Fig. 1Insulin-like growth factor II mRNA-binding protein 3 (IMP3), Ki-67, and p53 expression levels in a clear cell renal cell carcinoma (CCRCC) patient with metastasis. (A) Histologic features of CCRCC with metastasis (hematoxylin and eosin staining). (B) Immunohistochemical staining for IMP3 shows diffuse positivity in cytoplasmic and membranous pattern. (C) Ki-67 proliferating index is high (greater than 10%). (D) Immunohistochemical staining for p53 shows positivity in more than 5% of tumor cells.
Fig. 2Kaplan-Meier curves depicting the impact of insulin-like growth factor II mRNA-binding protein 3 (IMP3) expression on the metastasis-free survival (A) and cancer-specific survival (B) of patients with clear cell renal cell carcinoma.
Fig. 3Kaplan-Meier curves depicting the impact of Ki-67 proliferating index on the metastasis-free survival (A) and cancer-specific survival (B) of patients with clear cell renal cell carcinoma.
Fig. 4Kaplan-Meier curves depicting the impact of p53 expression on the metastasis-free survival (A) and cancer-specific survival (B) of patients with clear cell renal cell carcinoma.
Table 1.Comparison of clinicopathologic features by IMP3 tumor expression for patients with clear cell renal cell carcinoma
Feature |
IMP3 expression
|
p-value |
Negative (n = 105) |
Positive (n = 43) |
Age (yr) |
55.9± 11.7 (19-82) |
56.9± 11.6 (26-76) |
.648 |
Size (cm) |
5.2 ± 2.2 (2-11) |
6.6 ± 2.8 (1.0-14.0) |
.001 |
Sex |
|
|
.158 |
Male |
73 (69.5) |
35 (81.4) |
|
Female |
32 (30.5) |
8 (18.6) |
|
pT stage |
|
|
.001 |
pT1 |
74 (70.5) |
20 (46.5) |
|
pT2 |
20 (19.0) |
7 (16.3) |
|
pT3 |
11 (10.5) |
15 (34.9) |
|
pT4 |
0 (0) |
1 (2.3) |
|
Nuclear grade |
|
|
<.001 |
1 |
2 (1.9) |
0 (0) |
|
2 |
35 (33.3) |
2 (4.7) |
|
3 |
68 (64.8) |
31 (72.1) |
|
4 |
0 (0) |
10 (23.3) |
|
Sarcomatoid change |
|
|
<.001 |
Absent |
105 (100) |
37 (0) |
|
Present |
0 (0) |
6 (100) |
|
Distant metastasis |
|
|
<.001 |
Absent |
93 (88.6) |
25 (58.1) |
|
Present |
12 (11.4) |
18 (41.9) |
|
Outcome |
|
|
<.001 |
Alive |
101 (96.2) |
32 (74.4) |
|
Died of disease |
4 (3.8) |
11 (25.6) |
|
Table 2.Comparison of clinicopathologic features by tumor expression of p53 and Ki-67 for patients with clear cell renal cell carcinoma
Feature |
n |
p53 positive (n=61)
|
Ki-67 high (n = 44)
|
n (%) |
p-value |
n (%) |
p-value |
Sex |
|
|
.092 |
|
.242 |
Male |
108 |
49 (69.5) |
|
35 (79.5) |
|
Female |
40 |
12 (30.5) |
|
9 (20.5) |
|
pT stage |
|
|
.966 |
|
<.001 |
pT1 |
94 |
40 (65.8) |
|
21 (47.7) |
|
pT2 |
27 |
9 (14.8) |
|
7 (15.9) |
|
pT3 |
26 |
11 (18.0) |
|
15 (34.1) |
|
pT4 |
1 |
1 (1.6) |
|
1 (2.3) |
|
Nuclear grade |
|
|
.605 |
|
<.001 |
1 |
2 |
1 (1.6) |
|
0 (0) |
|
2 |
37 |
15 (24.6) |
|
4 (9.1) |
|
3 |
99 |
39 (63.9) |
|
33 (75.0) |
|
4 |
10 |
6 (9.8) |
|
7 (15.9) |
|
Sarcomatoid change |
|
|
.23 |
|
.009 |
Absent |
142 |
57 (93.4) |
|
39 (88.6) |
|
Present |
6 |
4 (6.6) |
|
5 (11.4) |
|
Distant metastasis |
|
|
.497 |
|
.007 |
Absent |
118 |
47 (77.0) |
|
29 (65.9) |
|
Present |
30 |
14 (23.0) |
|
15 (34.1) |
|
Outcome |
|
|
.651 |
|
.130 |
Survival |
133 |
54 (88.5) |
|
37 (84.1) |
|
Died of disease |
15 |
7 (11.5) |
|
7 (15.9) |
|
Table 3.Comparison of IMP3 expression by 53 and Ki-67 expression for patients with clear cell renal cell carcinoma
Feature |
Tumor IMP3 expression
|
p-value |
Negative (n = 105) |
Positive (n=43) |
p53 |
|
|
<.001 |
Negative |
72 (68.6) |
15 (34.9) |
|
Positive |
33 (31.4) |
28 (65.1) |
|
Ki-67 PI |
|
|
<.001 |
Low (<10%) |
87 (82.9) |
17 (39.5) |
|
High (≥ 10%) |
18 (17.1) |
26 (60.5) |
|
Table 4.Associations between clinicopathologic parameters and outcome of patients with clear cell renal cell carcinoma
Feature |
Metastasis
|
Died of disease
|
Absent (n = 118) |
Present (n=30) |
p-value |
Absent (n = 133) |
Present (n = 15) |
p-value |
Age (yr) |
55.4±11.7 |
59.3±13.1 |
.100 |
56.1±11.7 |
57.5±11.2 |
.663 |
Size (cm) |
5.3±2.4 |
6.8±2.6 |
.002 |
5.5±2.4 |
6. 9±3.0 |
.034 |
Sex |
|
|
.332 |
|
|
.357 |
Male |
84 (71.2) |
24 (80.0) |
|
95 (71.4) |
13 (86.7) |
|
Female |
34 (28.8) |
6 (20.0) |
|
38 (28.6) |
2 (13.3) |
|
pT stage |
|
|
<.001 |
|
|
<.001 |
pT1 |
82 (69.5) |
12 (40.0) |
|
88 (69.5) |
6 (40.0) |
|
pT2 |
24 (20.3) |
3 (10.0) |
|
27 (20.3) |
0 (0.0) |
|
pT3 |
12 (10.2) |
14 (46.7) |
|
18 (10.2) |
8 (53.3) |
|
pT4 |
0 (0) |
1 (3.3) |
|
0 (0) |
1 (6.7) |
|
Nuclear grade |
|
|
<.001 |
|
|
<.001 |
1 |
2 (1.7) |
0 (0) |
|
2 (1.5) |
0 (0) |
|
2 |
36 (30.5) |
1 (3.3) |
|
36 (27.1) |
1 (6.7) |
|
3 |
78 (66.1) |
21 (70.0) |
|
91 (68.4) |
8 (53.3) |
|
4 |
2 (1.7) |
8 (26.7) |
|
4 (3.0) |
6 (40.0) |
|
Sarcomatoid change |
|
|
.001 |
|
|
<.001 |
Absent |
117 (99.1) |
25 (83.3) |
|
132 (99.2) |
10 (66.6) |
|
Present |
1 (0.9) |
5 (16.7) |
|
1 (0.8) |
5 (33.4) |
|
IMP3 |
|
|
<.001 |
|
|
<.001 |
Negative |
93 (78.8) |
12 (40.0) |
|
101 (71.2) |
4 (26.7) |
|
Positive |
25 (21.2) |
18 (60.0) |
|
32 (28.8) |
11(73.3) |
|
p53 |
|
|
.497 |
|
|
.651 |
Negative |
71 (60.2) |
16 (53.3) |
|
79 (59.4) |
8 (53.3) |
|
Positive |
47 (39.8) |
14 (46.7) |
|
54 (40.6) |
7 (46.7) |
|
Ki-67 PI |
|
|
.007 |
|
|
.130 |
Low (<10%) |
89 (75.4) |
15 (50.0) |
|
96 (72.2) |
8 (53.3) |
|
High (> 10%) |
29 (24.6) |
15 (50.0) |
|
37 (27.8) |
7 (46.7) |
|