title: Expression and Clinical Significance of SOX9 in Renal Cell Carcinoma, Bladder Cancer and Penile Cancer.
abstract: BACKGROUND
  Novel molecular markers are important diagnostic tools for the assessment of cancer progression and evaluation of effectiveness of the treatment. SOX9, a key regulator of developmental processes, is overexpressed in various neoplasms, such as prostate, breast, and colorectal cancers. However, the utilization of SOX9 as a biomarker for other urological cancers has not yet been investigated.
  
  
  METHODS
  In the present study, paired patient tissue microarrays were analyzed by immunohistochemistry, and the SOX9 protein expression was quantitated as immunoreactive scores in patients with renal cell carcinoma (RCC), bladder cancer (BCa), and penile cancer (PC).
  
  
  RESULTS
  In comparison with normal tissues, SOX9 protein expression was signiﬁcantly upregulated in RCC (p < 0.001) and BCa (p < 0.001), and significantly correlated with the advanced pathological grade (RCC: p = 0.023) and clinical stage (RCC: p = 0.022 and BCa: p = 0.046) of patients. Based on the mRNA level in the TCGA dataset, SOX9 was upregulated in RCC with gender (p = 0.027), advanced pathological grade (p = 0.003) and advanced clinical stage (p = 0.001). Kaplan-Meier survival curves revealed that RCC patients with high SOX9 levels had shorter survival (p < 0.001). Further, high SOX9 expression was an independent prognostic factor for RCC patients (hazard ratio 0.056, 95% confidence interval 0.607-1.184; p < 0.001).
  
  
  CONCLUSIONS
  These findings suggest that SOX9 may play an important role in tumor progression of RCC and BCa and it may be used as a biomarker of this malignancy.
authors.forename: Yue-Ping
authors.initials: YP
authors.lastname: Wan
authors.forename: Ming
authors.initials: M
authors.lastname: Xi
authors.forename: Hui-Chan
authors.initials: HC
authors.lastname: He
authors.forename: Song
authors.initials: S
authors.lastname: Wan
authors.forename: Wei
authors.initials: W
authors.lastname: Hua
authors.forename: Zhao-Chang
authors.initials: ZC
authors.lastname: Zen
authors.forename: Yuan-Ling
authors.initials: YL
authors.lastname: Liu
authors.forename: Yu-Lin
authors.initials: YL
authors.lastname: Zhou
authors.forename: Ru-Jun
authors.initials: RJ
authors.lastname: Mo
authors.forename: Yang-Jia
authors.initials: YJ
authors.lastname: Zhuo
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Luo
authors.forename: Fu-Neng
authors.initials: FN
authors.lastname: Jiang
authors.forename: Wei-De
authors.initials: WD
authors.lastname: Zhong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D002292:Carcinoma, Renal Cell / Q000378:metabolism / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics; D055758:SOX9 Transcription Factor / Q000235:genetics / Q000378:metabolism*; D046888:Tissue Array Analysis; D001749:Urinary Bladder Neoplasms / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D012333:RNA, Messenger; D055758:SOX9 Transcription Factor; C527932:SOX9 protein, human