Analysis of various potential prognostic markers and survival data in clear cell renal cell carcinoma

ABSTRACT Purpose Clear cell renal cell cancers frequently harbor Von Hippel-Lindau gene mutations, leading to stabilization of the hypoxia-inducible factors (HIFs) and their target genes. In this study, we investigated the relationship between vascular endothelial growth factor (VEGF), HIF-1α, HIF-2α, p53 positivity, microvessel density, and Ki-67 rates with prognostic histopathologic factors (Fuhrman nuclear grade, stage, and sarcomatoid differentiation) and survival in clear cell renal cell carcinomas. Material and Methods Seventy-two nephrectomy specimens diagnosed as clear cell renal cell carcinoma between 2000 and 2012 were reevaluated. Immunohistochemically VEGF, HIF-1α, HIF-2α, p53, CD34 (for microvessel density evaluation), and Ki-67 antibodies were applied to the tumor areas. The relationships of these antibodies with prognostic factors and survival rates were evaluated with statistical analyses. Results Mean survival time was 105.6 months in patients with ccRCC. Patients with high expression of VEGF, HIF-1α and HIF-2α positivity, a high Ki-67 proliferation index, and a high microvessel density evaluation score had a shorter survival time (p<0.05). Conclusions Our findings supported that with the use of these immunohistochemical markers, prognosis of renal cell carcinoma may be predicted at the first step of patient management. New treatment modalities targeted to HIF-1α and HIF-2α might be planned as well as VEGF-targeted therapies in the management of clear cell renal cell carcinomas.

Could the mosaic pattern of chromosomal abnormality predict overall survival of patients with myelodysplastic syndrome?

Objective/background: Myelodysplastic syndromes [MDSs] are a group of monoclonal hematopoietic diseases consisting of a number of various entities. The presence of differences in chromosomal content of cells within the same individual is known as chromosomal mosaicism. The impact of mosaic pattern on the prognosis of MDS has been unclear. In this study, we aimed to determine the impact of mosaic pattern on the survival of patients with MDS

Methods: We retrospectively evaluated 119 patients diagnosed with MDS at the Trakya University Faculty of Medicine, Department of Hematology. Giemsa-Trypsin-Giemsa banding was used to evaluate chromosomal abnormality. The effect of chromosomal abnormality mosaicism on overall survival and transformation to acute leukemia was evaluated by Kaplan-Meier survival analysis

Results: The mean age at diagnosis was 66.3 years, and the mean disease duration was 24.2 months. Chromosomal abnormality was observed in 32.5% of patients. Patients with chromosomal abnormalities comprising at least 50% metaphases had significantly lower overall survival than patients with abnormality comprising up to 50% of all abnormal metaphases [p = .003]. There were no differences in transformation to acute leukemia among patients with higher and lower chromosomal mosaicism [p = .056]

Conclusion: The most important outcome of this study was to demonstrate worse overall survival rates in MDS patients with higher abnormal chromosomal mosaicism than patients with lesser abnormal chromosomal mosaicism. Higher levels of abnormal chromosomal mosaicism did not predict transformation to acute leukemia. The cause of worse outcomes of patients with higher abnormal chromosomal mosaicism may be related to clonal mass

Histopathological and immune alterations in autopsied kidneys

To collect data on all detectable histologic and immune alterations from the kidneys of 55 autopsy cases. This prospective study was carried out at the Department of Pathology, Medical Faculty, Trakya University, Edirne, Turkey. Fifty-five cases were subjected to the study among 248 autopsies that were performed in 2011 and 2012. All kidney samples were evaluated under a light microscope and fresh tissue samples were used for immunofluorescence microscopy. Immunohistochemically kappa [kappa] and lambda [lamda] antibodies were applied to the tissue sections. The glomerular, tubulo-interstitial, and vascular alterations, as well as immune depositions were noted. The microscopic morphology was close to normal histology in only 23 cases, and 23 cases had glomerular alterations. Nineteen cases had at least one immune deposition. There was immunoglobulin A deposition in 13 cases, and 9 cases showed positivity for both kappa and lamda immunohistochemically, and there was no clonal positivity. The most striking outcome of our study is the high rate of immune depositions. There was also a significant number of glomerular and nonglomerular renal alterations