Carbonic Anhydrase IX is not a predictor of outcomes in non-metastatic clear cell renal cell carcinoma - a digital analysis of tissue microarray.
BACKGROUND
The knowledge about the molecular biology of clear cell renal cell carcinoma (ccRCC) is evolving, and Carbonic Anhydrase type IX (CA-IX) has emerged as a potential prognostic marker in this challenging disease. However, most of the literature about CA-IX on ccRCC comes from series on metastatic cancer, with a lack of series on non-metastatic cancer. The objective is to evaluate the expression of CA-IX in a cohort of non-metastatic ccRCC, correlating with 1) overall survival, and 2) with established prognostic parameters (T stage, tumor size, Fuhrman nuclear grade, microvascular invasion and peri-renal fat invasion).


METHODS
This is a retrospective cohort study. We evaluated 95 patients with non-metastatic clear cell renal cell carcinoma, as to the expression of CA-IX. The analyzed parameters where: overall survival (OS), TNM stage, tumor size (TS), Fuhrman nuclear grade (FNG), microvascular invasion (MVI), peri-renal fat invasion (PFI). We utilized a custom built tissue microarray, and the immunoexpression was digitally quantified using the Photoshop ® software.


RESULTS
The mean follow-up time was 7.9 years (range 1.9 to 19.5 years). The analysis of CA-IX expression against the selected prognostic parameters showed no correlation. The results are as follows: Overall survival (p = 0.790); T stage (p = 0.179); tumor size (p = 0.143); grouped Fuhrman nuclear grade (p = 0.598); microvascular invasion (p = 0.685), and peri-renal fat invasion (p = 0.104).


CONCLUSIONS
Carbonic anhydrase type IX expression does not correlate with overall survival and conventional prognostic parameters in non-metastatic clear cell renal cell carcinoma.
Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School and Uro-Oncology Group, Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Marcelo
M
Zerati
Kátia R M
KR
Leite
José
J
Pontes-Junior
Cesar Camara
CC
Segre
Sabrina Thalita
ST
Reis
Miguel
M
Srougi
Marcos Francisco
MF
Dall'Oglio
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D000071231:Carbonic Anhydrase IX; D002256:Carbonic Anhydrases / Q000032:analysis*; D002292:Carcinoma, Renal Cell / Q000201:enzymology* / Q000473:pathology; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000201:enzymology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D046888:Tissue Array Analysis / Q000379:methods; D047368:Tumor Burden; D055815:Young Adult
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C089226:CA9 protein, human; D000071231:Carbonic Anhydrase IX; D002256:Carbonic Anhydrases