Background
Methods
Patients and samples
Patient | ||
---|---|---|
No. of patients | 77 | |
Age (yrs) | 63.1 (39–83) | |
Sex (male/female) | 48/29 | |
follow-up times (months) | 19 (3–43) | |
Tumor
| ||
Histology (clear cell/cell/sarcomatoid differentiation) | 57/11/9 | |
Histological Fuhrman grading (G1/G2/G3/G4) | 9/32/29/7 | |
pT stage (T1/T2/T3/T4) | 24/19/32/2 | |
pN stage (T0/N1/N2) | 62/12/3 | |
Microscopic vascular invasion (v0/v1) | 28/49 | |
Metastasis (M0/M1) | 52/25 | |
Surgery
| Radical nephrectomy | 77 |
with cavotomy with thrombectomy for > T3b tumor | (9) | |
with RPLND* for > N1 tumor | (15) |
Performance and evaluation of 18F-FDG PET /CT
Western blotting
Immunohistochemistry
Statistical analysis
Results
SUVmax and expression of pAkt and pS6 in the primary tumor
SUVmax in the primary tumor | Western blotting in primary tumor | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Number=77 | Number=77 | pAkt (Ser-473) | pAkt (Thr-308) | pS6K (Ser-235/236) | |||||||
mean ± S.D | P value | mean ± S.D | P value | mean ± S.D | P value | mean ± S.D | P value | ||||
Tissue | tumor | n=77 | 6.97 ± 5.96 | n=77 | 3.91 ± 3.01 | 0.000001 | 2.83 ± 2.13 | 0.000009 | 2.43 ± 1.58 | 0.000021 | |
non-tumor | n=77 | 1.00 | 1.00 | 1.00 | |||||||
Histological differentiation (Fuhrman grade) | G1 | n=9 | 2.72 ± 0.66 | 0.000073 | n=9 | 1.54 ± 0.57 | 0.000041 | 1.21 ± 0.36 | 0.000089 | 1.13 ± 0.15 | 0.000079 |
G2 | n=32 | 3.90 ± 2.33 | n=32 | 2.57 ± 2.03 | 2.03 ± 1.57 | 1.86 ± 1.08 | |||||
G3 | n=29 | 8.80 ± 3.79 | n=29 | 5.16 ± 2.73 | 3.46 ± 1.85 | 2.81 ± 1.23 | |||||
G4 | n=7 | 18.67 ± 10.23 | n=7 | 8.09 ± 3.49 | 6.00 ± 2.71 | 5.19 ± 2.07 | |||||
pT stage | pT1-2 | n=43 | 3.77 ± 2.02 | 0.000019 | n=43 | 2.43 ± 1.74 | 0.000029 | 1.93 ± 1.49 | 0.000083 | 1.75 ± 0.95 | 0.000100 |
pT3-4 | n=34 | 10.91 ± 6.82 | n=34 | 5.83 ± 3.24 | 4.00 ± 2.27 | 3.31 ± 1.79 | |||||
Microscopic vascular invasion | v0 | n=28 | 3.33 ± 1.46 | 0.000061 | n=28 | 2.08 ± 1.22 | 0.000100 | 1.67 ± 1.14 | 0.000200 | 1.60 ± 0.78 | 0.001000 |
v1 | n=49 | 9.01 ± 6.55 | n=49 | 4.97 ± 3.23 | 3.50 ± 2.28 | 2.91 ± 1.72 | |||||
pN stage | N0 | n=62 | 5.58 ± 5.80 | 0.000053 | n=62 | 3.13 ± 2.54 | 0.000076 | 2.41 ± 2.00 | 0.000200 | 2.04 ± 1.31 | 0.000092 |
N1-2 | n=15 | 12.38 ± 2.59 | n=15 | 7.38 ± 2.45 | 4.68 ± 1.64 | 4.14 ± 1.56 | |||||
Metastasis (cM stage) | M0 | n=52 | 4.56 ± 3.59 | 0.000029 | n=52 | 2.55 ± 2.03 | 0.000043 | 2.07 ± 1.69 | 0.000085 | 1.81 ± 1.52 | 0.000078 |
M1 | n=25 | 12.10 ± 6.78 | n=25 | 7.04 ± 2.53 | 4.57 ± 2.03 | 3.85 ± 1.16 | |||||
cell histology | clear cell carcinoma | n=57 | 4.94 ± 3.15 | 0.000069 | n=57 | 3.16 ± 2.44 | 0.000500 | 2.28 ± 1.68 | 0.000300 | 2.03 ± 1.19 | 0.001300 |
non-clear cell carcinoma | n=11 | 9.44 ± 5.04 | n=11 | 4.43 ± 3.36 | 3.21 ± 2.11 | 3.41 ± 2.24 | |||||
Sarcomatoid* | n=9 | 16.54 ± 9.37 | n=9 | 8.56 ± 1.88 | 6.17 ± 2.02 | 3.95 ± 1.59 |
Higher SUVmax and elevated expression of pAkt and pS6 of the primary tumor was associated with its aggressive and metastatic profiles
A higher SUVmax and increased expression of pAkt and pS6 of the primary tumor was associated with early relapse following radical nephrectomy and with shorter overall survival
Recurrence-free survival in cN0M0 cases | ||||||
---|---|---|---|---|---|---|
Variable | Unfavorable/favorable characteristics | No. of Patients | Analysis | Relative risk | 95% confidential interval | P value |
p-SUVmax*
|
high/low
|
26/26
|
Univariate (U)
|
14.361
|
4.283 - 64.472
|
0.00940
|
Multivariate (M)
|
1.714
|
0.021 - 142.351
|
0.64270
| |||
pAkt (Ser473)
|
high/low
|
26/26
|
U
|
5.895
|
1.688 - 50.514
|
0.03910
|
M
|
2.374
|
0.062 - 367.647
|
0.78520
| |||
pAkt (Thr308)
|
high/low
|
25/27
|
U
|
5.321
|
1.621 - 45.612
|
0.04810
|
2.157
|
0.069 - 397.026
|
0.79130
| ||||
pS6
|
high/low
|
26/26
|
U
|
3.994
|
0.466 - 34.272
|
0.12190
|
M
| ||||||
Grade
|
4/3/2/1
|
2/13/28/9
|
U
|
11.397
|
3.320 - 33.119
|
0.00007
|
M
|
31.171
|
1.836 - 529.228
|
0.01730
| |||
pT
|
4,3/2,1
|
13/39
|
U
|
7.807
|
1.920 - 31.753
|
0.00410
|
M
|
5.151
|
0.187 - 151.279
|
0.15370
| |||
v
|
1/0
|
24/28
|
U
|
4.941
|
1.016 - 24.035
|
0.04780
|
M
|
2.355
|
0.156 - 35.559
|
0.53630
| |||
cell type
|
sarcomatoid/non-cc/cc*
|
3/9/40
|
U
|
7.051
|
2.634 - 18.876
|
0.00010
|
M
|
1.029
|
0.091 - 11.577
|
0.78180
|