Enrichment of C5a-C5aR axis predicts poor postoperative prognosis of patients with clear cell renal cell carcinoma.
Anaphylatoxin C5a and its receptor C5aR on cancer cells constitute a vital axis to cancer progression. In this study, we measured C5aR level by immunohistochemistry in the same cohort of our previous C5a research, and C5a-C5aR axis status was determined by synthesizing C5a and C5aR data. C5aR was an adverse independent prognostic factor for ccRCC patients. Kaplan-Meier analyses revealed the unique position of both C5a and C5aR high population in postoperative survival, based on which patients were then shunted into C5a-C5aR enriched and non-enriched groups. Obviously, C5a-C5aR enriched patients significantly had a poorer overall survival (OS) and recurrence free survival (RFS) compared with non-enriched ones, and the independence of C5a-C5aR axis was verified by multivariable analyses (HR 2.118, P = 0.001 for OS, HR 1.715, P = 0.035 for RFS). Established nomograms based on our findings reflected much better predicting accuracy in contrast with most common used TNM and Fuhrman systems. Meanwhile, consistent with HR, C5a-C5aR axis in this study held its advantages over C5a and C5aR for OS prediction by c-index analyses, rather than RFS prediction.
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Wei
W
Xi
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Li
L
Liu
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Jiajun
J
Wang
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Yu
Y
Xia
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Qi
Q
Bai
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Ying
Y
Xiong
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Yang
Y
Qu
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Qilai
Q
Long
Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
Jiejie
J
Xu
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Jianming
J
Guo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis*; D002292:Carcinoma, Renal Cell / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D015936:Complement C5a / Q000032:analysis*; D003661:Decision Support Techniques; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000009:adverse effects / Q000401:mortality; D049451:Nomograms; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D044087:Receptor, Anaphylatoxin C5a / Q000032:analysis*; D012189:Retrospective Studies; D012307:Risk Factors; D015398:Signal Transduction; D013997:Time Factors; D046888:Tissue Array Analysis; D016896:Treatment Outcome; D055815:Young Adult
D014408:Biomarkers, Tumor; C488033:C5AR1 protein, human; D044087:Receptor, Anaphylatoxin C5a; D015936:Complement C5a
C5a-C5aR axis; C5aR; ccRCC; nomogram; prognosis