Podoplanin associates with adverse postoperative prognosis of patients with clear cell renal cell carcinoma

Abstract

Podoplanin, a transmembrane sialomucin-like glycoprotein, was recently shown to be involved in tumor progression and metastasis for its potential role in facilitating platelet-based tumor embolization and promigratory phenotype of cancer cells. In this study, we assessed the clinical significance of tumoral podoplanin expression in 295 patients with clear cell renal cell carcinoma (ccRCC) through immunohistochemistry on tissue microarrays and analyzed the staining intensity quantitatively. Univariate analysis suggested an adverse prognostic effect of high tumoral podoplanin expression on patients' overall survival (OS) and recurrence free survival (RFS) (P<0.001 for both). In multivariate analysis, the staining intensity used as either a continuous or dichotomous variable, was still an independent adverse prognostic factor for patient survival (OS, P<0.001, RFS, P<0.001 for continuous; OS, P<0.001, RFS, P=0.002 for dichotomous). Moreover, stratified analysis identified a higher prognostic power in the intermediate/high risk patient groups. After utilizing those parameters in the validated multivariate analysis, two nomograms were constructed to predict ccRCC patients' OS and RFS (c-index 0.815 and 0.805, respectively), and performed better than existed integrated models (P<0.001 for all comparisons). In conclusion, high tumoral podoplanin expression could independently predict an adverse clinical outcome for ccRCC patients, and it might be used for future clinical decision making and therapeutic developments.

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