High mucin 5AC expression predicts adverse postoperative recurrence and survival of patients with clear-cell renal cell carcinoma

// Haijian Zhang 1,2,* , Yidong Liu 1,* , Huyang Xie 3,* , Weisi Liu 1 , Qiang Fu 1 , Dengfu Yao 2 , Jiejie Xu 1 and Jianxin Gu 1 1 Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China 2 Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Jiangsu, China 3 Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China * These authors have contributed equally to this work Correspondence to: Dengfu Yao, email: // Jiejie Xu, email: // Jianxin Gu, email: // Keywords : mucin 5AC, clear-cell renal cell carcinoma, overall survival, recurrence-free survival, prognostic biomarker Received : December 21, 2016 Accepted : February 23, 2017 Published : March 04, 2017 Abstract Background: Mucin 5AC (MUC5AC), as a member of secreted/gel-forming mucin family, was frequently found to be abnormally expressed in inflammation or malignant diseases. However, the clinic pathologic features and prognostic values of MUC5AC in clear-cell renal cell carcinoma (ccRCC) have not been reported up to now. Methods: MUC5AC expression was analyzed by immunohistochemistry on tissue microarrays. Kaplan-Meier survival curves, Univariate and Multivariate Cox analysis and newly-established nomogram model were performed to evaluate the prognostic value. Results: MUC5AC expression was firstly found to be up-regulated in patients with ccRCC, positively associated with tumor size, pN stage, lymphovascular invasion, Fuhrman grade, rahbdoid differentiation, sarcomatoid features, tumor necrosis, ECOG-PS and recurrence. Furthermore, MUC5AC expression might be contributed to risk stratification of ccRCC patients with TNM stage III+IV or Fuhrman grade 3 or 4 for overall survival (OS) and recurrence-free survival (RFS) analysis, and it was demonstrated to be negatively correlated with OS and RFS of ccRCC patients. What’s more, MUC5AC was identified as a potential independent adverse prognostic factor; prediction accuracy of MUC5AC-based new nomogram model was drastically improved for OS and RFS of ccRCC patients. Conclusion: MUC5AC is a promising independent adverse prognostic factor for ccRCC patients, it maybe conducive to postoperative risk stratification and guide treatment in the future.