title: Serum IgG against Candida predict survival in patients with metastatic renal cell carcinoma.
abstract: OBJECTIVE
  In contrast to hematologic malignancies, little is known about the role of fungi in the development and progression of solid tumors. This prompted us to analyze and correlate serum levels of different fungal IgG with survival of patients with metastatic renal cell carcinoma.
  
  
  METHODS
  Serum IgG to Candida sp., Saccharomyces cerevisiae and Aspergillus fumigatus were measured in a cross-sectional study in 64 patients with advanced disease. Univariate and multivariate analyses were chosen to study serum IgG as prognostic indicators.
  
  
  RESULTS
  Median follow-up was 29.0 months (range 0.3-122). Median overall survival of patients, which tested negative for Candida IgG, was significantly increased (median not reached, >29 months) compared with Candida IgG positive patients (17.8 months, P = 0.002). Median survival of Saccharomyces IgG negative patients was 33.1 months as opposed to 19.4 months in Saccharomyces IgG positive patients, although this difference was not significant (P = 0.281). No difference in overall survival was found between Aspergillus IgG positive patients (28.0 months) and Aspergillus IgG negative patients (29.1 months) (P = 0.181). Cox backward-stepwise regression confirmed Candida IgG as the strongest predictor of survival in metastatic renal cell carcinoma patients (risk ratio 3.27, P = 0.001, [95% CI 1.86-5.73]).
  
  
  CONCLUSIONS
  Our findings suggest that IgG antibodies directed against yeast fungi and particularly against Candida but not against mold fungi have prognostic relevance.
authors.affiliation: Immunotherapy Unit, Department of Urology, Innsbruck Medical University, Innrain 66a, 6020, Innsbruck, Austria.
authors.forename: Reinhold
authors.initials: R
authors.lastname: Ramoner
authors.forename: Andrea
authors.initials: A
authors.lastname: Rahm
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Falkensammer
authors.forename: Nicolai
authors.initials: N
authors.lastname: Leonhartsberger
authors.forename: Martin
authors.initials: M
authors.lastname: Thurnher
mesh_terms: D000368:Aged; D000908:Antibodies, Fungal / Q000097:blood* / Q000276:immunology; D000946:Antigens, Fungal / Q000276:immunology; D014408:Biomarkers, Tumor / Q000097:blood; D002175:Candida / Q000276:immunology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005656:Fungal Proteins / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007680:Kidney Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D000908:Antibodies, Fungal; D000946:Antigens, Fungal; D014408:Biomarkers, Tumor; D005656:Fungal Proteins; D007074:Immunoglobulin G