title: Cathepsin D expression in renal cell cancer-clinical implications.
abstract: BACKGROUND
  Whereas the expression of Cathepsin D (Cath D) is suggested to enhance the biological aggressiveness of human malignancies, its role in renal cell carcinoma (RCC), however, has not been investigated.
  
  
  METHODS
  By tissue microarray analysis, tumor and benign tissue samples from 176 RCC patients were investigated for Cath D expression by immunohistochemistry and Western blots. Expression levels were correlated to clinical variables and to the postoperative outcome.
  
  
  RESULTS
  High Cath D expression levels were detected in 29%/9% of tumor and benign tissue samples, respectively (p < 0.0001). In case of a high vs. low Cath D expression level, development of distant metastases was observed in 12% vs. 88% of cases (p < 0.05). With a median follow-up of 50 (2-146) months, high level Cath D expression was correlated with an improved long-term survival when compared with patients presenting with decreased expression [median long-term survival: 82 vs. 53 months in case of a high vs. low expression level] (p < 0.05).
  
  
  CONCLUSIONS
  The Cath D staining pattern predicted a reduced risk for metastatic spread and tumor dependent death, hereby indicating its role as a biological variable revealing additional prognostic information for renal cell cancer patients. Increased expression of Cath D in tumor vs. benign tissue samples might indicate a role for the development and progression of RCC.
authors.affiliation: Department of Urology, Eberhard - Karls - University Tuebingen, Hoppe - Seyler, Germany. axel.merseburger@med.uni-tuebingen.de
authors.forename: Axel S
authors.initials: AS
authors.lastname: Merseburger
authors.forename: Joerg
authors.initials: J
authors.lastname: Hennenlotter
authors.forename: Perikles
authors.initials: P
authors.lastname: Simon
authors.forename: Petra A
authors.initials: PA
authors.lastname: Ohneseit
authors.forename: Ursula
authors.initials: U
authors.lastname: Kuehs
authors.forename: Stephan
authors.initials: S
authors.lastname: Kruck
authors.forename: Eva
authors.initials: E
authors.lastname: Koch
authors.forename: Ulrich
authors.initials: U
authors.lastname: Vogel
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
authors.forename: Markus A
authors.initials: MA
authors.lastname: Kuczyk
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D015153:Blotting, Western; D002292:Carcinoma, Renal Cell / Q000378:metabolism*; D002402:Cathepsin D / Q000378:metabolism*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000378:metabolism*; D008297:Male; D046228:Microarray Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D002402:Cathepsin D