Kim Sung Han, Park Weon Seo, Park Eun Young, Park Boram, Joo Jungnam, Joung Jae Young, Seo Ho Kyung, Lee Kang Hyun, Chung Jinsoo
Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
Department of Pathology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
PLoS One. 2017 Jun 27;12(6):e0179610. doi: 10.1371/journal.pone.0179610. eCollection 2017.
To assess the prognostic roles of BAP1, PBRM1, pS6, PTEN, TGase2, PD-L1, CA9, PSMA, and Ki-67 tissue biomarkers in localized renal cell carcinoma (RCC).
Patients who underwent a nephrectomy during 1992-2015 and had a primary specimen of their kidney tumor were included. The nine tissue biomarkers were immunohistochemically stained on tissue microarrays of RCC, and the semi-quantitative H-score, including intensity score, was used to grade the sample. The Cox proportional hazards model was used to evaluate tissue markers significant for overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) after adjusting for significant clinicopathological parameters.
Samples from 351 RCC patients were included. The mean age of the patients was 53.9 years; the rates of pathologic T1-2/≥T3 stage, Fuhrman 1+2/3+4 grade, recurrence, and death were 269/65(80.5/19.5%), 222/107 (67.5/32.5%), 6.6%, and 10.5%, respectively. Median OS, CSS, and RFS were 220.6, 220.6, and 147.1 months, respectively. The multivariable analysis showed that pathologic T stage and Fuhrman nuclear grade were significantly associated with OS and CSS. Pathologic T stage and tumor size were associated with RFS. After adjusting for these significant prognostic clinicopathological factors, Ki-67 was significantly associated with OS (hazard ratio [HR], 2.7), CSS (HR, 3.82), and RFS (HR, 4.85) and pS6 was associated with CSS (HR, 8.63) and RFS (HR, 8.51) in the multivariable model (p<0.05).
pS6 and Ki-67 are significant prognostic factors of RCC; however, BAP1, PBRM1, TGase 2, PD-L1, CA9, PTEN loss, and PSMA markers did not show this association.
评估BAP1、PBRM1、pS6、PTEN、TGase2、PD-L1、CA9、PSMA和Ki-67组织生物标志物在局限性肾细胞癌（RCC）中的预后作用。
纳入1992年至2015年间接受肾切除术且有原发性肾肿瘤标本的患者。对RCC组织芯片上的九种组织生物标志物进行免疫组织化学染色，并使用包括强度评分的半定量H评分对样本进行分级。在调整了显著的临床病理参数后，使用Cox比例风险模型评估对总生存期（OS）、癌症特异性生存期（CSS）和无复发生存期（RFS）有显著意义的组织标志物。
纳入了351例RCC患者的样本。患者的平均年龄为53.9岁；病理T1-2/≥T3期、Fuhrman 1+2/3+4级、复发和死亡的发生率分别为269/65（80.5/19.5%）、222/107（67.5/32.5%）、6.6%和10.5%。OS、CSS和RFS的中位数分别为220.6、220.6和147.1个月。多变量分析显示，病理T分期和Fuhrman核分级与OS和CSS显著相关。病理T分期和肿瘤大小与RFS相关。在调整了这些显著的预后临床病理因素后，在多变量模型中，Ki-67与OS（风险比[HR]，2.7）、CSS（HR，3.82）和RFS（HR，4.85）显著相关，pS6与CSS（HR，8.63）和RFS（HR，8.51）相关（p<0.05）。
pS6和Ki-67是RCC的显著预后因素；然而，BAP1、PBRM1、TGase 2、PD-L1、CA9、PTEN缺失和PSMA标志物未显示出这种关联。
