title: Hypoxia-inducible factor-2alpha mRNA expression in human renal cell carcinoma.
abstract: BACKGROUND
  Hypoxia-inducible factor (HIF)-2alpha is upregulated in hypoxia or by inactivation of the von Hippel-Lindau (VHL) tumour suppressor gene. In a number of malignancies, increased HIF-2alpha expression may indicate worse prognosis. The aim of this study was to evaluate the prognostic information of HIF-2alpha mRNA expression in renal cell carcinoma (RCC).
  
  
  METHODS
  HIF-2alpha mRNA was quantified by real time polymerase chain reaction (rt-PCR) in tumour tissue samples from 202 patients. Samples from 50 corresponding kidney cortex tissue were analysed as controls. mRNA levels were evaluated in relation to tumour cell type, TNM stage, nuclear grade and disease specific survival.
  
  
  RESULTS
  The levels of HIF-2alpha mRNA were significantly higher in 168 clear cell (c)RCC than in 23 papillary (p)RCC (p < 0.001) or 11 chromophobe (ch)RCC (p < 0.006). Among cRCC there was an inverse correlation between HIF-2alpha mRNA levels and TNM stage I and II-IV tumours (p=0.01), and nuclear grade (p = 0.006). After a median follow-up time of 99 months (range 34-247), 106 patients had died of RCC. No correlation of HIF-2alpha mRNA to survival was observed. A multivariate analysis of prognostic factors in cRCC showed that TNM stage alone was an independent predictor of prognosis; HIF-2alpha mRNA levels did not add further prognostic information.
  
  
  CONCLUSIONS
  The results demonstrated that HIF-2alpha mRNA levels were higher in cRCC compared to pRCC and chRCC. Furthermore, HIF-2alpha mRNA levels were inversely related to TNM stage and nuclear grade in cRCC.
authors.affiliation: Department of Radiation Sciences, Oncology, Umeå University, Sweden.
authors.forename: Johanna
authors.initials: J
authors.lastname: Sandlund
authors.forename: Börje
authors.initials: B
authors.lastname: Ljungberg
authors.forename: Pernilla
authors.initials: P
authors.lastname: Wikström
authors.forename: Kjell
authors.initials: K
authors.lastname: Grankvist
authors.forename: Gudrun
authors.initials: G
authors.lastname: Lindh
authors.forename: Torgny
authors.initials: T
authors.lastname: Rasmuson