Arp2 Protein Expression In Clear Cell Rell Cell Carcinoma And Its Significance

Part I.Relation between Arp2 Protein Expression Condition and Clinicopathologic Features of Renal Clear Cell CarcinomaObjective: it has been found that Arp2 protein expression is associated with a wide variety of tumors.In this study,clear cell renal cell carcinoma post-operative tissue paraffin embedding samples were collected and immunohistochemistry method was used to analyze the expression condition of Arp2 protein in the renal clear cell carcinoma and to study its relation with relevant clinicopathologic features of renal clear cell carcinoma.Methods: 306 cases of nephrectomy pathological specimens in our hospital from January 2010 to December 2015 were collected and 60 cases of peritumorial normal tissue pathological specimens were randomly selected as controls.Immunocytochemistry using tissue chip was adopted to detect the expression condition of Arp2 protein and the relation between Arp2 expressionsand clinicopathologic indexes of patients with renal clear cell carcinoma.Results: 1.Arp2 protein is mainly expressed in the cytoplasm of positive cells;Arp2 protein were expressed both in normal renal tissues and clear cell renal cell carcinoma,with positive expression rates of 81.7% and 30%(P<0.001),respectively.2.Arp2 protein expression condition was related to tumor diameter,pathological stage,Furman grading,tumor with cystic degeneration,tumor with pelvis invasion,tumor with peri-renal fat invasion,tumor with sarcoma change,tumor with vascular invasion,tumor with necrosis of patients(P<0.05),but had no significant relation with patients' age,gender,tumor site,kidney neoplasms with cystic degeneration(P>0.05).Spearman rank correlation analysis found that protein expression intensity was positively related to tumor diameter,pathological stage,Fuhrman grading,tumor with cystic degeneration tumor with pelvis invasion,tumor with peri-renal fat invasion,tumor with sarcoma change,tumor with vascular invasion,tumor with necrosis,etc.,(P<0.05,R>0).Conclusions: the expression of Arp2 protein in clear cell renal cell carcinoma is evidently higher than that in the peritumorial normal tissue.The high expression of Arp2 protein may be the predicating factor of poor prognosis of renal clear cell carcinoma.Part II.The Relation between Arp2 Protein Expression Condition and Post-operative Prognosis of Renal Clear Cell CarcinomaObjectives: it has been found that Arp2 protein expression is not only related to clinical pathology of tumors,but also has a significant relation with the poor prognosis of tumors.This study is to discuss its relation with postoperative survival condition of patients with clear cell renal cell carcinoma.Methods:(1)Overall Survival: phone follow-ups were conducted on 306 cases of the first part and the survival time was calculated from the day of clear cell renal cell carcinoma operation.Patients were followed up via phone calls.The follow-up was ended at the day of death or the expiration date.(2)Disease-free Survival: 11 patients that had been found with metastasis before operation and lymphatic metastasis after operation were excluded.B ultrasound,CT examination,chest X-ray,MRI,IVP,systematic bone scanning,selective angiography and reoperation were conducted to check if there is any clinical relapse or metastasis.The follow-up was ended at the day of relapse or the expiration date.The expiration date of follow-ups was December 2016.2.Kaplan-Meier survival curve and Cox regression analysis were used to evaluate the value of Arp2 protein expression for predicating the prognosis of clear cell renal cell carcinoma.3.R software was used to establish predicating nomogram model of renal clear cell carcinoma postoperative relapse-free survival and C-index was used to evaluate the accuracy of the model,Bootstrap method for internal validation,and correction curves were drawn.Results: 1.The total follow-up time of 306 cases of patients was 2-74 months and the median follow-up time was 31 months.The total follow-up time of 259 cases of patients was 3-74 months and the median follow-up time was 32 months.During this period,29 patients died,32 patients got relapse.Kaplan-Meier survival curve indicates that compared with low expression Arp2 protein,high expression Arp2 protein had a shorter survival time and disease-free survival(Log-rank P<0.001);Cox multi-factor regression analysis indicates that Arp2 protein high expression,high TNM stages,high Fuhrman staging and tumor with necrosis predicated a poor post-operative prognosis of clear cell carcinoma of kidney(P<0.05).2.The established predicating nomogram model can accurately predicate postoperative relapse-free survival of renal clear cell carcinoma(C-index=0.867;95%CI,0.8305~0.9035).Conclusions: high expression of Arp2 protein indicates a poor prognosis of renal clear cell carcinoma.New established predicating nomogram model of clear cell renal cell carcinoma postoperative Recurrence-free survival can achieve individualized predication.