Prognostic significance of survivin, P53 and PGP in renal cell carcinoma

SUMMARY?Prognostic significance of survivin, p53 and PGP in Renal Cell Carcinoma?Purpose of review: Renal cell carcinoma (RCC) consists 3% of all human malignancies. Morethan the standart prognostic parameters are needed to identify the tumors with metastaticpotential, but classified in low risk group. By the way, various biologic molecules are beingstudied for their prognostic significance, worldwide. In this study, we evaluated the proteinssurvivin and p53 which are entegrated in cell cycle regulation and apoptosis, and P-glycoproteinwhich plays a role in multidrug resistance.Material and methods: We established the data from pathology reports, H&E stained slides of104 patients who has undergone radical nephrectomy, diagnosed as RCC, and had archivalmaterial, between 1986-2004. Slides which contain tumour and normal renal parenchyma werestained immunohistochemically for survivin, p53, PGP antibodies by standart streptavidin biotinmethod. Immunohistochemical evaluation was made semiquantitatively, and the results wereanalysed for the correlation of the expressions with tumour stage, Fuhrman nuclear grade,histologic subtype, and survival.Results: Of the 34 cases with positive control, only three were positive for PGP. 14 (13.5%)were positive above the cut-off value (10%) for p53, and p53 positivity was found to becorrelated with tumour stage (p=0.014). 49 of 104 (52.9%) cases were nuclear and/orcytoplasmically positive for survivin. PGP positivity did not show any correlation with theclinical and pathological parameters. p53 correlated with grade and stage, but not with survival.Survivin positivity also did not correlate with clinical and pathological prognostic parameters,however, there was similar staining patterns between the cases with initial or late metastaticdisease. In addition, there was a significant survivin staining difference between the metastaticand non-metastatic diseases.Conclusion: p53 seems to correlate indirectly with the prognosis, and is not a prognosticindicator for RCC. Survivin may be helpfull in assassing the tumours which have metastaticpotential, but does not seem to be a prognostic marker. PGP looks like playing a minor role inchemoresistance of RCC.