Ano de Publicação: 2017
AUTORIA
Daniel Beltrame Ferreiraa,∗, Walter Henriques da Costaa, Diego Abreu Clavijoc, Ricardo Deciac,
Isabela Werneck Cunhab,d, Luciana Schultzd, Rafael Malagoli Rochad,
Gustavo Cardoso Guimar˜aese and Stˆenio de C´assio Zequia,b
aUrology Division, Department of Pelvic Surgery, AC Camargo Cancer Center, São Paulo, Brazil
bNational Institute for Science and Technology in Oncogenomics and Therapeutic Innovation
cDepartment of Urology, Pasteur Hospital, Montevideo, Uruguay
dDepartment of Anatomic Pathology, AC Camargo Cancer Center, São Paulo, Brazil
eChairman of Urology Division, Department of Pelvic Surgery, AC Camargo Cancer Center, São Paulo, Brazil
RESUMO
Objective: To evaluate immunohistochemical erythropoietin (EPO) expression in clear cell renal cell carcinoma (ccRCC),
its association with major clinicopathological variables and its prognostic impact.
Methods: A total of 220 patients with renal cell carcinoma (RCC) surgically treated between 1989 and 2009 were evaluated
in this multi-institutional study. All the cases were reviewed by a single pathologist and the immunohistochemical reactivity
to EPO was analysed using tissue microarray.
Results: A total of 176 patients with ccRCC were considered, with an average of 48 months of follow-up. Of the tumours
evaluated, 47 (26.7%) were negative for EPO expression, and 129 (73.3%) were positive. EPO expression was associated with
incidental tumour (p = 0.016), tumour size (p = 0.015), Karnofsky Performance Score (KPS) (p = 0.016), blood transfusion
(p = 0.009) and adrenal involvement (p = 0.038). The median ages of the patients with positive and negative EPO expression
were 56.2 years and 66.6 years. Immunohistochemical EPO expression affected overall survival (OS) and disease-specific
survival (DSS) rates. The DSS rates of the patients whose tissue was positive and negative for EPO expression were 85.3%
and 76.1%, respectively (p = 0.044). In a multivariate analysis, the absence of EPO expression proved to be a bad prognostic
factor and negatively affected the OS (p < 0.001) and DSS (p < 0.001) rates.
Conclusion: The absence of tumourEPOexpression is an independent predictive factor with a negative effect on survival rates.
The use of EPO as possible marker in the management of ccRCC patients requires further studies and a better understanding
of the role of EPO in tumour biology.