Dados do Trabalho

Título

Analysis of PTEN/MMCA1 gene and Akt protein associated to clinical and anatomopathologic features as prognostic factors in renal cell carcinoma patients.

Introdução

Renal cell carcinoma account for 3% of neoplasms. Despite the increase in the number of incidentally diagnosed cases, many patients are metastatic at diagnosis and tumours of same stage have different evolution.

Objetivo

This study was designed to evaluate the hybridization in situ reaction and immunohistoquimical expression of PTEN and Akt protein, looking to the influence of those on disease free survival (DFS) and global survival (GS) such as the concurrence between the results found in hybridization and immunohistoquimical reactions for PTEN, the correlation between the Akt and PTEN immunohistoquimical reactions and the most significant clinical and anatomopathologic factors on survivals

Método

It were analysed 110 patients with renal cell carcinoma (RCC) submitted to surgical resection of primary neoplasm. Epidemiologic factors, clinical factors, anatomopathologic factors, TNM stage and hybridization in situ and immunohistoquimical results were correlated to survivals. The reactions were analised in a tissue microarray with the 110 cases.

Resultados

The mean follow-up was 41,95 months. The overall survival was influenced on multivariate analysis by: symptons at the diagnosis, performance status (karnofski and Ecog), clinical tumor stage IV, tumor recurrence and high Fuhrman grade (p<0,05). The disease free survival was only influenced by clinical tumor stage II and III on multivariate analysis (p<0,05). The results from hybridization in situ reaction did not influence the OS (p=0.486) and DFS (p=0.344). The majority of patients showed hipoexpression on immunohistoquimical reaction (88,2%), but it were not significant on global survival (p=0,816) and disease free survival (p=0,273). Despite of the immunohistoquimical results didn´t showed significantlyon survival, patients with positive PTEN expression had not tumor recurrence during the follow-up. There was a low concurrence and not significant association between PTEN hybridization and PTEN immunohistochemistry (Kappa=0,146, p=0,235). There were no statiscaly differences on GS (p=0,934) and DFS (p=0,705) according to imunohistoquemistry for phosphorilated Akt protein expression. The Akt overexpression did not correlated to the PTEN low expression (OR=0,169, p=0,235). The DFS and GS were respectively 74,8% and 76,8%.

Conclusão

the habitual renal prognostic factors were significant on survivals. PTEN deletion at hybridization situ reaction or PTEN and Akt immunohistochemistry analysis did not influence the GS and DFS.

Palavras-chave

PTEN, Akt, renal cell carcinoma.