Abstract
BackgroundChemokine (C–C motif) ligand 17 (CCL17) is a chemokine mainly produced by myeloid dendritic cells. It is a ligand for CC chemokine receptor 4 (CCR4) and CC chemokine receptor 8 (CCR8). The aim of this study was to investigate prognostic values of CCL17 expression in patients with clear cell renal cell carcinoma (ccRCC).MethodsThe study included 286 patients with ccRCC. CCL17 expression was analyzed by immunohistochemistry on tissue microarrays. Prognostic values of CCL17 expression and patients’ clinical outcomes were evaluated.ResultsKaplan-Meier method showed that low CCL17 expression was associated with worse patient overall survival (OS) and recurrence-free survival (RFS) (OS, P = 0.002; RFS, P = 0.007). Low CCL17 expression was an adverse independent risk factor for OS and RFS in multivariate analyses (OS, P = 0.006, P = 0.011 for bootstrap; RFS, P = 0.002, P = 0.025 for bootstrap). We constructed two nomograms incorporating parameters derived from multivariate analyses to predict patients’ OS and RFS (OS, c-index 0.799; RFS, c-index 0.787) and they performed better than existed integrated models.ConclusionLow CCL17 expression is a potential independent adverse prognostic biomarker for recurrence and survival of patients with ccRCC after nephrectomy. Established nomograms based on this information could help predict ccRCC patients’ OS and RFS.
Highlights
Chemokine (C–C motif) ligand 17 (CCL17) is a chemokine mainly produced by myeloid dendritic cells
According to the cutoff value (8461) derived from IOD scores and “minimum p value method”, 143 of 286 patients were assigned to the low chemokine ligand 17 (CCL17) expression group and others were assigned to the high CCL17 expression group
The curve of smooth estimates did not fluctuate much and log hazard ratio kept decreasing with the increase of IOD scores of CCL17 expression, which indicated that a two-level classification was appropriate (Fig. 1c)
Summary
Chemokine (C–C motif) ligand 17 (CCL17) is a chemokine mainly produced by myeloid dendritic cells. It is a ligand for CC chemokine receptor 4 (CCR4) and CC chemokine receptor 8 (CCR8). Several prognostic factors and integrated staging systems have been developed for RCC patients such as TNM stage, Fuhrman grade and several integrated models like University of California Integrated. Staging System (UISS) and Mayo Clinic stage, size, grade and necrosis (SSIGN) score [4]. These models are not accurate enough due to the genetic complexity and heterogeneity of the disease [5].
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