title: Prognostic significance of CD44, platelet-derived growth factor receptor alpha, and cyclooxygenase 2 expression in renal cell carcinoma.
abstract: BACKGROUND
  Pathologic stage is the main prognostic factor for predicting outcome in renal cell carcinoma (RCC). Because of its unreliability in predicting tumor progression, other factors are needed to provide additional prognostic information.
  
  
  OBJECTIVE
  The expression of CD44, cyclooxygenase 2, and platelet-derived growth factor receptor alpha (PDGFR-alpha) was evaluated as a potential prognostic factor for survival in patients with RCC.
  
  
  METHODS
  Sixty-two patients (42 men and 20 women; median age, 61 years), undergoing partial (10 cases) or radical (55 cases) nephrectomy for RCC were retrospectively analyzed by immunohistochemical analysis for CD44, cyclooxygenase 2, and PDGFR-alpha expression. Impact of various factors on disease-specific and overall survival was calculated using Cox proportional hazards models.
  
  
  RESULTS
  There was a gradual increase in CD44 and cyclooxygenase 2 expression with increasing RCC nuclear grade. In contrast, PDGFR-alpha expression showed no consistent relationship with nuclear grade. On univariate analysis, metastasis at time of surgery (P < .001), tumor size (P = .004), pathologic stage group (P = .001), and nuclear grade (P = .004) were correlated with disease-specific survival. On multivariate analysis, only the presence of metastasis at diagnosis (P < .001) was significant. For overall survival, metastasis (P < .001), tumor size (P = .02), pathologic stage group (P = .01), nuclear grade (P = .003), and PDGFR-alpha (P = .03) were significant on univariate analysis. Only metastasis (P = .001) and PDGFR-alpha (P = .03) were significant on multivariate analysis.
  
  
  CONCLUSIONS
  When combined with other variables, PDGFR-alpha expression in RCC may provide additional predictive value related to the patient's overall survival. However, CD44 and cyclooxygenase 2 do not seem to be independent prognostic indicators in predicting outcomes for patients with RCC.
authors.affiliation: Department of Pathology and Laboratory Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA. otawfik@kumc.edu
authors.forename: Ossama W
authors.initials: OW
authors.lastname: Tawfik
authors.forename: Brandan
authors.initials: B
authors.lastname: Kramer
authors.forename: Barbara
authors.initials: B
authors.lastname: Shideler
authors.forename: Marsha
authors.initials: M
authors.lastname: Danley
authors.forename: Bruce F
authors.initials: BF
authors.lastname: Kimler
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Holzbeierlein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D051546:Cyclooxygenase 2 / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000096:biosynthesis*; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010982:Platelet-Derived Growth Factor / Q000096:biosynthesis*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D018960:Hyaluronan Receptors; D010982:Platelet-Derived Growth Factor; C075278:platelet-derived growth factor A; D051546:Cyclooxygenase 2