Loss of expression of transforming growth factor-beta receptor as a prognostic factor in patients with renal cell carcinoma.
OBJECTIVE
To determine the clinical implication of the loss of transforming growth factor-beta (TGF-beta) receptor (TbetaR) expression for the pathologic features in renal cell carcinoma (RCC) and the prognosis of 62 patients (Stage I, 4; Stage II, 28; Stage III, 11; and Stage IV, 19) who underwent radical nephrectomy for RCC. Loss of expression in TbetaR could result in escape from the growth inhibitory effect of TGF-beta in TGF-beta-secreting cancer.


METHODS
TbetaR and apoptosis in the tumor were detected by immunohistochemistry using samples from 62 patients. We statistically investigated the relationship among the TbetaR expression pattern, pathologic features, and the prognosis of patients with RCC.


RESULTS
A loss of expression of TbetaR-I and TbetaR-II was identified in 29 patients (46.7%) and 31 patients (50.0%), respectively. Although the loss of TbetaR-I was not associated with clinical stage, the loss of TbetaR-II was associated with clinical stage (P <0.01). Univariate analysis of all patients demonstrated that Stage T3 or greater, clinical Stage III or greater, loss of TbetaR-II, and a tumor apoptotic index of less than 35 were associated with a significantly lower survival rate than their respective counterparts. Multivariate analysis showed that the only two significant prognostic factors were clinical stage and loss of TbetaR-II. In addition, TbetaR-negative RCC had significantly lower apoptosis than did TbetaR-positive RCC.


CONCLUSIONS
These results suggest that a loss of TbetaR-II expression in the primary tumor is a significant prognostic factor in patients with RCC.
Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan.
Akira
A
Miyajima
Tomohiko
T
Asano
Kaori
K
Seta
Takako
T
Asano
Narihiko
N
Kakoi
Masamichi
M
Hayakawa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000502:physiology; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D053938:DNA Fragmentation / Q000502:physiology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D009392:Nephrectomy / Q000379:methods; D016612:Paraffin Embedding; D011379:Prognosis; D016016:Proportional Hazards Models; D018125:Receptors, Transforming Growth Factor beta / Q000096:biosynthesis* / Q000235:genetics / Q000276:immunology; D015996:Survival Rate
D018125:Receptors, Transforming Growth Factor beta