Neutrophil Gelatinase Associated Lipocalin is an Independent Predictor of Poor Prognosis in Cases of Papillary Renal Cell Carcinoma
Neutrophil Gelatinase Associated Lipocalin is an Independent Predictor of Poor Prognosis in Cases of Papillary Renal Cell Carcinoma
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DOI：
10.1016/j.juro.2015.04.080
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发表时间：
2015-09-01
影响因子：
6.6
通讯作者：
Guo, Hongqian
中科院分区：
文献类型：
--
作者：
Zhang, Mingxin;Zhao, Xiaozhi;Guo, Hongqian
目的：中性粒细胞明胶酶相关脂质运载蛋白，也称为脂质运载蛋白-2，是一种25 kDa的蛋白质，现在被认为是急性肾损伤早期诊断的生化金标准。最近，脂质运载蛋白-2被认为在几种人类肿瘤中具有重要作用。在这项研究中，我们评估脂质运载蛋白-2表达在2种肾脏肿瘤类型，并分析其与临床病理参数和预后的关系。材料和方法：研究组包括189例患者接受手术治疗的肾脏病变在2003年和2013年。在这些患者中，105例为透明细胞肾细胞癌，84例为乳头状肾细胞癌。评估了脂质运载蛋白-2免疫表达与临床病理特征的关系。考克斯比例风险回归估计潜在的混杂因素在预测总体和无病survival.Results的预后意义：Lipocalin-2表达在不同组织类型的分析肿瘤是高度和显着相关乳头状肾细胞癌（p < 0.001）。在乳头状肾细胞癌中，高脂质运载蛋白-2表达与高Fuhrman分级（p < 0.001）、肿瘤大小大于7 cm（p = 0.007）、TNM分期增加（p < 0.001）和淋巴结转移（p = 0.009）相关。中位随访49.1个月后，乳头状肾细胞癌的单变量和多变量考克斯生存分析（范围7至136）脂质运载蛋白-2表达与总生存率降低相关（HR 4.10，95% CI 1.19-14.14，p = 0.026）和无病生存期（HR 2.56，95% CI 1.01-6.48，p = 0.047）。Lipocalin-2过度表达可能是乳头状肾细胞癌患者总体生存率和无病生存率降低的一个预后因素。脂质运载蛋白-2过度表达和预后不良与乳头状肾细胞癌的关系可能具有潜在的诊断和治疗价值。
Purpose: Neutrophil gelatinase associated lipocalin, also known as lipocalin-2, is a 25 kDa protein now considered the biochemical gold standard for the early diagnosis of acute kidney injury. Recently lipocalin-2 was suggested to have an important role in several human neoplasias. In this study we assess lipocalin-2 expression in 2 renal tumor types and analyze its association with clinicopathological parameters and prognosis.Materials and Methods: The study group included 189 patients who underwent surgery for renal lesions between 2003 and 2013. Of these patients 105 had clear cell renal cell carcinoma and 84 had papillary renal cell carcinoma. The association of lipocalin-2 immunoexpression and clinicopathological characteristics was evaluated. Cox proportional hazard regression was performed to estimate the prognostic significance of potential confounders in predicting overall and disease-free survival.Results: Lipocalin-2 expression in different histotypes of analyzed tumors was highly and significantly associated with papillary renal cell carcinoma (p < 0.001). In papillary renal cell carcinoma high lipocalin-2 expression was associated with high Fuhrman grade (p < 0.001), tumor size greater than 7 cm (p = 0.007), increased TNM stage (p < 0.001) and lymph node metastasis (p = 0.009). On univariable and multivariable Cox survival analyses of papillary renal cell carcinoma, after a median followup of 49.1 months (range 7 to 136) lipocalin-2 expression was associated with reduced overall survival (HR 4.10, 95% CI 1.19-14.14, p = 0.026) and disease-free survival (HR 2.56, 95% CI 1.01-6.48, p = 0.047).Conclusions: Lipocalin-2 over expression may be a prognostic factor in decreased overall and disease-free survival in papillary renal cell carcinoma. The association of lipocalin-2 over expression and poor prognosis with papillary renal cell carcinoma may have potential diagnostic and therapeutic utility.