Abstract
Placental Growth Factor (PlGF) plays a crucial role in angiogenesis and was identified as a potential prognostic biomarker in various types of cancer. Therefore, we evaluated the diagnostic accuracy and prognostic value of PlGF serum concentration in patients with clear cell renal cell carcinoma (ccRCC). A total of 49 patients subjected to partial or radical nephrectomy for ccRCC [localized without relapse (lccRCC; n=31), localized with later relapse (rccRCC; n=8), primary metastatic cancer (mccRCC; n=10); median of follow-up 4.4 years] were enrolled in a prospective study to assess the significance of PlGF serum concentration. PlGF was measured prior to surgery and 3 months postoperatively. Our control group consisted of 38 healthy subjects. PlGF serum concentration was significantly higher in ccRCC compared to controls (P=0.002). The cut-off value of PlGF concentration for the risk of ccRCC was determined at 12.71 pg/mL (AUC=0.729; P=0.0001). Prior to surgery, among ccRCC subgroups, significantly higher PlGF concentration was detected in mccRCC compared to lccRCC (P=0.002). Postoperatively, we observed a tendency to higher PlGF serum concentration in rccRCC compared to lccRCC subgroup, however without significance (P=0.17). The cut-off value for the risk of relapse was 11.41 pg/mL (AUC=0.792; P=0.0003). In subjects with localized ccRCC with PlGF concentration below 11.41 pg/mL 3-years cancer specific survival was 93% compared to 61% in subject with concentration above the cut-off value (P=0.018). Based on our findings, PlGF serum concentration seems to be a useful biomarker in diagnostics and prediction of prognosis in ccRCC.
Highlights
Worldwide, renal cell carcinoma (RCC) is the sixth most frequently diagnosed cancer in men and eighth in women, accounting for 5% respectively 3% of all carcinomas with the highest incidence in the Western countries[1]
The present study aimed to evaluate Placental Growth Factor (PlGF) serum concentration in patients suffering from clear cell renal cell carcinoma, and to explore its diagnostic accuracy and prognostic value
The cut-off value of PlGF serum concentration for the risk of clear cell renal cell carcinoma (ccRCC) was determined at 12.71 pg/mL with area under the ROC curve (AUC) 0.729, providing the specificity of 84.21% and sensitivity of 61.22% (P=0.0001) (Fig 1)
Summary
Renal cell carcinoma (RCC) is the sixth most frequently diagnosed cancer in men and eighth in women, accounting for 5% respectively 3% of all carcinomas with the highest incidence in the Western countries[1]. Biomarkers can improve the diagnostics of RCC, and even more can provide additional predictive accuracy in identifying patients with higher risk of recurrence which would enable treatment individualization and improvement of patientsprognosis. We evaluated the diagnostic accuracy and prognostic value of PlGF serum concentration in patients with clear cell renal cell carcinoma (ccRCC). Results: PlGF serum concentration was significantly higher in ccRCC compared to controls (P=0.002). Among ccRCC subgroups, significantly higher PlGF concentration was detected in mccRCC compared to lccRCC (P=0.002). We observed a tendency to higher PlGF serum concentration in rccRCC compared to lccRCC subgroup, without significance (P=0.17). In subjects with localized ccRCC with PlGF concentration below 11.41 pg/mL 3-years cancer specific survival was 93% compared to 61% in subject with concentration above the cut-off value (P=0.018). Conclusion: Based on our findings, PlGF serum concentration seems to be a useful biomarker in diagnostics and prediction of prognosis in ccRCC
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