Purpose: Recent lung cancer data have shown an association of XPA-210, a key peptide of thymidine kinase, with advanced disease. We thus assessed its proliferation status in primary (M0) and metastatic (M1) renal cell carcinoma (RCC).
Methods: Paraffin slides from 30 patients (mean age: 61.2 years; range: 42-84) with clear-cell RCC (M0 in 10; non-osseous M1 in 10; osseous M1 in 10) were T-matched for pT1/pT3. Corresponding malignant and benign renal parenchyma were immunohistochemically stained against XPA-210. Staining density was determined by a semi-quantitative score of positive cell shares. Staining intensity included the precise cellular location.
Results: XPA-210 occurred predominantly in the nucleus, with a minor cytoplasmatic component. RCC tissue showed higher density and stronger intensity than did benign renal tissue in both nucleus (P = 0.005) and cytoplasm (P = 0.01). Density and intensity were positively associated with tumor diameters ≤7 cm, whereas they tended to correlate inversely in tumors >7 cm (P 0.07). Density of stained cells was significantly higher in metastatic than in localized RCC in both nucleus and cytoplasm (P < 0.04). Non-osseous M1 tissue showed significantly higher nuclear and cytoplasmatic expression than did M0 tissue (P < 0.05), whereas osseous M1 tissue did not.
Conclusions: In all RCC tissues, XPA-210 staining was significantly higher in the nucleus than in cytoplasm, potentially owing to large cytoplasmatic spaces as a characteristic histologic feature of clear-cell component. XPA-210 expression gradually increased from localized to metastatic disease, peaking in patients without bone involvement. Therefore, XPA-210 might aid the selection of appropriate adjuvant treatment in high-risk patients.