title: Analysis of various potential prognostic markers and survival data in clear cell renal cell carcinoma.
abstract: OBJECTIVE
  Clear cell renal cell cancers frequently harbor Von Hippel-Lindau gene mutations, leading to stabilization of the hypoxia-inducible factors (HIFs) and their target genes. In this study, we investigated the relationship between vascular endotelial growth factor (VEGF), HIF-1α, HIF-2α, p53 positivity, microvessel density, and Ki-67 rates with prognostic histopathologic factors (Fuhrman nuclear grade, stage, and sarcomatoid differentiation) and survival in clear cell renal cell carcinomas.
  
  
  METHODS
  Seventy-two nephrectomy specimens diagnosed as clear cell renal cell carcinoma between 2000 and 2012 were reevaluated. Immunohistochemically VEGF, HIF-1α, HIF-2α, p53, CD34 (for microvessel density evaluation), and Ki-67 antibodies were applied to the tumor areas. The relationships of these antibodies with prognostic factors and survival rates were evaluated with statistical analyses.
  
  
  RESULTS
  Mean survival time was 105.6 months in patients with ccRCC. Patients with high expression of VEGF, HIF-1α and HIF-2α positivity, a high Ki-67 proliferation index, and a high microvessel density evaluation score had a shorter survival time (p < 0.05).
  
  
  CONCLUSIONS
  Our findings supported that with the use of these immunohistochemical markers, prognosis of renal cell carcinoma may be predicted at the first step of patient management. New treatment modalities targeted to HIF-1α and HIF-2α might be planned as well as VEGF-targeted therapies in the management of clear cell renal cell carcinomas.
authors: Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors: Tastekin
authors: T
authors: Ebru
authors: Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors: Oz Puyan
authors: OP
authors: Fulya
authors: Department of Urology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors: Akdere
authors: A
authors: Hakan
authors: Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors: Yurut-Caloglu
authors: YC
authors: Vuslat
authors: Department of Biostatistics, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors: Sut
authors: S
authors: Necdet
authors: Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors: Can
authors: C
authors: Nuray
authors: Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors: Ozyilmaz
authors: O
authors: Filiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000032:analysis; D051792:Basic Helix-Loop-Helix Proteins / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D002292:Carcinoma, Renal Cell / Q000098:blood supply / Q000378:metabolism* / Q000401:mortality; D005260:Female; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000032:analysis; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D007680:Kidney Neoplasms / Q000098:blood supply / Q000378:metabolism* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis; D000099162:Endothelial PAS Domain-Containing Protein 1
chemical_list: D018952:Antigens, CD34; D051792:Basic Helix-Loop-Helix Proteins; D014408:Biomarkers, Tumor; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53; D042461:Vascular Endothelial Growth Factor A; D000099162:Endothelial PAS Domain-Containing Protein 1; C497442:HIF1A protein, human
keywords: Carcinoma; Carcinoma, Renal Cell; Survival Rate