Liu Weisi, Liu Yidong, Liu Haiou, Zhang Weijuan, An Huimin, Xu Jiejie
Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, China.
Department of Immunology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, China.
Urol Oncol. 2015 Feb;33(2):69.e1-10. doi: 10.1016/j.urolonc.2014.08.003. Epub 2014 Sep 11.
Snail (known as SNAI1), a zinc-finger transcription factor, is best known for the induction of epithelial-to-mesenchymal transition, which has emerged as a recognized mechanism underlying epithelial cancer progression. Herein, the aim is to determine the effect of Snail expression on recurrence and survival of patients with localized clear cell renal cell carcinoma (ccRCC) following surgery.
We retrospectively enrolled 255 patients (188 in group A and 67 in group B) with localized ccRCC undergoing nephrectomy at a single center. Prognostic value and clinical outcomes were evaluated.
In both groups, cytoplasmic Snail intensity correlates positively with Fuhrman grade. High nuclear but not cytoplasmic Snail intensity indicates early recurrence and poor survival of patients with localized ccRCC. Moreover, high nuclear Snail intensity predicts unfavorable survival of patients with T2-4 stage cancer and early recurrence of all stage patients. Nuclear Snail intensity was identified as an independent adverse prognostic factor for recurrence and survival. The predictive accuracy of University of Los Angeles Integrated Staging System and the Mayo Clinic Stage, Size, Grade, and Necrosis prognostic models was improved when nuclear Snail expression was added.
Nuclear Snail expression is a potential independent adverse prognostic biomarker for recurrence and survival of patients with localized ccRCC after nephrectomy.
蜗牛蛋白（又称SNAI1）是一种锌指转录因子，因其诱导上皮-间质转化而最为人所知，上皮-间质转化已成为上皮性癌进展的一种公认机制。在此，目的是确定蜗牛蛋白表达对局限性透明细胞肾细胞癌（ccRCC）患者术后复发和生存的影响。
我们回顾性纳入了在单一中心接受肾切除术的255例局限性ccRCC患者（A组188例，B组67例）。评估了预后价值和临床结局。
在两组中，细胞质蜗牛蛋白强度与福尔曼分级呈正相关。高核蜗牛蛋白强度而非细胞质蜗牛蛋白强度表明局限性ccRCC患者早期复发且生存较差。此外，高核蜗牛蛋白强度预示T2-4期癌症患者生存不良以及所有分期患者早期复发。核蜗牛蛋白强度被确定为复发和生存的独立不良预后因素。当加入核蜗牛蛋白表达时，洛杉矶大学综合分期系统以及梅奥诊所分期、大小、分级和坏死预后模型的预测准确性得到提高。
核蜗牛蛋白表达是局限性ccRCC患者肾切除术后复发和生存的潜在独立不良预后生物标志物。
