High mucin-7 expression is an independent predictor of adverse clinical outcomes in patients with clear-cell renal cell carcinoma
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Mucin-7 is a member of the secreted mucins family. Mucins might play a crucial role during tumor development and its aberrant expression was observed in several types of tumor. Our study aims to evaluate the prognostic significance of Mucin-7 expression in postoperative clear-cell renal cell carcinoma (ccRCC) patients. In this retrospective study, we enrolled 392 patients with ccRCC undergoing nephrectomy between 2008 and 2009 in a single center. The median follow-up was 73 months (range 39–74 months). Mucin-7 expression was evaluated by immunohistochemistry protocol on ccRCC specimens. Kaplan-Meier survival analysis was conducted to compare survival curves. Univariate and multivariate Cox regression models were applied to assess the impact of prognostic factors in overall survival (OS) and recurrence-free survival (RFS). A nomogram was then constructed based on the independent prognosticators identified on multivariate analysis. The results displayed that Mucin-7 expression was significantly associated with tumor size (p = 0.034), pT stage (p = 0.004), TNM stage (p = 0.008), and necrosis (p = 0.043). Patients with high Mucin-7 expression had significant worse outcomes in both OS (p < 0.001) and RFS (p < 0.001) compared to those with low Mucin-7 expression. MUC7 expression was considered as an independent predictive factor for OS (HR 2.286; 95 %CI 1.167–4.475; p = 0.016) and RFS (HR 2.055; 95 %CI 1.086–3.887; p = 0.027). A nomogram integrating Mucin-7 expression and other independent prognosticators was constructed. In summary, the high Mucin-7 expression is a potential prognosticator of adverse clinical outcome in ccRCC patients after surgery.
KeywordsClear-cell renal cell carcinoma Mucin-7 Overall survival Recurrence-free survival Prognostic biomarker
This study was funded by grants from National Key Projects for Infectious Diseases of China (2012ZX10002012-007, 2016ZX10002018-008), the National Natural Science Foundation of China (31100629, 31270863, 81372755, 31470794, 81401988, 81402082, 81402085, 81471621, 81472227, 81472376, 31570803, 81501999, and 81572352), and Program for New Century Excellent Talents in University (NCET-13-0146). All these study sponsors have no roles in the study design, collection, analysis, and interpretation of data.
Sontung and Nguyenhoang were responsible for the acquisition of data, analysis and interpretation of data, statistical analysis, and drafting of the manuscript; D. Liu, L. Xu, Y. Chang, L. Zhou, and Z. Liu were responsible for the technical and material support; J. Xu and Z. Lin were responsible for the study concept and design, analysis and interpretation of data, drafting of the manuscript, obtaining of funding, and study supervision. All the authors read and approved the final manuscript.
Compliance with ethical standards
All study protocols were permitted by the Clinical Research Medical Ethics Committee of Zhongshan Hospital of Fudan University (Shanghai, China) and were carried out in accordance with the approved guidelines.
Conflicts of interest
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