Horiguchi Akio, Asano Tomohiko, Asano Takako, Ito Keiichi, Sumitomo Makoto, Hayakawa Masamichi
Department of Urology, National Defense Medical College, Tokorozawa-City, Saitama, Japan.
J Urol. 2008 Sep;180(3):1137-40. doi: 10.1016/j.juro.2008.04.135. Epub 2008 Jul 18.
Fatty acid synthase is a key enzyme in the de novo biosynthesis of fatty acids. Increased fatty acid synthase expression and its association with tumor aggressiveness and poor prognosis have been demonstrated in various human malignant tumors. We investigated fatty acid synthase expression in patients with renal cell carcinoma and its impact on clinicopathological parameters.
Fatty acid synthase expression in 120 patients with renal cancer was examined by immunohistochemistry. The relationship between fatty acid synthase expression status and various clinicopathological parameters was analyzed. Survival analysis was performed using the log rank test and a Cox multivariate hazard model.
Of 120 tumors 18 (15%) showed positive fatty acid synthase expression, which was significantly associated with advanced pathological T stage (pT3-4, p = 0.0009), regional lymph node metastasis (p = 0.0429), distant metastasis (p = 0.0042), higher histological grade (G3, p = 0.0017) and microvascular invasion (p = 0.0357). Patients with positive fatty acid synthase expression had significantly shorter cancer specific survival than those with negative FAS expression (p <0.0001). Multivariate Cox proportional hazards model analysis demonstrated that positive fatty acid synthase expression was an independent predictor of shortened cancer specific survival (p = 0.0363, HR 3.736).
Increased FAS expression could be an indicator of tumor aggressiveness and poor prognosis of renal cell carcinoma. Patients with fatty acid synthase positive tumors should be followed closely and carefully, and adjuvant therapy should be considered.
脂肪酸合酶是脂肪酸从头生物合成中的关键酶。在多种人类恶性肿瘤中，已证实脂肪酸合酶表达增加及其与肿瘤侵袭性和预后不良相关。我们研究了肾细胞癌患者中脂肪酸合酶的表达及其对临床病理参数的影响。
采用免疫组织化学法检测120例肾癌患者中脂肪酸合酶的表达。分析脂肪酸合酶表达状态与各种临床病理参数之间的关系。使用对数秩检验和Cox多变量风险模型进行生存分析。
120例肿瘤中，18例（15%）显示脂肪酸合酶表达阳性，这与晚期病理T分期（pT3 - 4，p = 0.0009）、区域淋巴结转移（p = 0.0429）、远处转移（p = 0.0042）、较高的组织学分级（G3，p = 0.0017）和微血管侵犯（p = 0.0357）显著相关。脂肪酸合酶表达阳性的患者的癌症特异性生存期明显短于脂肪酸合酶表达阴性的患者（p <0.0001）。多变量Cox比例风险模型分析表明，脂肪酸合酶表达阳性是癌症特异性生存期缩短的独立预测因素（p = 0.0363，HR 3.736）。
脂肪酸合酶表达增加可能是肾细胞癌肿瘤侵袭性和预后不良的一个指标。对于脂肪酸合酶阳性肿瘤的患者应密切且仔细地随访，并应考虑辅助治疗。
