title: Cytoplasmic expression of β-catenin is an independent predictor of progression of conventional renal cell carcinoma: a simple immunostaining score.
abstract: OBJECTIVE
  The aims of this study were to investigate the potential of β-catenin as a biomarker for predicting cancer-specific survival, and to find a reproducible mode of evaluation of immunohistochemistry.
  
  
  RESULTS
  β-Catenin expression was analysed by immunohistochemistry in a cohort of 488 patients with conventional renal cell carcinoma (RCC) operated on between 2000 and 2010. The association between β-catenin expression and cancer-specific survival was assessed with univariate and multivariate Cox regression models in relation to conventional clinical pathological prognostic factors, and by Kaplan-Meier survival analysis with the log rank test. The univariate Cox regression model revealed an association of cytoplasmic β-catenin positivity and pathological variables with cancer-specific death. The multivariate Cox regression model analysis of tumours without metastatic disease at the first presentation identified the T-classification (P < 0.001) and cytoplasmic β-catenin positivity as risk factors for postoperative tumour progression. Specifically, cytoplasmic β-catenin expression was an independent factor indicating an unfavourable prognosis, with a four-fold higher risk of cancer-specific death (relative risk 4.017; 95% confidence interval 2.489-6.482; P < 0.001). The median survival time for patients with tumours showing cytoplasmic accumulation of β-catenin was 48 months, whereas the overall survival time was 166 months.
  
  
  CONCLUSIONS
  Cytoplasmic β-catenin expression is an independent prognostic factor for conventional RCC, and may help to identify patients with a high risk of cancer-specific death and to direct optimized active surveillance or adjuvant therapy.
authors: Medical Faculty, Ruprecht-Karls-University, Heidelberg, Germany.|Department of Urology, Medical School, University of Pecs, Pecs, Hungary.
authors: Gyula
authors: G
authors: Kovacs
authors: Medical Faculty, Ruprecht-Karls-University, Heidelberg, Germany.
authors: Nina Kaerger
authors: NK
authors: Billfeldt
authors: Institute of Bioanalysis, Medical School, University of Pecs, Pecs, Hungary.
authors: Nelli
authors: N
authors: Farkas
authors: Institute of Bioanalysis, Medical School, University of Pecs, Pecs, Hungary.
authors: Timea
authors: T
authors: Dergez
authors: Department of Urology, Medical School, University of Pecs, Pecs, Hungary.
authors: Andras
authors: A
authors: Javorhazy
authors: Department of Urology, Medical School, University of Pecs, Pecs, Hungary.
authors: Daniel
authors: D
authors: Banyai
authors: Department of Urology, Medical School, University of Pecs, Pecs, Hungary.
authors: Csaba
authors: C
authors: Pusztai
authors: Department of Urology, Medical School, University of Pecs, Pecs, Hungary.
authors: Arpad
authors: A
authors: Szanto
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology*; D003593:Cytoplasm / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D046888:Tissue Array Analysis; D051176:beta Catenin / Q000032:analysis / Q000096:biosynthesis*
chemical_list: D014408:Biomarkers, Tumor; C495270:CTNNB1 protein, human; D051176:beta Catenin
keywords: biomarker; immunochemistry; postoperative progression; renal cancer; β-catenin