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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Cancer 1/2017

ABCG2 is a potential prognostic marker of overall survival in patients with clear cell renal cell carcinoma

BMC Cancer > Ausgabe 1/2017
Haofei Wang, Fangxiu Luo, Zhe Zhu, Zhaoping Xu, Xin Huang, Renyi Ma, Hongchao He, Yu Zhu, Kun Shao, Juping Zhao
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12885-017-3224-6) contains supplementary material, which is available to authorized users.



ATP-binding cassette sub-family G member 2 (ABCG2) is a semi-transport protein that plays a major role in multidrug resistance. We aimed to evaluate the prognostic significance of ABCG2 expression in patients with clear cell renal cell carcinoma.


From 2008 to 2013, 120 patients with clear cell kidney cancer underwent surgery with paraffin-embedded specimens and necessary clinical information available. Immunohistochemistry staining was performed to grade the expression of ABCG2 as ABCG2(−): less than 10% of tumor cells stained; ABCG2(+): weak membrane staining; and ABCG2(++): moderate or strong membrane staining. The overall survival was analyzed using Kaplan-Meier method. Multivariable Cox regression evaluated the independent predictors for overall survival.


ABCG2(−) was diagnosed in 57 (48%) patients, ABCG2(+) in 52 (43%) patients, and ABCG2 (++) in 11(9.2%) patients. ABCG2 expression significantly correlated with the five-year survival (p < 0.001) and distant metastasis (p = 0.001). In the multivariable analysis, besides Fuhrman grade, the ABCG2 expression was an independent prognostic marker for overall survival (p < 0.001) when incorporating other relevant tumor and clinical parameters (HR = 3.84, 95% CI: 1.92–7.70).


The current data suggests that ABCG2 may serve as a prognostic marker for overall survival in patients with clear cell renal cell carcinoma. Further studies with large cohorts of patients will be essential for validating these findings and defining the clinical utility of ABCG2 in the patient population.
Additional file 1: Fig. S1. The RNA-seq V2 data was downloaded from TCGA database and analyzed by the cBioPortal-MSKCC tool. Statistical analysis was performed between clear cell RCC and all the other genitourinary tumors available from TCGA database using unpaired t-tests and nonparametric test. (Significance was considered as * = p < 0.5; **p = < 0.01; *** = p < 0.001). UCEC (Uterine Corpus Endometrial Carcinoma) N = 177. BUC (Bladder Urothelial Carcinoma) N = 408. OSC (Ovarian Serous Cystadenocarcinoma) N = 122. KRPCC (Kidney Renal Papillary Cell Carcinoma) N = 291. UC (Uterine Carcinosarcoma) N = 57. ADC (Adrenocortical Carcinoma (TCGA, Provisional) N = 79. KCP (Kidney Chromophobe) N = 66. Clear Cell RCC (Kidney Renal Clear Cell Carcinoma) N = 598. (PDF 58 kb)
Additional file 2: Fig. S2. The mRNA data was downloaded from TCGA database on the public scientific website: https://​mexpress.​be/​ and drafted into graphics. A, comparison of mRNA levels of ABCG2 between normal kidney tissue and tumor, p = <0.0001. B, comparison of mRNA levels of ABCG2 at different stages, p = 0.024. C, comparison of mRNA levels of ABCG2 in different grades, p = 0.503. KIRC(Kidney renal clear cell carcinoma). (PDF 381 kb)
Additional file 3: Fig. S3. The TCGA data about ABCG2 expression and overall survival in Kidney clear cancer were available on the website: https://​www.​oncolnc.​org. Kaplan-Meier survival was significant for various groups based on the expression of ABCG2, p < 0.001. (PDF 180 kb)
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