[Assessment of the basal membrane status as prognostic factor in renal carcinoma].
OBJECTIVE
To know the basal membrane (BM) integrity in renal cell carcinoma (RC) and its importance as prognostic factor.


METHODS
73 patients with RC were selected. Immunohistochemistry with monoclonal antibodies against basal proteins laminin and collagen IV was performed. Percentage for BM fragmentation in the whole tumour was considered taking 75% as cut off.


RESULTS
Follow-up was 6.3 +/- 4.3 years and 27 patients progressed. Correlation between laminin and collagen IV was significative (p = 0.000). A BM fragmentation expressed with laminin bigger than 75% was related to tumoural symptoms (p = 0.019), worse grade (p = 0.004) and necrosis in more than 10% of the tumour (p = 0.000). Fragmentation observed with collagen IV was associated to tumours greater than 7 cm (p = 0.014). Those patients whose tumours displayed more than 75% of BM fragmentation, measured with collagen IV, presented worse survival (p = 0.042). A similar trend was observed in the case of laminin, but it did not reach statistic significance (p = 0.119). In the unvariated analysis grade III-IV, more than 10% of necrosis within the tumour, tumoural symptoms and BM fragmentation bigger than 75% measured with collagen IV were prognostic, while only grade and necrosis did so in the multivariate analysis.


CONCLUSIONS
Collagen IV and laminin represent nicely, with a similar expression pattern, the BM fragmentation in RC. Within a battery of immunohistochemical markers to study RC at least one of them should be included because their prognostic implication.
Rubio Briones
J
J
Servicio de Urología, Instituto Valenciano de Oncología, Valencia.
Morell Quadreny
L
L
López Guerrero
J A
JA
Casanova Ramón-Borja
J
J
Mejía Vázquez
C
C
Iborra Juan
I
I
Pellín Pérez
A
A
Solsona Narbón
E
E
Llombart Bosch
A
A
D001485:Basement Membrane / Q000473:pathology*; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
Valoración del estado de la membrana basal como factor pronóstico en el carcinoma renal.