title: CD133 immunohistochemical expression predicts progression and cancer-related death in renal cell carcinoma.
abstract: OBJECTIVE
  To evaluate the prognostic impact of the histological expression of CD133 in renal cell carcinoma (RCC).
  
  
  METHODS
  From 1992 to 2009, 142 consecutive patients underwent radical nephrectomy or partial nephrectomy for RCC. All cases were reviewed by a single pathologist and then subjected to analysis of the immunohistochemical expression of CD133 using tissue microarray. Several clinical and pathological variables were also evaluated.
  
  
  RESULTS
  The median postoperative follow-up was 44 months. Of the 142 immunostained RCC specimens, 77 (54%) showed low and 65 (46%) high expression of CD133. Expression of CD133 was associated with clinical stage (P = 0.05), lymph node involvement (P = 0.03), metastatic disease (P = 0.02) and MVI (P = 0.03). Among other variables, clinical stage, necrosis and metastasis were associated with disease-specific survival (DSS) and progression-free survival (PFS) on univariate analysis. The 5-year PFS rates in patients who provided specimens with high and low expression of CD133 were 83 and 66%, respectively (P = 0.01). It was observed that the 5-year DSS for patients who provided specimens with high and low expression of CD133 was 90 and 71%, respectively (P = 0.003). Multivariate survival analysis showed that patients in the CD133 low-expression group had a higher probability of disease progression (HR 3.4, P = 0.02) and a higher probability of death from cancer (HR 2.4, P = 0.01).
  
  
  CONCLUSIONS
  Immunohistochemical expression of CD133 had an impact on survival in patients with RCC, which shows that CD133 might be a useful tool for risk stratification. Low expression of this marker remained as an independent predictor of poor DSS and PFS.
authors.affiliation: Urology, A.C. Camargo Hospital, Rua Cerro Cora 1540, Alto de Pinheiros, Sao Paulo, SP, Brazil. waltercosta@hotmail.com
authors.forename: Walter Henriques da
authors.initials: WH
authors.lastname: Costa
authors.forename: Rafael Malagoli
authors.initials: RM
authors.lastname: Rocha
authors.forename: Isabela Werneck da
authors.initials: IW
authors.lastname: Cunha
authors.forename: Francisco Paula da
authors.initials: FP
authors.lastname: Fonseca
authors.forename: Gustavo Cardoso
authors.initials: GC
authors.lastname: Guimaraes
authors.forename: Stenio de Cassio
authors.initials: Sde C
authors.lastname: Zequi
mesh_terms: D000071916:AC133 Antigen; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000401:mortality* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006023:Glycoproteins / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007668:Kidney / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D010455:Peptides / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D046888:Tissue Array Analysis
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; D014408:Biomarkers, Tumor; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides