Value of immunohistochemical Ki-67 and p53 determinations as predictive factors of outcome in renal cell carcinoma

Prognostic Factors in Renal Cell Carcinoma: An Evaluation of T-Stage, Histopathological Grade, p53, Ki-67, COX-2, and Her-2 Expressions

“…The incidence of p53-and Ki-67-positive expression in RCC tumors was low in RCC studies (Kankuri-Tammilehto et al 2010, Kirkali et al 2001, Haitel et al 2000, Rioux-Leclercq et al 2000. It is known that in addition to melanoma, RCC belongs to tumors with a low incidence of p53 mutations compared to, e.g.…”

“…Several studies have failed to demonstrate any statistically significant differences in the survival of patients with different grades, when all three or four grades are analyzed separately (Kankuri et al 2006, Rioux-Leclercq et al 2000, Usubutyn et al 1998, Selli et al 1983 although when analyzing only the highest and the lowest grades the statistically significant difference in survival have been found (Kankuri et al 2006). This is partly because, as yet, no consensus has been reached on a universal tumor grading system (Kanamaru et al 2001, Medeiros et al 1997.…”

“…Additionally, reducing the grades in the Fuhrman system has been proposed, for better outcome stratification (Rioux-Leclercq et al 2007, Lohse et al 2002, Bretheau et al 1995. Overall, histopathological grade seem to be imprecise for prognostic evaluation in RCC patients (Uchida et al 2002, Rioux-Leclercq et al 2000, Lanigan et al 1994). …”

“…Published results on the association of p53 with survival have been controversial, some studies suggesting positive p53 associating with poor survival (Shvarts et al 2005, Zigeuner et al 2004, Uchida et al 2002, Haitel et al 2000, while others have observed no association (Itoi et al 2004, Olumi et al 2001, Rioux-Leclercq et al 2000, Hofmockel et al 1996. In the study of Phuoc et al (2007), p53 was significantly associated with survival in univariate analysis, but the association was not independent.…”

“…An association between Ki-67 and high T-stage and metastases development have been observed (Kankuri et al 2006, Dudderidge et al 2005, Rioux-Leclercq et al 2000, indicating that Ki-67 is a marker for aggressive disease in RCC with an increased risk of early metastases development. Ki-67 has been reported to independently predict survival following nephrectomy in many studies (Dudderidge et al 2005, Bui et al 2004, Itoi et al 2004, Rioux-Leclercq et al 2000, Aaltomaa et al 1997. Ki-67 has been observed to increase in sarcomatoid change (Kanamaru et al 1999), indicating different protein expression profiles in different entities according to the Heidelberg classification.…”