title: Low Expression of Mucin-4 Predicts Poor Prognosis in Patients With Clear-Cell Renal Cell Carcinoma.
abstract: Mucin-4 (MUC4), a member of membrane-bound mucins, has been reported to exert a large variety of distinctive roles in tumorigenesis of different cancers. MUC4 is aberrantly expressed in clear-cell renal cell carcinoma (ccRCC) but its prognostic value is still unveiled. This study aims to assess the clinical significance of MUC4 expression in patients with ccRCC.The expression of MUC4 was assessed by immunohistochemistry in 198 patients with ccRCC who underwent nephrectomy retrospectively in 2003 and 2004. Sixty-seven patients died before the last follow-up in the cohort. Kaplan-Meier method with log-rank test was applied to compare survival curves. Univariate and multivariate Cox regression models were applied to evaluate the prognostic value of MUC4 expression in overall survival (OS). The predictive nomogram was constructed based on the independent prognostic factors. The calibration was built to evaluate the predictive accuracy of nomogram.In patients with ccRCC, MUC4 expression, which was determined to be an independent prognostic indicator for OS (hazard ratio [HR] 3.891; P < 0.001), was negatively associated with tumor size (P = 0.036), Fuhrman grade (P = 0.044), and OS (P < 0.001). The prognostic accuracy of TNM stage, UCLA Integrated Scoring System (UISS), and Mayo clinic stage, size, grade, and necrosis score (SSIGN) prognostic models was improved when MUC4 expression was added. The independent prognostic factors, pT stage, distant metastases, Fuhrman grade, sarcomatoid, and MUC4 expression were integrated to establish a predictive nomogram with high predictive accuracy.MUC4 expression is an independent prognostic factor for OS in patients with ccRCC.
authors.affiliation: From the Department of Biochemistry and Molecular Biology (HF, YL, JX), Department of Immunology, School of Basic Medical Sciences (WZ), Department of Urology, Zhongshan Hospital, Fudan University (YC, LZ, YY), and Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (LX).
authors.forename: Hangcheng
authors.initials: H
authors.lastname: Fu
authors.forename: Yidong
authors.initials: Y
authors.lastname: Liu
authors.forename: Le
authors.initials: L
authors.lastname: Xu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Chang
authors.forename: Lin
authors.initials: L
authors.lastname: Zhou
authors.forename: Weijuan
authors.initials: W
authors.lastname: Zhang
authors.forename: Yuanfeng
authors.initials: Y
authors.lastname: Yang
authors.forename: Jiejie
authors.initials: J
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015870:Gene Expression / Q000235:genetics*; D006801:Humans; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D055264:Mucin-4 / Q000235:genetics*; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D055264:Mucin-4