Abstract
MUC3A is a membrane-associated mucin that recent evidence reveals the role of MUC3A in pathogenesis and progression of cancers. To evaluate the association between MUC3A expression with overall survival (OS) and recurrence-free survival (RFS) in patients with localized clear-cell renal cell carcinoma (ccRCC), we retrospectively detected MUC3A expression in samples of 384 postoperative localized ccRCC patients by immunohistochemistry. Median follow-up was 73 months (range: 42 – 74 mo). Overall, 41 patients died, 47 experienced recurrence. High MUC3A expression occurred in 45.8% of localized ccRCC cases, which was significantly associated with high pT-stage, high Fuhrman grade, high frequency of necrosis and LVI, and increased risk of recurrence and death (Logrank test P < 0.001 and P < 0.001, respectively). By multivariate analysis, MUC3A expression was confirmed as an adverse independent prognostic factor for OS and RFS. The prognostic accuracy of UISS, SSIGN, Leibovich models was significantly increased when MUC3A expression was integrated. Meanwhile, MUC3A was enrolled into a newly built nomogram with other factors selected by multivariate analysis. Calibration curves revealed optimal consistency between observations and prognosis. In conclusion, high MUC3A expression is an adverse prognostic biomarker for OS and RFS in postoperative localized ccRCC patients.
Highlights
Renal cell carcinoma (RCC) was ranked the seventh most common tumor worldly, with over 350 000 new cases in 2013 and 140000 death cases worldwide per year [1]
Our goal is to evaluate the correlation between MUC3A expression and clinical characteristics, as well as the prognostic parameters in localized clear-cell renal cell carcinoma (ccRCC)
This work indicated that MUC3A may play an important role in oncogenesis and progression in localized ccRCC
Summary
Renal cell carcinoma (RCC) was ranked the seventh most common tumor worldly, with over 350 000 new cases in 2013 and 140000 death cases worldwide per year [1]. As the most predominant subtype, clear cell RCC (ccRCC) accounted nearly 70–75% in the kidney cancer [3]. Even the ccRCC patients of similar or same subtype usually performed complex and unpredictable course of disease and clinical outcomes. Another challenge in management of RCC is that most localized RCC patients could be cured by surgical intervention, but the prognosis is poor when patients experience local recurrence or distant metastasis. Due to the complexity of signal pathways in ccRCC, even more extensive biomarkers are required to improve diagnosis, therapy and postoperative management
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