Abstract
INTRODUCTION AND OBJECTIVES: We investigated the correlation between the expression of the vascular endothelial cell growth factor (VEGF), the platelet-derived growth factor(PDGF), their receptors (VEGFR2, PDGFR), and the pathologic stage or cell type in non-metastatic, renal cell carcinoma (RCC). METHODS: A prospective, observational study was conducted to assess the VEGF, VEGFR2, PDGF, and PDGFRprotein expression by immunohistochemical assay in tumor tissue samples obtained from surgical specimens after radical or partial nephrectomy performed at our center between January 2008 and March 2012. The intensity of these proteins were quantified by a single pathologist and rated on a scale of 0 to 3. We dichotomized the expression level as weak (scale 0-1) or strong (scale 2-3). The correlation between the expression of these proteins and the oncologic parameters, especially the pathologic classification according to the cell type of RCC, was analyzed. RESULTS: A total of 1,423 patients diagnosed with RCC underwent surgery during the study period. Excluding 292 patients with pathologically proven tumor other than RCC and 50 patients with metastasis, 1,091 patients with a mean age of 54 years were finally included in the analysis. Clear cell, papillary, chromophobe, and other types of RCC occurred in 962 (88.8%), 80 (7.4%), 31 (2.9%), and 10 (0.8%), respectively, of the 1,091 study patients (Table). PDGFRexpression was the highest in clear cell RCC, however VEGF and PDGFexpression was the highest in papillary RCC. VEGF staining showed higher expression with the increasing T or N stage. After adjusting the T stage and Furhman nuclear grade using multivariate logistic regression analysis, papillary RCC showed significantly stronger expression of VEGF (OR 3.57, 95% CI 1.74–7.32, p 0.001), VEGFR2 (OR 1.82, 95% CI 1.11–2.99, p 0.017), and PDGF(OR 2.46, 95% CI 1.49–4.06, p 0.019) compared to clear cell RCC. CONCLUSIONS: In this large series of immunohistochemical assay, we demonstrated different cytoplasmic expression of VEGF, VEGFR2, PDGF, and PDGFRin tumor cell according to the pathologic stage and the cell type of RCC. It is noteworthy that VEGF and PDGFexpression was the highest in papillary RCC, not in clear cell RCC.
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