Osteopontin Expression Is A Marker Of Poor Prognosis In Patients With Clear Cell Renal Cell Carcinoma

UroToday.com - Osteopontin (OPN) is a phosphorylated glycoprotein that is secreted into the extracellular matrix by a variety of cell types and has diverse functions which include enhancement of tumorigenesis and tumor progression in a variety of human tumors. Here, Matusan and colleagues examine the expression of OPN in human clear cell renal cell carcinoma (RCC).

The authors performed immunohistochemistry for OPN on 171 specimens of clear cell RCC. Of note, OPN is expressed by the distal tubular epithelium in the normal kidney. Mean tumor size was 7 cm, median follow up was 85 months (range 1-165), and 68.4% of tumors were organ confined. The authors found that OPN expression was increased in 35.7% of patients with clear cell RCC and was associated with increased tumor size (p<0.001), higher grade (p<0.001), advanced tumor stage (p=0.011), and a higher Ki67 proliferation index (p<0.001). The 5 year overall survival was 71% for patients without OPN staining, and only 40% for patients that were positive for OPN (p=0.004). Despite these findings, only pathologic stage (p=0.013) predicted survival in their multivariate analysis.

The authors conclude that OPN is a marker of progression in clear cell RCC and that overexpression may be involved in the molecular events that result in RCC progression.

Koviljka Matusan, MD , Gordana Dordevic, MD, Darko Stipic, MD , Vladimir Mozetic, MD , Ksenija Lucin, PhD

J Surg Oncol 94: 325-331, 2006

Reviewed by UroToday.com Contributing Editor Christopher G. Wood, MD, FACS

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