title: [Prognostic value of erythrocyte polyamines levels in renal cell carcinoma. Prospective study in 418 cases].
abstract: OBJECTIVE
  Polyamines: Spermine (Spm) and Spermidine (Spmd), are essential for cell proliferation and differentiation. A measurement of erythocytes polyamines (EPA) was developed in our institution. Our objective was to evaluate this marker as a new prognostic factor in renal cell carcinoma.
  
  
  METHODS
  A blood sample was prospectively taken before surgery, among 418 patients who had an enlarged nephrectomy (n=318) or a partial nephrectomy (n=100) to quantify EPA rates by using the HPLC technique. The qualitative and quantitative variables have been compared using chi(2) and Student statistical analyses. The survivals have been normalized by the Kaplan Meier and Cox methods.
  
  
  RESULTS
  The average age of our population was 64 years (21-88). The average decline was 41 months (1-214). The median size of tumors was 6.5cm (1-24). The median rate of Spm and Spmd were respectively 4.7 (1-83) and 9 (2-86)nmol/8.10(9) erythrocytes. Spm and Spmd were linked to the T stage (p=0.001), and the ECOG (p=0.001 and 0,008). Spm was not linked at N and M stages but at the Fuhrman grade (p=0.001). Spmd was linked to the N, M stages (p=0.04). With univariate analysis, the tumor diameter, the TNM stage, the Fuhrman grade as well as Spm and Spmd (p<0.0001) were predictors of specific survival. With multivariate analysis, some prognostic factors remained independent: the TNM stage, the ECOG and Spmd, a continuous variable (p=0.0001), pushing the rank of Fuhrman out of the model. When Spm and Spmd were dichotomized in quantitative variables, they were both independent factors.
  
  
  CONCLUSIONS
  The EPA is a new prognostic tool, before surgery, which will be tested for its integration into prognostic normograms.
authors.affiliation: Service d'urologie, université de Rennes-1, 2, rue Henri-Le-Guilloux, 35065 Rennes cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Bigot
authors.forename: G
authors.initials: G
authors.lastname: Lughezzani
authors.forename: K
authors.initials: K
authors.lastname: Bensalah
authors.forename: N
authors.initials: N
authors.lastname: Rioux-Leclercq
authors.forename: F
authors.initials: F
authors.lastname: Guillé
authors.forename: B
authors.initials: B
authors.lastname: Lobel
authors.forename: J-P
authors.initials: JP
authors.lastname: Moulinoux
authors.forename: V
authors.initials: V
authors.lastname: Catros-Quemener
authors.forename: B
authors.initials: B
authors.lastname: Cipolla
authors.forename: A-R
authors.initials: AR
authors.lastname: Azzouzi
authors.forename: P
authors.initials: P
authors.lastname: Karakiewicz
authors.forename: J-J
authors.initials: JJ
authors.lastname: Patard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000097:blood*; D004912:Erythrocytes / Q000737:chemistry*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013095:Spermidine / Q000032:analysis*; D013096:Spermine / Q000032:analysis*; D055815:Young Adult
chemical_list: D013096:Spermine; D013095:Spermidine