title: Factor-inhibiting hypoxia-inducible factor expression in patients with high-risk locally advanced renal cell carcinoma and its relationship with tumor progression.
abstract: Hypoxia-inducible factor (HIF) plays an important role in renal cell carcinoma (RCC) associated with angiogenesis. Factor-inhibiting HIF (FIH), which is the upstream mediator protein of HIF, is receiving more attention today. In the present study, the role of FIH expression in high-risk locally advanced renal cell carcinoma (LARCC) was explored. Eighty-eight high-risk LARCC cases were divided into two groups based on their prognosis. Using immunohistochemical staining, the correlations of FIH expression along with clinicopathological factors, progression-free survival (PFS), and overall survival (OS) were analyzed. FIH was mainly located in the cytoplasm (34/88) and nucleus (31/88) of the renal tumor cell. Nuclear negative expression or cytoplasmic positive expression of FIH were associated with an increased risk of disease progression (p = 0.007 and p < 0.001, respectively) and worse OS (p = 0.020 and p = 0.008, respectively). Using the group with nuclear and cytoplasmic FIH negative expression as reference, further stratified analysis found that the exclusive nuclear FIH expression group had a better PFS and OS [hazard ratio (HR) = 0.153, p = 0.07 and HR = 0, p = 0.961, respectively], and the exclusive cytoplasmic FIH positive group experienced the worst PFS and OS (HR = 2.876, p = 0.005 and HR = 2.799, p = 0.034, respectively). In addition, nuclear negative expression of FIH was associated with a significant negative predictive value for the effect of interferon-alpha (IFN-α) on PFS (p = 0.045). The nuclear negative and cytoplasmic positive expressions of FIH were identified not only as risk factors for disease progression in high-risk LARCC postoperative patients, but also to be associated with poor OS. Furthermore, the nuclear negative expression of FIH may be a promising biomarker for postoperative adjuvant therapy.
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Shi
authors.initials: S
authors.lastname: Deng
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zeng
authors.affiliation: Department of Pathology, West China Second University Hospital, Chengdu, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Jin
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, China. Electronic address: dongqianghxi@163.com.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Dong
mesh_terms: D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D002467:Cell Nucleus / Q000378:metabolism / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D006899:Mixed Function Oxygenases / Q000378:metabolism*; D011182:Postoperative Care; D016016:Proportional Hazards Models; D012097:Repressor Proteins / Q000378:metabolism*; D012307:Risk Factors
chemical_list: D012097:Repressor Proteins; D006899:Mixed Function Oxygenases; C439790:HIF1AN protein, human
keywords: Adjuvant therapy; Factor-inhibiting hypoxia-inducible factor; Locally advanced renal cell carcinoma