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Zhang W, Patterson NH, Verbeeck N, Moore JL, Ly A, Caprioli RM, De Moor B, Norris JL, Claesen M. Multimodal MALDI imaging mass spectrometry for improved diagnosis of melanoma. PLoS One 2024; 19:e0304709. [PMID: 38820337 PMCID: PMC11142536 DOI: 10.1371/journal.pone.0304709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 05/17/2024] [Indexed: 06/02/2024] Open
Abstract
Imaging mass spectrometry (IMS) provides promising avenues to augment histopathological investigation with rich spatio-molecular information. We have previously developed a classification model to differentiate melanoma from nevi lesions based on IMS protein data, a task that is challenging solely by histopathologic evaluation. Most IMS-focused studies collect microscopy in tandem with IMS data, but this microscopy data is generally omitted in downstream data analysis. Microscopy, nevertheless, forms the basis for traditional histopathology and thus contains invaluable morphological information. In this work, we developed a multimodal classification pipeline that uses deep learning, in the form of a pre-trained artificial neural network, to extract the meaningful morphological features from histopathological images, and combine it with the IMS data. To test whether this deep learning-based classification strategy can improve on our previous results in classification of melanocytic neoplasia, we utilized MALDI IMS data with collected serial H&E stained sections for 331 patients, and compared this multimodal classification pipeline to classifiers using either exclusively microscopy or IMS data. The multimodal pipeline achieved the best performance, with ROC-AUCs of 0.968 vs. 0.938 vs. 0.931 for the multimodal, unimodal microscopy and unimodal IMS pipelines respectively. Due to the use of a pre-trained network to perform the morphological feature extraction, this pipeline does not require any training on large amounts of microscopy data. As such, this framework can be readily applied to improve classification performance in other experimental settings where microscopy data is acquired in tandem with IMS experiments.
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Affiliation(s)
- Wanqiu Zhang
- STADIUS Center for Dynamical Systems, Signal Processing, and Data Analytics, Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
- Aspect Analytics NV, Genk, Belgium
| | - Nathan Heath Patterson
- Frontier Diagnostics, LLC, Nashville, Tennessee, United States of America
- Mass Spectrometry Research Center, Department of Biochemistry, Vanderbilt University, Nashville, Tennessee, United States of America
| | | | - Jessica L. Moore
- Frontier Diagnostics, LLC, Nashville, Tennessee, United States of America
| | - Alice Ly
- Aspect Analytics NV, Genk, Belgium
| | - Richard M. Caprioli
- Frontier Diagnostics, LLC, Nashville, Tennessee, United States of America
- Mass Spectrometry Research Center, Department of Biochemistry, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Bart De Moor
- STADIUS Center for Dynamical Systems, Signal Processing, and Data Analytics, Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
| | - Jeremy L. Norris
- Frontier Diagnostics, LLC, Nashville, Tennessee, United States of America
- Mass Spectrometry Research Center, Department of Biochemistry, Vanderbilt University, Nashville, Tennessee, United States of America
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Erlmeier M, Mikuteit M, Zschäbitz S, Autenrieth M, Weichert W, Hartmann A, Steffens S, Erlmeier F. Immunohistochemical expression of the hepatocyte growth factor in chromophobe renal cell carcinoma. BMC Urol 2023; 23:90. [PMID: 37170275 PMCID: PMC10176764 DOI: 10.1186/s12894-023-01263-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 04/28/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND The prognostic value of Hepatocyte growth factor (HGF) in non-clear cell renal cell carcinoma (RCC) is still unclear. The aim of this study is to evaluate the prognostic impact of HGF expression in a large cohort of chromophobe RCC (chRCC). METHODS Patients who underwent renal surgery due to chRCC were recruited. Clinical data was retrospectively evaluated. Tumor specimen were analyzed for HGF expression by immunohistochemistry. RESULTS 81 chRCC patients were eligible for analysis, thereof 37 (45.7%) patients were positive for HGF. No significant associations were found for HGF expression and clinical attributes in patients with chRCC. Kaplan-Meier analysis revealed no differences in 5-year overall survival (OS) for patients with HGF- compared to HGF+ tumors (95.0% versus 90.9%; p = 0.410). CONCLUSIONS In chRCC HGF expression is not associated with parameters of aggressiveness or survival.
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Affiliation(s)
| | - Marie Mikuteit
- Department for Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Stefanie Zschäbitz
- Dept. of Medical Oncology, National Center of Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Autenrieth
- Department of Urology, Technical University of Munich, Klinikum Rechts der Isar, München, Germany
| | - Wilko Weichert
- Institute for Pathology and Pathological Anatomy, Technical University Munich, Munich, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Hospital of Erlangen, Erlangen, Germany
| | - Sandra Steffens
- Department for Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
- Department of Urology, University Hospital Münster, Münster, Germany
| | - Franziska Erlmeier
- Institute of Pathology, University Hospital of Erlangen, Erlangen, Germany
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Tzortzakakis A, Papathomas T, Gustafsson O, Gabrielson S, Trpkov K, Ekström-Ehn L, Arvanitis A, Holstensson M, Karlsson M, Kokaraki G, Axelsson R. 99mTc-Sestamibi SPECT/CT and histopathological features of oncocytic renal neoplasia. Scand J Urol 2022; 56:375-382. [PMID: 36065481 DOI: 10.1080/21681805.2022.2119273] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND 99mTc-Sestamibi Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) contributes to the non-invasive differentiation of renal oncocytoma (RO) from renal cell carcinoma (RCC) by characterising renal tumours as Sestamibi positive or Sestamibi negative regarding their 99mTc-Sestamibi uptake compared to the non-tumoral renal parenchyma. PURPOSE To determine whether 99mTc- Sestamibi uptake in renal tumour and the non-tumoral renal parenchyma measured using Standard Uptake Value (SUV) SPECT, has a beneficial role in differentiating RO from RCC. MATERIAL AND METHODS Fifty-seven renal tumours from 52 patients were evaluated. In addition to visual evaluation of 99mTc-Sestamibi uptake, SUVmax measurements were performed in the renal tumour and the ipsilateral non-tumoral renal parenchyma. Analysis of the area under the receiver operating characteristic curve identified an optimal cut-off value for detecting RO, based on the relative ratio of 99mTc- Sestamibi uptake. RESULTS Semiquantitative evaluation of 99mTc-Sestamibi uptake did not improve the performance of 99mTc- Sestamibi SPECT/CT in detecting RO. 99mTc- Sestamibi SPECT/CT identifies a group of mostly indolent Sestamibi-positive tumours with low malignant potential containing RO, Low-Grade Oncocytic Tumours, Hybrid Oncocytic Tumours, and a subset of chromophobe RCCs. CONCLUSION The imaging limitations for accurate differentiation of Sestamibi-positive renal tumours mirror the recognised diagnostic complexities of the histopathologic evaluation of oncocytic neoplasia. Patients with Sestamibi-positive renal tumours could be better suited for biopsy and follow-up, according to the current active surveillance protocols.
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Affiliation(s)
- Antonios Tzortzakakis
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.,Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Thomas Papathomas
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom.,Gloucestershire Cellular Pathology Laboratory, Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom
| | - Ove Gustafsson
- Division of Urology, Karolinska University Hospital, Huddinge, Sweden
| | - Stefan Gabrielson
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.,Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Kiril Trpkov
- Department of Pathology and Laboratory Medicine, Alberta Precision Labs, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Alexandros Arvanitis
- Department of Clinical Pathology and Cytology, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Maria Holstensson
- Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden.,Division of Function and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet
| | - Mattias Karlsson
- Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Georgia Kokaraki
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.,Department of Clinical Pathology and Cytology, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Rimma Axelsson
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.,Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden
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Prade VM, Sun N, Shen J, Feuchtinger A, Kunzke T, Buck A, Schraml P, Moch H, Schwamborn K, Autenrieth M, Gschwend JE, Erlmeier F, Hartmann A, Walch A. The synergism of spatial metabolomics and morphometry improves machine learning‐based renal tumour subtype classification. Clin Transl Med 2022; 12:e666. [PMID: 35184396 PMCID: PMC8858620 DOI: 10.1002/ctm2.666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- Verena M. Prade
- Research Unit Analytical Pathology Helmholtz Zentrum München – German Research Center for Environmental Health Neuherberg Germany
| | - Na Sun
- Research Unit Analytical Pathology Helmholtz Zentrum München – German Research Center for Environmental Health Neuherberg Germany
| | - Jian Shen
- Research Unit Analytical Pathology Helmholtz Zentrum München – German Research Center for Environmental Health Neuherberg Germany
| | - Annette Feuchtinger
- Research Unit Analytical Pathology Helmholtz Zentrum München – German Research Center for Environmental Health Neuherberg Germany
| | - Thomas Kunzke
- Research Unit Analytical Pathology Helmholtz Zentrum München – German Research Center for Environmental Health Neuherberg Germany
| | - Achim Buck
- Research Unit Analytical Pathology Helmholtz Zentrum München – German Research Center for Environmental Health Neuherberg Germany
| | - Peter Schraml
- Institute of Pathology and Molecular Pathology University Hospital Zurich Zurich Switzerland
| | - Holger Moch
- Institute of Pathology and Molecular Pathology University Hospital Zurich Zurich Switzerland
| | | | | | | | - Franziska Erlmeier
- Institute of Pathology, University Hospital Erlangen Friedrich‐Alexander‐University Erlangen‐Nürnberg Erlangen Germany
- Comprehensive Cancer Center Erlangen‐EMN (CCC ER‐EMN) Erlangen Germany
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen Friedrich‐Alexander‐University Erlangen‐Nürnberg Erlangen Germany
- Comprehensive Cancer Center Erlangen‐EMN (CCC ER‐EMN) Erlangen Germany
| | - Axel Walch
- Research Unit Analytical Pathology Helmholtz Zentrum München – German Research Center for Environmental Health Neuherberg Germany
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In Situ Metabolomics Expands the Spectrum of Renal Tumours Positive on 99mTc-sestamibi Single Photon Emission Computed Tomography/Computed Tomography Examination. EUR UROL SUPPL 2020; 22:88-96. [PMID: 34337482 PMCID: PMC8317898 DOI: 10.1016/j.euros.2020.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 02/07/2023] Open
Abstract
Background Definite noninvasive characterisation of renal tumours positive on 99mTc-sestamibi single photon emission computed tomography/computed tomography (SPECT/CT) examination including renal oncocytomas (ROs), hybrid oncocytic chromophobe tumours (HOCTs), and chromophobe renal cell carcinoma (chRCC) is currently not feasible. Objective To investigate whether combined 99mTc-sestamibi SPECT/CT and in situ metabolomic profiling can accurately characterise renal tumours exhibiting 99mTc-sestamibi uptake. Design, setting, and participants A tissue microarray analysis of 33 tumour samples from 28 patients was used to investigate whether their in situ metabolomic status correlates with their features on 99mTc-sestamibi SPECT/CT examination. In order to validate emerging data, an independent cohort comprising 117 tumours was subjected to matrix-assisted laser desorption/ionisation mass spectrometry imaging (MALDI MSI). Outcome measurements and statistical analysis MALDI MSI data analysis and image generation were facilitated by FlexImaging v. 4.2, while k-means analysis by SCiLS Lab software followed by R-package CARRoT analysis was used for assessing the highest predictive power in the differential of RO versus chRCC. Heatmap-based clustering, sparse partial least-squares discriminant analysis, and volcano plots were created with MetaboAnalyst 3.0. Results and limitations We identified a discriminatory metabolomic signature for 99mTc-sestamibi SPECT/CT–positive Birt-Hogg-Dubè–associated HOCTs versus other renal oncocytic tumours. Metabolomic differences were also evident between 99mTc-sestamibi–positive and 99mTc-sestamibi–negative chRCCs, prompting additional expert review; two of three 99mTc-sestamibi–positive chRCCs were reclassified as low-grade oncocytic tumours (LOTs). Differences were identified between distal-derived tumours from those of proximal tubule origin, including differences between ROs and chRCCs. Conclusions The current study expands the spectrum of 99mTc-sestamibi SPECT/CT–positive renal tumours, encompassing ROs, HOCTs, LOTs, and chRCCs, and supports the feasibility of in situ metabolomic profiling in the diagnostics and classification of renal tumours. Patient summary For preoperative evaluation of solid renal tumours, 99mTc-sestamibi single photon emission computed tomography/computed tomography (SPECT/CT) is a novel examination method. To increase diagnostic accuracy, we propose that 99mTc-sestamibi–positive renal tumours should be biopsied and followed by a combined histometabolomic analysis.
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Abstract
Chromophobe renal cell carcinoma is one of four malignant kidney tumor subtypes. Due to its morphological variance in clinical pathological routine diagnostics, this subtype can cause certain difficulties. The tumor can be mistaken for more aggressive or benign tumors. In both cases the consequences of misdiagnosis regarding treatment decisions can be serious. Due to the morphological variance of the tumor, it has not yet been possible to develop a generally accepted, prognostically convincing graduation scheme. The aim is to improve the quality of diagnostics and estimation of prognosis for this subtype of tumor in order to optimize patient care.
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Affiliation(s)
- F Erlmeier
- Pathologisches Institut, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland.
- Pathologie München-Nord, Ernst-Platz-Str. 2, 80992, München, Deutschland.
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Maertens Y, Humberg V, Erlmeier F, Steffens S, Steinestel J, Bögemann M, Schrader AJ, Bernemann C. Comparison of isolation platforms for detection of circulating renal cell carcinoma cells. Oncotarget 2017; 8:87710-87717. [PMID: 29152114 PMCID: PMC5675666 DOI: 10.18632/oncotarget.21197] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/25/2017] [Indexed: 02/06/2023] Open
Abstract
Background Analysis of circulating tumor cells (CTCs) has progressed in several tumor entities. However, little is known about CTCs in clear cell renal cell carcinoma (ccRCC) patients. Aim of our studies was to build a stable in vitro fundament for isolation of CTCs in ccRCC. Methods We compared the analytical performance of different CTC isolation methods with regard to yield and purity: EpCAM based enrichment, leukocyte depletion and size based enrichment. EpCAM and cytokeratin 8 (KRT8) as biomarker for CTCs expression were evaluated in ccRCC cell lines as well as clinical samples. Results While the EpCAM based approach failed to successfully isolate tumor cells, CD45 based approaches showed intermediate recovery rates. The cell-size based Parsortix system showed highest recovery rates. EpCAM expression was low or absent in most cell lines as well as in clinical samples, whereas KRT8 was detected as a potential biomarker in ccRCC. Conclusion EpCAM based approaches might miss a high number of CTCs due to low or absent expression of EpCAM in ccRCC, as shown in cell lines as well as in patient samples. We identified the cell-sized based, label independent Parsortix system to be the most effective recovery system for ccRCC CTCs.
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Affiliation(s)
- Yvonne Maertens
- Clinic for Urology, University Hospital Muenster, Muenster, Germany
| | - Verena Humberg
- Clinic for Urology, University Hospital Muenster, Muenster, Germany
| | - Franziska Erlmeier
- Institute for Pathology and Pathological Anatomy, Technical University Munich, Munich, Germany
| | - Sandra Steffens
- Clinic for Urology, University Hospital Muenster, Muenster, Germany
| | - Julie Steinestel
- Clinic for Urology, University Hospital Muenster, Muenster, Germany
| | - Martin Bögemann
- Clinic for Urology, University Hospital Muenster, Muenster, Germany
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Erlmeier F, Weichert W, Autenrieth M, Wiedemann M, Schrader AJ, Hartmann A, Ivanyi P, Steffens S. PD-L2: A prognostic marker in chromophobe renal cell carcinoma? Med Oncol 2017; 34:71. [PMID: 28353093 DOI: 10.1007/s12032-017-0926-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/21/2017] [Indexed: 01/01/2023]
Abstract
In the context of cancer immunotherapy, PD-1 as well as PD-L1 has been widely studied in renal cell carcinoma (RCC). PD-1 and PD-L1 play a significant role as prognostic markers in clear cell renal cell carcinoma. In contrast, little is known about PD-L2 expression patterns in RCC, especially in rarer subtypes. The aim of this study was to evaluate the prevalence, distribution and prognostic impact of PD-L2 expression in chromophobe (ch)RCC. Eighty-one patients who underwent renal surgery due to chRCC were retrospectively evaluated. Tumor specimens were analyzed for PD-L2 expression by immunohistochemistry. Expression data were associated with clinicopathological parameters and overall survival (OS). Twenty-three (28.4%) patients showed a PD-L2 > median (PD-L2 high) staining intensity. No significant association between clinicopathological parameters and PD-L2 expression was identified. A significant difference between 5- and 10-year OS in dependence of PD-L2 expression was found (PD-L2 low 96.4 and 87.7% vs. PD-L2 high 87.1 and 56%; log rank, p = 0.029). However, in multivariate analysis PD-L2 expression failed to be proofed as an independent prognostic factor. In conclusion, to our knowledge this is the first study evaluating the prognostic impact of PD-L2 in a considerably large cohort of chRCC. Our results showed a significant diminished OS in dependence of PD-L2 expression. This implicates that PD-L2 might play a role as prognostic marker in chRCC demanding further evaluation.
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Affiliation(s)
- Franziska Erlmeier
- Institute of Pathology, Technical University Munich (TUM), Trogerstraße 18, 81675, Munich, Germany. .,Member of the German Renal Cell Tumor Consortium, Jena, Germany.
| | - Wilko Weichert
- Institute of Pathology, Technical University Munich (TUM), Trogerstraße 18, 81675, Munich, Germany.,Member of the German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Michael Autenrieth
- Department of Urology, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
| | - Max Wiedemann
- The Munich Cancer Registry of the Tumorzentrum Munich, Institute of Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Andres Jan Schrader
- Member of the German Renal Cell Tumor Consortium, Jena, Germany.,Clinic for Urology, University Hospital Muenster, Münster, Germany
| | - Arndt Hartmann
- Member of the German Renal Cell Tumor Consortium, Jena, Germany.,Institute of Pathology, University Hospital of Erlangen, Erlangen, Germany
| | - Philipp Ivanyi
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Sandra Steffens
- Member of the German Renal Cell Tumor Consortium, Jena, Germany.,Clinic for Urology, University Hospital Muenster, Münster, Germany
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c-Met in chromophobe renal cell carcinoma. Med Oncol 2016; 34:15. [PMID: 28035577 DOI: 10.1007/s12032-016-0874-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 12/19/2016] [Indexed: 01/05/2023]
Abstract
c-Met plays a role as a prognostic marker in clear cell renal cell carcinoma. In addition, recently the tyrosine kinase inhibitor cabozantinib targeting c-Met was approved for the treatment of advanced renal cell carcinoma (RCC). In contrast to clear cell RCC, little is known about c-Met expression patterns in rarer RCC subtypes. The aim of this study was to evaluate the prevalence, distribution and prognostic impact of c-Met expression on chromophobe (ch)RCC. Patients who underwent renal surgery due to chRCC were retrospectively evaluated. Tumor specimens were analyzed for c-Met expression by immunohistochemistry. Expression data were associated with clinicopathological parameters including patient survival. Eighty-one chRCC patients were eligible for analysis. Twenty-four (29.6%) patients showed a high c-Met expression (c-Methigh, staining intensity higher than median). Our results showed an association between c-Methigh expression and the existence of lymph node metastasis (p = 0.007). No further significant clinicopathological associations with c-Met were identified, also regarding c-Met expression and overall survival. In conclusion, to our knowledge this is the first study evaluating the prognostic impact of c-Met in a considerably large cohort of chRCC. High c-Met expression is associated with the occurrence of lymph node metastasis. This indicates that c-Met might be implicated into metastatic progression in chRCC.
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Taatjes DJ, Roth J. The Histochemistry and Cell Biology omnium-gatherum: the year 2015 in review. Histochem Cell Biol 2016; 145:239-74. [DOI: 10.1007/s00418-016-1417-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2016] [Indexed: 02/07/2023]
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