Complexity in radiological morphology predicts worse prognosis and is associated with an increase in proteasome component levels in clear cell renal cell carcinoma

放射学形态的复杂性预示着更差的预后,并与透明细胞肾细胞癌中蛋白酶体成分水平的增加有关

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作者:Kohei Kobatake, Kenichiro Ikeda, Jun Teishima, Yohei Sekino, Takashi Babasaki, Yuki Kohada, Ryo Tasaka, Kenshiro Takemoto, Takafumi Fukushima, Shunsuke Miyamoto, Hiroyuki Kitano, Keisuke Goto, Keisuke Hieda, Tetsutaro Hayashi, Nobuyuki Hinata

Background

We previously reported preoperative radiological morphology (RM) as an independent predictor for pathological upstaging after partial nephrectomy in patients with T1 renal cell carcinoma (RCC).

Conclusions

Investigating RM on pre-treatment CT scans can effectively predict worse prognosis. Increased RM complexity may indirectly predict drug sensitivity via increased expression of PSMB1 and PSMB3 in patients with ccRCC. Specific targeting of the ubiquitin-proteasome system might be a novel treatment strategy for ccRCC with increased RM complexity. Patient summary: The clinical and morphological characteristics of patients with ccRCC vary greatly according to cancer staging. In this study, we built upon our prior findings of the prognostic importance of RM in T1 RCC and expanded it to encompass all stages of RCC, using a series of patients from a Japanese hospital.

Purpose

To investigate the prognostic importance of RM in all stages and the molecular characteristics underlying the differences between each type of RM in patients with clear cell RCC (ccRCC). Design setting and participants: The Cancer Imaging Archive datasets (TCIA), comprising CT images and RNA-sequencing data, were used (n = 163). Specimens from 63 patients with ccRCC at our institution and their CT images were used. All images were divided into three types according to RM classification. Outcome measurements and statistical analysis: Relationships with outcome were analyzed using Cox regression analysis and log-rank test.

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