title: Concurrent CD44s and STAT3 expression in human clear cell renal cellular carcinoma and its impact on survival.
abstract: Although CD44 was overexpressed and considered as a useful prognostic marker in renal cell carcinoma, the prognostic role of CD44s in clear cell renal cell carcinoma (ccRCC) remains controversial. Moreover, the correlation and prognostic significance of CD44s and its downstream signaling target pSTAT3 are unclear in ccRCC. In this study, 75 pairs of carcinoma and paired adjacent non-tumor renal tissue samples were collected from patients with localized ccRCC who underwent a nephrectomy. The expression levels of CD44s and pSTAT3 were analyzed using immunohistochemistry. Correlations between CD44s/pSTAT3 expression and clinical and pathological characteristics were determined using x(2) test, Kaplan-Meier analysis and Cox's proportional hazards model. We found that CD44s is highly expressed in 46.67% of tumor tissues, and its high expression was significantly associated with high tumor grade (P < 0.001), large tumor size (P = 0.009) and advanced T stage (P = 0.004). A strong correlation exists between high expression of CD44s and pSTAT3 (r = 0.4013, P = 0.0004). The joint over expression of CD44s and pSTAT3 was present in 42.66% of tumor specimens and had an additive negative impact on overall survival. Patients with CD44s(high)pSTAT3(high) expression had significantly poor survival as compared to patients with CD44s(low)pSTAT3(low) tumor expression (P = 0.024), though the concurrent overexpression of CD44s and pSTAT3 was not an independent prognostic factor for overall survival. Our data indicate that expression of both CD44s and pSTAT3 in ccRCC is associated with advanced tumor stage and patient survival. The conclusions from this study may improve the prediction of ccRCC prognosis information when CD44s and pSTAT3 expression are evaluated together with classical clinicopathological parameters.
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University 15 West Changle Street, Xi'an, Shaanxi 710032, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University 15 West Changle Street, Xi'an, Shaanxi 710032, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Cell Biology and Cell Engineering Research Centre, State Key Laboratory of Cancer Biology, Fourth Military Medical University 17 West Changle Street, Xi'an, Shaanxi 710032, China.
authors.forename: Bao-Qin
authors.initials: BQ
authors.lastname: Xu
authors.affiliation: Departments of Molecular Biosciences, Radiation Oncology and Urology, University of Kansas 1200 Sunnyside Avenue, Lawrence, KS 66045, USA.
authors.forename: Amber
authors.initials: A
authors.lastname: Smithc
authors.affiliation: Departments of Molecular Biosciences, Radiation Oncology and Urology, University of Kansas 1200 Sunnyside Avenue, Lawrence, KS 66045, USA.
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University 15 West Changle Street, Xi'an, Shaanxi 710032, China.
authors.forename: Jian-Lin
authors.initials: JL
authors.lastname: Yuan
authors.affiliation: Department of Cell Biology and Cell Engineering Research Centre, State Key Laboratory of Cancer Biology, Fourth Military Medical University 17 West Changle Street, Xi'an, Shaanxi 710032, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002292:Carcinoma, Renal Cell / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000032:analysis / Q000096:biosynthesis*; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D050796:STAT3 Transcription Factor / Q000032:analysis / Q000096:biosynthesis*; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; C497483:CD44 protein, human; D018960:Hyaluronan Receptors; D050796:STAT3 Transcription Factor; C494086:STAT3 protein, human
keywords: CD44s; ccRCC; pSTAT3; prognosis; survival