High nuclear Livin expression is a favourable prognostic indicator in renal cell carcinoma.
OBJECTIVE
To assess the protein expression of Livin, an apoptosis inhibitor, in renal cell carcinoma (RCC) and to determine its prognostic relevance.


METHODS
Immunohistochemical staining for Livin was performed in tissue microarrays (TMAs), including tumour tissue cores, from patients with RCC who had undergone renal surgery. In 682 TMAs cytoplasmatic staining intensity and nuclear staining quantity were evaluated, and the association of Livin expression with progression-free survival (PFS) and cancer-specific survival (CSS) was analysed with a multivariate Cox regression model.


RESULTS
Over a median (range) follow-up of 5.2 (0-16.1) years, 204 patients (28%) had died from their disease. The CSS rates at 1 and 5 years for the entire cohort was 88% and 71%. Cytoplasmatic Livin staining was absent in 516 (76%) specimens; staining was positive in 166 (24%) specimens. Weak nuclear Livin staining (<or=25%) was present in 571 (84%) specimens, strong nuclear staining (26-100%) in 111 (16%). In multivariate analysis, high (>25%) nuclear Livin expression was a favourable independent predictor of PFS and CSS even after adjusting for tumour stage, Fuhrman grade, age, sex and Karnofsky severity rating. Cytoplasmatic Livin expression did not offer additional prognostic information.


CONCLUSIONS
High nuclear Livin expression is a favourable independent predictor of PFS and CSS in patients with RCC.
Haferkamp
Axel
A
Department of Urology, University of Heidelberg, Heidelberg, Germany. Axel_Haferkamp@med.uni-heidelberg.de
Bedke
Jens
J
Vetter
Caroline
C
Pritsch
Maria
M
Wagener
Nina
N
Buse
Stephan
S
Crnkovic-Mertens
Irena
I
Hoppe-Seyler
Karin
K
Macher-Goeppinger
Stephan
S
Hoppe-Seyler
Felix
F
Autschbach
Frank
F
Hohenfellner
Markus
M
D048868:Adaptor Proteins, Signal Transducing / Q000378:metabolism*; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism*; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009363:Neoplasm Proteins / Q000378:metabolism*; D009392:Nephrectomy / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
D048868:Adaptor Proteins, Signal Transducing; C419866:BIRC7 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D009363:Neoplasm Proteins