title: Immunohistochemical analysis with multiple antibodies in search of prognostic markers for clear cell renal cell carcinoma.
abstract: OBJECTIVE
  To simultaneously analyze multiple biologic markers to identify strong prognostic markers for disease-specific survival of patients with clear cell renal cell carcinoma (ccRCC).
  
  
  METHODS
  The expression of Ki-67, p53, bcl-2, cyclin-D1, caveolin-1, vascular endothelial growth factor, and HER-2 was evaluated in 119 paraffin-embedded ccRCC specimens using immunohistochemistry. The clinical significance of these markers in relation to disease-specific survival was analyzed.
  
  
  RESULTS
  On univariate analysis, high-level staining for Ki-67 (P <0.0001), p53 (P = 0.0029), vascular endothelial growth factor (P = 0.0062), and caveolin-1 (P = 0.0396) was associated with decreased survival, but high-level staining for bcl-2 (P <0.0001) and cyclin-D1 (P = 0.0002) was associated with increased survival. Only HER-2 expression was not related to survival (P = 0.1131). Multivariate analysis revealed the following independent predictors of disease-specific survival: expression of p53 (P = 0.0059) or bcl-2 (P = 0.0413) in all cases of ccRCC; expression of p53 (P = 0.0043) or bcl-2 (P = 0.0227) in cases of grade 1-2 disease; and expression of p53 (P = 0.0207) in cases with metastasis at surgery.
  
  
  CONCLUSIONS
  Of the seven markers reviewed, p53 and bcl-2 were strong prognostic factors in all cases and in cases of grade 1-2 ccRCC. Only p53 attained independent prognostic significance in metastatic ccRCC. This information could prove useful in selecting markers to predict for survival and plan therapy for patients with ccRCC.
authors.affiliation: Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Nguyen Ba
authors.initials: NB
authors.lastname: Phuoc
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Ehara
authors.forename: Takahiro
authors.initials: T
authors.lastname: Gotoh
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakano
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Yokoi
authors.forename: Takashi
authors.initials: T
authors.lastname: Deguchi
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Hirose
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000912:Antibodies, Neoplasm / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001707:Biopsy, Needle; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D019938:Cyclin D1 / Q000378:metabolism; D005260:Female; D016158:Genes, p53; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis
chemical_list: D000912:Antibodies, Neoplasm; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D019938:Cyclin D1