Expression And Clinicopathological Significance Of CYP4A11 And LEPR In Clear Cell Renal Cell Carcinoma

Objective:To investigate the expression of cytochrome P450 4A11(CYP4A11)and leptin receptor(LEPR)in renal clear cell carcinoma(CCRCC)and to analyze the relationship between the expression of CYP4A11,LEPR and the clinic pathological features and prognosis of CCRCC,and to discuss the role of these in the occurrence and development of CCRCC.Methods:The expression of CYP4A11,LEPR in 151 cases of CCRCC and 48 cases of adjacent tissues were detected and analyzed by immunohistochemistry,and the expression in different WHO/ISUP nuclear grades were analyzed.The relationship between the expression of CYP4A11,LEPR and clinicopathological features with CCRCC were analyzed.Survival analysis and prognostic analysis were analyzed.Results:The expression levels of CYP4A11 and LEPR in CCRCC were lower than adjacent normal tissues(Z=-2.100,-8.057,p<0.05).The expression of CYP4A11 and LEPR in different WHO/ISUP nuclear grades were statistically significant(H=12.802,35.589,p<0.05).The expression of CYP4A11 in gradeⅠand gradeⅣ,gradeⅡand gradeⅣwere statistically significant(p<0.05).The expression level of CYP4A11 in CCRCC was related to the gender,tumor maximum diameter,clinical stage,Ki-67 index,sarcomatoid change,distant metastasis(χ~2=4.438～13.082,p<0.05).There were significant differences in the expression of LEPR between grade I and grade II,grade III,grade IV,grade II and grade IV(p<0.05).The expression level of LEPR in CCRCC was related to the maximum diameter of the tumor,clinical stage,Ki-67 index,sarcomatoid change,distant metastasis(χ~2=6.151～8.442,p<0.05).Kaplan-Meier survival analysis showed that the expression level of CYP4A11,Ki-67,gender,tumor maximum diameter,WHO/ISUP nuclear grade,clinical stage,sarcomatoid change and distant metastasis were related to the overall survival time of patients with CCRCC(p<0.05).Univariate Cox regression analysis showed that gender and tumor maximum diameter,WHO/ISUP nuclear grade,clinical stage,sarcomatosis,distant metastasis,and CYP4A11,Ki-67 levels had an impact on the overall survival time of patients.Multivariate Cox regression analysis showed that clinical stage and distant metastasis were independent risk factors for overall survival of patients with CCRCC.Conclusion:CYP4A11 and LEPR may participate in the occurrence and progress of CCRCC.The expression levels of CYP4A11 and LEPR were related to the differentiation,proliferation,growth and metastasis of CCRCC,and the expression level of CYP4A11 was related to the overall survival time.CYP4A11 and LEPR expression can be used as the index to judge the biological behavior of CCRCC.Clinical stage and distant metastasis were independent risk factors affecting the total survival time of CCRCC patients.