title: Correlation of Ki-67 and gelsolin expression to clinical outcome in renal clear cell carcinoma.
abstract: OBJECTIVE
  To analyze the expression levels of Ki-67 and gelsolin in renal cell carcinoma (RCC) and determine their prognostic value in association with other clinicopathologic factors using tissue microarray technology. Histologic nuclear grade, performance status, and clinical stage are important prognostic factors in RCC. Because patients with tumors of similar grade, performance status, and stage may show a wide variation in biologic behavior and clinical outcome, additional biomarkers for RCC are needed to provide further prognostic information and possibly offer insight into the mechanisms of the disease.
  
  
  METHODS
  Using a renal cancer tissue microarray, we correlated the expression of Ki-67, a marker of cell proliferation, and gelsolin, an actin-binding protein, with grade, stage, and survival in patients with clear cell RCC.
  
  
  RESULTS
  In Cox multivariate regression analysis, stage (pT) was the most significant predictor of cancer-specific survival (P <0.0001), followed by Ki-67 (P = 0.0216). In univariate analysis, increased Ki-67 expression predicted poor cancer-specific survival (P = 0.0006) when a cutoff value for Ki-67 staining was applied. In patients with grade 2 tumors, increased Ki-67 expression and decreased gelsolin expression in the same tumor was suggestive of poor cancer-specific survival (P = 0.0507).
  
  
  CONCLUSIONS
  Our findings support the utility of Ki-67 as a prognostic biomarker for RCC and suggest a role for gelsolin in renal carcinogenesis.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of California, Los Angeles, School of Medicine, USA.
authors.forename: Harri
authors.initials: H
authors.lastname: Visapää
authors.forename: Matthew
authors.initials: M
authors.lastname: Bui
authors.forename: Yunda
authors.initials: Y
authors.lastname: Huang
authors.forename: David
authors.initials: D
authors.lastname: Seligson
authors.forename: Henry
authors.initials: H
authors.lastname: Tsai
authors.forename: Allan
authors.initials: A
authors.lastname: Pantuck
authors.forename: Robert
authors.initials: R
authors.lastname: Figlin
authors.forename: Jian Y u
authors.initials: JY
authors.lastname: Rao
authors.forename: Arie
authors.initials: A
authors.lastname: Belldegrun
authors.forename: Steve
authors.initials: S
authors.lastname: Horvath
authors.forename: Aarno
authors.initials: A
authors.lastname: Palotie
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D005260:Female; D018260:Gelsolin / Q000032:analysis* / Q000276:immunology; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis* / Q000276:immunology; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020411:Oligonucleotide Array Sequence Analysis; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D018260:Gelsolin; D019394:Ki-67 Antigen