title: Snail predicts recurrence and survival of patients with localized clear cell renal cell carcinoma after surgical resection.
abstract: BACKGROUND
  Snail (known as SNAI1), a zinc-finger transcription factor, is best known for the induction of epithelial-to-mesenchymal transition, which has emerged as a recognized mechanism underlying epithelial cancer progression. Herein, the aim is to determine the effect of Snail expression on recurrence and survival of patients with localized clear cell renal cell carcinoma (ccRCC) following surgery.
  
  
  METHODS
  We retrospectively enrolled 255 patients (188 in group A and 67 in group B) with localized ccRCC undergoing nephrectomy at a single center. Prognostic value and clinical outcomes were evaluated.
  
  
  RESULTS
  In both groups, cytoplasmic Snail intensity correlates positively with Fuhrman grade. High nuclear but not cytoplasmic Snail intensity indicates early recurrence and poor survival of patients with localized ccRCC. Moreover, high nuclear Snail intensity predicts unfavorable survival of patients with T2-4 stage cancer and early recurrence of all stage patients. Nuclear Snail intensity was identified as an independent adverse prognostic factor for recurrence and survival. The predictive accuracy of University of Los Angeles Integrated Staging System and the Mayo Clinic Stage, Size, Grade, and Necrosis prognostic models was improved when nuclear Snail expression was added.
  
  
  CONCLUSIONS
  Nuclear Snail expression is a potential independent adverse prognostic biomarker for recurrence and survival of patients with localized ccRCC after nephrectomy.
authors.affiliation: Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, China.
authors.forename: Weisi
authors.initials: W
authors.lastname: Liu
authors.affiliation: Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, China.
authors.forename: Yidong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, China.
authors.forename: Haiou
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Immunology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, China.
authors.forename: Weijuan
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Urology, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, China.
authors.forename: Huimin
authors.initials: H
authors.lastname: An
authors.affiliation: Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, China. Electronic address: jjxufdu@fudan.edu.cn.
authors.forename: Jiejie
authors.initials: J
authors.lastname: Xu
mesh_terms: D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D002292:Carcinoma, Renal Cell / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D000071250:Snail Family Transcription Factors; D015996:Survival Rate; D046888:Tissue Array Analysis; D014157:Transcription Factors / Q000096:biosynthesis*
chemical_list: D014408:Biomarkers, Tumor; C000604407:SNAI1 protein, human; D000071250:Snail Family Transcription Factors; D014157:Transcription Factors
keywords: Clear cell renal cell carcinoma; Overall survival; Prognostic biomarker; Recurrence-free survival; Snail