title: High nuclear Livin expression is a favourable prognostic indicator in renal cell carcinoma.
abstract: 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.
authors.affiliation: Department of Urology, University of Heidelberg, Heidelberg, Germany. Axel_Haferkamp@med.uni-heidelberg.de
authors.forename: Axel
authors.initials: A
authors.lastname: Haferkamp
authors.forename: Jens
authors.initials: J
authors.lastname: Bedke
authors.forename: Caroline
authors.initials: C
authors.lastname: Vetter
authors.forename: Maria
authors.initials: M
authors.lastname: Pritsch
authors.forename: Nina
authors.initials: N
authors.lastname: Wagener
authors.forename: Stephan
authors.initials: S
authors.lastname: Buse
authors.forename: Irena
authors.initials: I
authors.lastname: Crnkovic-Mertens
authors.forename: Karin
authors.initials: K
authors.lastname: Hoppe-Seyler
authors.forename: Stephan
authors.initials: S
authors.lastname: Macher-Goeppinger
authors.forename: Felix
authors.initials: F
authors.lastname: Hoppe-Seyler
authors.forename: Frank
authors.initials: F
authors.lastname: Autschbach
authors.forename: Markus
authors.initials: M
authors.lastname: Hohenfellner
mesh_terms: 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
chemical_list: D048868:Adaptor Proteins, Signal Transducing; C419866:BIRC7 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D009363:Neoplasm Proteins