Significant variation of immunohistochemical marker expression in paired primary and metastatic clear cell renal cell carcinomas.

Pan Z, Grizzle W, Hameed O
Am J Clin Pathol. 2013 140 (3): 410-8

PMID: 23955461 · DOI:10.1309/AJCP8DMPEIMVH6YP

OBJECTIVES - To compare the immunohistochemical expression of diagnostic markers in primary clear cell renal cell carcinomas (RCCs) and their matched metastases.

METHODS - Tissue microarrays were constructed from 15 pairs of primary and metastatic clear cell RCCs and then evaluated for the immunohistochemical expression of renal cell carcinoma antigen (RCCA), kidney-specific cadherin, carbonic anhydrase IX (CAIX), and paired box genes 2 (PAX2) and 8 (PAX8).

RESULTS - There was significantly higher overall marker expression in metastatic tumors compared to their matched primaries (P < .001). Individually, there was greater CAIX, PAX2, and PAX8 expression and lower RCCA expression in metastatic tumors. Most importantly, a significant proportion of originally RCCA-positive tumors lost such expression in metastases.

CONCLUSIONS - Metastatic RCCs have significantly higher expression of PAX2 and PAX8 compared to primary RCCs. RCCA is not very reliable in this diagnostic setting, both because of its lower overall sensitivity and loss of expression in metastatic RCCs.

MeSH Terms (12)

Antigens, Neoplasm Biomarkers, Tumor Cadherins Carbonic Anhydrase IX Carbonic Anhydrases Carcinoma, Renal Cell Humans Kidney Neoplasms Paired Box Transcription Factors PAX2 Transcription Factor PAX8 Transcription Factor Receptor for Advanced Glycation End Products

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