Abstract
BackgroundMucin13 (MUC13) is a transmembrane glycoprotein that is aberrantly expressed in ovarian and gastro-intestinal tumors, but its role in renal cell carcinoma remains elusive. The purpose of this study is to evaluate the prognostic value of MUC13 expression in patients with non-metastatic clear cell renal cell carcinoma (ccRCC) after surgical resection.ResultsMUC13 high expression was associated with high Fuhrman grade (p < 0.001), high SSIGN score (p = 0.011), early recurrence (p < 0.001) and poor survival (p < 0.001). Multivariate Cox regression analysis identified MUC13 expression as an independent prognostic factor for RFS and OS of ccRCC patients. A nomogram integrating MUC13 expression and other independent prognosticators was established to predict RFS and OS of ccRCC patients. Optimal agreement was shown between the predictions and observations in calibration curves.Matrials and methodsThis study enrolled 410 postoperative non-metastatic ccRCC patients at a single institution. Clinicopathologic variables, recurrence-free survival (RFS), and overall survival (OS) were recorded. MUC13 expression was detected by immunohistochemical staining in tumor specimens. Association of MUC13 expression with clinicopathological factors was explored. Kaplan-Meier analysis was performed to compare survival curves. Univariate and multivariate Cox regression models were used to analyze the impact of prognostic factors on RFS and OS. A prognostic nomogram was constructed based on the independent prognostic factors identified by multivariate analysis.ConclusionsMUC13 high expression is a novel independent adverse prognostic factor of clinical outcome in non-metastatic ccRCC patients after surgery.
Highlights
In 2013, renal cell carcinoma became the seventh most common tumor, which was diagnosed in more than 350,000 people worldwide and is associated with more than 140000 deaths per year [1]
MUC13 high expression was associated with high Fuhrman grade (p < 0.001), high SSIGN score (p = 0.011), early recurrence (p < 0.001) and poor survival (p < 0.001)
MUC13 expression levels was identified by immunohistochemical staining in 410 non-metastatic clear cell renal cell carcinoma (ccRCC) specimens
Summary
In 2013, renal cell carcinoma became the seventh most common tumor, which was diagnosed in more than 350,000 people worldwide and is associated with more than 140000 deaths per year [1]. Several outcome prediction models in RCC have been proposed to evaluate the risk of disease progression of patients after nephrectomy. One widely used model based on features predictive of death from renal cell carcinoma is SSIGN (stage, size, grade, and necrosis) score, which incorporates 1997 TNM stage, tumor size, nuclear grade and histological tumor necrosis [5]. Even though pathologic factors have been collected, their influence on the prognosis of ccRCC patients remain inconclusive [4]. These facts accentuate the urgent need for the improved predictors of RFS and OS of ccRCC patients. The purpose of this study is to evaluate the prognostic value of MUC13 expression in patients with non-metastatic clear cell renal cell carcinoma (ccRCC) after surgical resection
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