Prognostic Value of CD44 and Ki-67 in Renal cell carcinoma

Abstract

Renal cell carcinoma accounts for approximately 3% of adult malignancies and 80 - 90% of all primary malignant renal tumors. The origin of renal cell carcinoma is from the proximal renal tubular epitheliumtumor stage and nuclear grade were considered as the most important prognostic variables for patients with renal cell carcinoma but they are insufficient to predict the clinical behavior of this tumor. Ki-67 is a nuclear proteinthat is widely accepted as a reliable indicator of cell proliferation and has a demonstrable utility as a prognostic marker for several malignancies The cluster of differentiation 44 (CD44) is a transmembrane glycoprotein that involved in cell-cell and cell-matrix interactions; and its expression has been linked totumor cell invasion and tumor metastasis in several cancers.The objective of this study is to provide a better understanding of the biology of renal cell carcinoma by: Evaluation of the expression of CD44 and Ki- 67 in renal cell carcinoma. Correlate their expression with the usual prognostic variables (tumor size and stage and nuclear grade). Thirty cases of nephrectomy for renal cell carcinomawere included in this retrospective study. All formalin fixed and paraffin embedded tissues were retrieved from thepathology department of Al- Harreri surgical specialties teaching hospital and teaching Laboratories in the Medical City during the period from January 2010 to March 2013. Hematoxylin and eosin sections were prepared by routine technique and also 3 µm thickness sections were stained immunohistochemically for CD44 and Ki-67.The clear cell renal cell carcinoma was the most common histological subtype (86.7% of the cases). The expression of ki-67 was positive in twenty five of cases (83.3%) while CD44 was expressed in twenty seven of cases (90%) out of thirty. The expression of CD44 and Ki-67 was increase progressively with increase nuclear grade and tumor stage. The expression of CD44 and Ki-67 showed weak correlation with tumor size and there was no significant correlation with age, gender and histological type of tumor. The expression of CD44 and Ki-67 were significantly associated with tumor stage and nuclear grade of renal cell carcinoma. CD44 and Ki-67can be used as an additional adverse prognostic factor in patients with renal cell carcinoma.