Association of serum amyloid A protein and peptide fragments with prognosis in renal cancer.
BACKGROUND
In renal cell carcinoma (RCC), the discovery of biomarkers for clinical use is a priority. This study aimed to identify and validate diagnostic and prognostic serum markers using proteomic profiling.


METHODS
Pre-operative sera from 119 patients with clear cell RCC and 69 healthy controls was analysed by surface-enhanced laser desorption/ionisation time-of-flight mass spectrometry with stringent in-house quality control and analysis routines. Following identification of one prognostic peak as a fragment of serum amyloid A (SAA), total serum SAA and CRP were also determined by immunoassay for further validation.


RESULTS
Several peptides were identified as having independent prognostic but not diagnostic significance on multivariable analysis. One was subsequently identified as a 1525 Da fragment of SAA (hazard ratio (HR)=0.26, 95% CI 0.08-0.85, P=0.026). This was weakly negatively correlated with total SAA, which was also of independent prognostic significance (HR=2.46, 95% CI 1.17-5.15, P=0.017). Both potentially strengthened prognostic models based solely on pre-operative variables.


CONCLUSIONS
This is the first description of the prognostic value of this peptide in RCC and demonstrates proof of principle of the approach. The subsequent examination of SAA protein considerably extends previous studies, being the first study to focus solely on pre-operative samples and describing potential clinical utility in pre-operative prognostic models.
Wood
S L
SL
Cancer Research UK Clinical Centre, Leeds Institute of Molecular Medicine, Leeds LS9 7TF, UK.
Rogers
M
M
Cairns
D A
DA
Paul
A
A
Thompson
D
D
Vasudev
N S
NS
Selby
P J
PJ
Banks
R E
RE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000401:mortality*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D000685:Serum Amyloid A Protein / Q000032:analysis*; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D015996:Survival Rate
D010446:Peptide Fragments; D000685:Serum Amyloid A Protein