were staged as early stage (ES; cTI,II), or late stage (LS; cTIII,IV). Lymphovascular, renal vein, perirenal, regional lymph node invasions (LVI, RVI, PRI, RLN, respectively), and Mx were noted. Marker status, and expression patterns (cyt/nuc) of markers, established predictors of prognosis were considered when developing a prognostic model for disease-specific survival (DSS).
Results: Median diameter of the tumors was 7 cm (range=1,5-20 cm). HNG tumors were larger. Local invasiveness correlated with larger size (p=0.003), HNG (p=0.006). Mx correlated with HNG (p=0.001), and older age (>57 yrs, p=0.045). Median follow-up was 24 months (range=1-144 months). While NG (p=0.001), LVI (p=0.042), RVI (p=0.001), PRI (p=0.012), pT (p=0.006), RLN (p=0.001), Mx (p=0.001), cT (p=0.001) correlated with DSS, only cT (p=0.010) was found to be an independent predictor of survival. Loss of SURVCyt correlated with a low rate of HNG (p=0.018), and tumor invasiveness (p=0.054). SURVNuc and PAX2 over-expressions were correlated (p=0.040, CC:0.206). CAV1 and PAX2 did not correlate with clinicopathological factors, and CAV1, PAX2, and SURV (SURVCyt,, SURVNuc), did not correlate with DSS.
Conclusions: Novel molecular proteins in CRCC research; CAV1, PAX2, and SURV, either alone or in a combination, does not seem to identify a group of patients with CRCC at high risk for Mx and decreased DSS. Although DSS is not dependent on SURV, the correlation of SURV with HNG, and tumor invasiveness, may designate SURV as a potential marker for tumor aggressiveness.
Category: Genitourinary (including renal tumors)
Wednesday, March 24, 2010 9:30 AM
Poster Session V # 113, Wednesday Morning