Immunohistochemical expression of renin is a prognostic factor for recurrence in nonmetastatic renal cell carcinoma

Felipe de Almeida e Paula, Stephania Martins Bezerra, Isabela Werneck da Cunha, Guilherme Consentino Munhoz, Diego Abreu, Primo N Lara, Walter Henriques da Costa, Stênio de Cássio Zéqui

Research output: Contribution to journalArticle

Abstract

Purpose: To analyze the intratumoral immunohistochemical expression of renin and its value as a prognostic factor for recurrence in nonmetastatic clear cell renal cell carcinoma (ccRCC). Methods: A total of 498 patients with nonmetastatic ccRCC from the Latin American Renal Cancer Group database who underwent partial or radical nephrectomy between 1990 and 2016 were selected. All cases were revised, and 2 distinct samples were obtained for tissue microarray construction. Ten years of follow-up was assessed, and disease-free survival rates (DFS) were analyzed. Renin expression was classified qualitatively as negative or positive. For the quantitative analysis, a cutoff was estimated using the maximum of the standardized log-rank statistic. Results: Nuclear renin was qualitatively positive in 360 cases (72%) and negative in 138 (28%), whereas quantitatively, an equal number of cases had ≤35% or >35% renin-positive nuclei. The absence of renin expression was associated with high-grade tumors (by ISUP and Fuhrman classification, both P < 0.001), greater microscopic venous invasion (P = 0.046), and renal vein invasion (P = 0.026). In the multivariate analyses, qualitatively negative renin expression was an unfavorable prognostic factor for DFS (RR = 2.923, P < 0.001). With regard to quantitative renin expression, a cutoff of ≤35 was associated with worse DFS (RR = 4.085, P < 0.001). Conclusions: The intratumoral immunohistochemical expression of renin in patients with ccRCC provides valuable prognostic data regarding the likelihood of recurrence.

Original languageEnglish (US)
JournalUrologic Oncology: Seminars and Original Investigations
DOIs
StateAccepted/In press - Jan 1 2019

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Renal Cell Carcinoma
Renin
Recurrence
Disease-Free Survival
Survival Rate
Renal Veins
Kidney Neoplasms
Nephrectomy
Multivariate Analysis
Databases
Neoplasms

Keywords

  • Biomarkers
  • Disease-free survival
  • Kidney Neoplasms
  • Renin

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Immunohistochemical expression of renin is a prognostic factor for recurrence in nonmetastatic renal cell carcinoma. / de Almeida e Paula, Felipe; Bezerra, Stephania Martins; da Cunha, Isabela Werneck; Munhoz, Guilherme Consentino; Abreu, Diego; Lara, Primo N; da Costa, Walter Henriques; Zéqui, Stênio de Cássio.

In: Urologic Oncology: Seminars and Original Investigations, 01.01.2019.

Research output: Contribution to journalArticle

de Almeida e Paula, Felipe ; Bezerra, Stephania Martins ; da Cunha, Isabela Werneck ; Munhoz, Guilherme Consentino ; Abreu, Diego ; Lara, Primo N ; da Costa, Walter Henriques ; Zéqui, Stênio de Cássio. / Immunohistochemical expression of renin is a prognostic factor for recurrence in nonmetastatic renal cell carcinoma. In: Urologic Oncology: Seminars and Original Investigations. 2019.
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title = "Immunohistochemical expression of renin is a prognostic factor for recurrence in nonmetastatic renal cell carcinoma",
abstract = "Purpose: To analyze the intratumoral immunohistochemical expression of renin and its value as a prognostic factor for recurrence in nonmetastatic clear cell renal cell carcinoma (ccRCC). Methods: A total of 498 patients with nonmetastatic ccRCC from the Latin American Renal Cancer Group database who underwent partial or radical nephrectomy between 1990 and 2016 were selected. All cases were revised, and 2 distinct samples were obtained for tissue microarray construction. Ten years of follow-up was assessed, and disease-free survival rates (DFS) were analyzed. Renin expression was classified qualitatively as negative or positive. For the quantitative analysis, a cutoff was estimated using the maximum of the standardized log-rank statistic. Results: Nuclear renin was qualitatively positive in 360 cases (72{\%}) and negative in 138 (28{\%}), whereas quantitatively, an equal number of cases had ≤35{\%} or >35{\%} renin-positive nuclei. The absence of renin expression was associated with high-grade tumors (by ISUP and Fuhrman classification, both P < 0.001), greater microscopic venous invasion (P = 0.046), and renal vein invasion (P = 0.026). In the multivariate analyses, qualitatively negative renin expression was an unfavorable prognostic factor for DFS (RR = 2.923, P < 0.001). With regard to quantitative renin expression, a cutoff of ≤35 was associated with worse DFS (RR = 4.085, P < 0.001). Conclusions: The intratumoral immunohistochemical expression of renin in patients with ccRCC provides valuable prognostic data regarding the likelihood of recurrence.",
keywords = "Biomarkers, Disease-free survival, Kidney Neoplasms, Renin",
author = "{de Almeida e Paula}, Felipe and Bezerra, {Stephania Martins} and {da Cunha}, {Isabela Werneck} and Munhoz, {Guilherme Consentino} and Diego Abreu and Lara, {Primo N} and {da Costa}, {Walter Henriques} and Z{\'e}qui, {St{\^e}nio de C{\'a}ssio}",
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doi = "10.1016/j.urolonc.2019.07.012",
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T1 - Immunohistochemical expression of renin is a prognostic factor for recurrence in nonmetastatic renal cell carcinoma

AU - de Almeida e Paula, Felipe

AU - Bezerra, Stephania Martins

AU - da Cunha, Isabela Werneck

AU - Munhoz, Guilherme Consentino

AU - Abreu, Diego

AU - Lara, Primo N

AU - da Costa, Walter Henriques

AU - Zéqui, Stênio de Cássio

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: To analyze the intratumoral immunohistochemical expression of renin and its value as a prognostic factor for recurrence in nonmetastatic clear cell renal cell carcinoma (ccRCC). Methods: A total of 498 patients with nonmetastatic ccRCC from the Latin American Renal Cancer Group database who underwent partial or radical nephrectomy between 1990 and 2016 were selected. All cases were revised, and 2 distinct samples were obtained for tissue microarray construction. Ten years of follow-up was assessed, and disease-free survival rates (DFS) were analyzed. Renin expression was classified qualitatively as negative or positive. For the quantitative analysis, a cutoff was estimated using the maximum of the standardized log-rank statistic. Results: Nuclear renin was qualitatively positive in 360 cases (72%) and negative in 138 (28%), whereas quantitatively, an equal number of cases had ≤35% or >35% renin-positive nuclei. The absence of renin expression was associated with high-grade tumors (by ISUP and Fuhrman classification, both P < 0.001), greater microscopic venous invasion (P = 0.046), and renal vein invasion (P = 0.026). In the multivariate analyses, qualitatively negative renin expression was an unfavorable prognostic factor for DFS (RR = 2.923, P < 0.001). With regard to quantitative renin expression, a cutoff of ≤35 was associated with worse DFS (RR = 4.085, P < 0.001). Conclusions: The intratumoral immunohistochemical expression of renin in patients with ccRCC provides valuable prognostic data regarding the likelihood of recurrence.

AB - Purpose: To analyze the intratumoral immunohistochemical expression of renin and its value as a prognostic factor for recurrence in nonmetastatic clear cell renal cell carcinoma (ccRCC). Methods: A total of 498 patients with nonmetastatic ccRCC from the Latin American Renal Cancer Group database who underwent partial or radical nephrectomy between 1990 and 2016 were selected. All cases were revised, and 2 distinct samples were obtained for tissue microarray construction. Ten years of follow-up was assessed, and disease-free survival rates (DFS) were analyzed. Renin expression was classified qualitatively as negative or positive. For the quantitative analysis, a cutoff was estimated using the maximum of the standardized log-rank statistic. Results: Nuclear renin was qualitatively positive in 360 cases (72%) and negative in 138 (28%), whereas quantitatively, an equal number of cases had ≤35% or >35% renin-positive nuclei. The absence of renin expression was associated with high-grade tumors (by ISUP and Fuhrman classification, both P < 0.001), greater microscopic venous invasion (P = 0.046), and renal vein invasion (P = 0.026). In the multivariate analyses, qualitatively negative renin expression was an unfavorable prognostic factor for DFS (RR = 2.923, P < 0.001). With regard to quantitative renin expression, a cutoff of ≤35 was associated with worse DFS (RR = 4.085, P < 0.001). Conclusions: The intratumoral immunohistochemical expression of renin in patients with ccRCC provides valuable prognostic data regarding the likelihood of recurrence.

KW - Biomarkers

KW - Disease-free survival

KW - Kidney Neoplasms

KW - Renin

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U2 - 10.1016/j.urolonc.2019.07.012

DO - 10.1016/j.urolonc.2019.07.012

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JO - Urologic Oncology

JF - Urologic Oncology

SN - 1078-1439

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