title: Oncofetal protein IMP3: a novel molecular marker that predicts metastasis of papillary and chromophobe renal cell carcinomas.
abstract: BACKGROUND
  Whether an oncofetal protein, IMP3, can serve as a prognostic biomarker to predict metastasis for patients with localized papillary and chromophobe subtypes of renal cell carcinomas (RCCs) was investigated.
  
  
  METHODS
  The expression of IMP3 in 334 patients with primary papillary and chromophobe RCC from multiple medical centers was evaluated by immunohistochemistry. The 317 patients with localized papillary and chromophobe RCCs were further evaluated for outcome analyses.
  
  
  RESULTS
  IMP3 was significantly increased in a subset of localized papillary and chromophobe RCCs that subsequently metastasized. Patients with localized IMP3-positive tumors (n=33; 10%) were over 10 times more likely to metastasize (risk ratio [RR], 11.38; 95% confidence interval [CI], 5.40-23.96; P<.001) and were nearly twice as likely to die (RR, 1.91; 95% CI, 1.13-3.22; P=.016) compared with patients with localized IMP3 negative tumors. The 5-year metastasis-free and overall survival rates were 64% and 58% for patients with IMP3-positive localized papillary and chromophobe RCCs compared with 98% and 85% for patients with IMP3 negative tumors, respectively. In multivariable analysis adjusting for the TNM stage and nuclear grade, patients with IMP3-positive tumors were still over 10 times more likely to progress to distant metastasis (RR, 13.45; 95% CI, 6.00-30.14; P<.001) and were still nearly twice as likely die (RR, 1.95; 95% CI, 1.15-3.31; P=.013) compared with patients with IMP3-negative tumors.
  
  
  CONCLUSIONS
  IMP3 is an independent prognostic biomarker that can be used to identify a subgroup of patients with localized papillary and chromophobe RCC who are at high risk for developing distant metastasis.
authors.affiliation: Department of Pathology, University of Massachusetts Medical Center, Worcester, Massachusetts 01605, USA. jiangz@ummhc.org
authors.forename: Zhong
authors.initials: Z
authors.lastname: Jiang
authors.forename: Christine M
authors.initials: CM
authors.lastname: Lohse
authors.forename: Peigou G
authors.initials: PG
authors.lastname: Chu
authors.forename: Chin-Lee
authors.initials: CL
authors.lastname: Wu
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Woda
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Rock
authors.forename: Eugene D
authors.initials: ED
authors.lastname: Kwon
mesh_terms: D000951:Antigens, Neoplasm / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000473:pathology; D018572:Disease-Free Survival; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000473:pathology; D009363:Neoplasm Proteins / Q000032:analysis*; D016601:RNA-Binding Proteins / Q000032:analysis*
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C498780:IGF2BP3 protein, human; D009363:Neoplasm Proteins; D016601:RNA-Binding Proteins; C031192:oncofetal antigens