The first 2 authors contributed equally to this article.
Pericyte coverage of differentiated vessels inside tumor vasculature is an independent unfavorable prognostic factor for patients with clear cell renal cell carcinoma
Article first published online: 18 JUL 2012
Copyright © 2012 American Cancer Society
Volume 119, Issue 2, pages 313–324, 15 January 2013
How to Cite
Cao, Y., Zhang, Z.-L., Zhou, M., Elson, P., Rini, B., Aydin, H., Feenstra, K., Tan, M.-H., Berghuis, B., Tabbey, R., Resau, J. H., Zhou, F.-J., Teh, B. T. and Qian, C.-N. (2013), Pericyte coverage of differentiated vessels inside tumor vasculature is an independent unfavorable prognostic factor for patients with clear cell renal cell carcinoma. Cancer, 119: 313–324. doi: 10.1002/cncr.27746
- Issue published online: 4 JAN 2013
- Article first published online: 18 JUL 2012
- Manuscript Accepted: 18 JUN 2012
- Manuscript Revised: 13 JUN 2012
- Manuscript Received: 17 FEB 2012
- clear cell renal cell carcinoma;
- microvessel density;
- prognosis, survival
The objective of this study was to evaluate the effect of pericyte coverage (PC) of differentiated tumor microvessels on the prognosis of patients with clear cell renal cell carcinoma (CCRCC).
Samples from 2 cohorts of patients with CCRCC (101 Asian patients and 524 US patients) were prepared using 2 different histologic approaches: routine sectioning versus tissue microarray. Then, the samples were immunohistochemically doubled-stained for a pericyte marker (alpha smooth muscle actin [α-SMA]) and a differentiated vessel marker (cluster of differentiation 34 [CD34]), followed by multispectral image capturing and computerized image analyses to quantify the microvessel density (MVD) and the PC of differentiated vessels. The correlations of PC and the MVD:PC ratio with clinicopathologic characteristics were analyzed.
There was an inverse correlation between differentiated MVD and PC. Higher PC correlated with more aggressive clinicopathologic characteristics of CCRCC in both cohorts, including more advanced T-classification, higher pathologic grades, and the occurrence of tumor necrosis. The MVD:PC ratio was an independent favorable prognostic factor for overall and recurrence-free survival in the Asian cohort and for recurrence-free survival in the US cohort. PC also was an independent prognostic factor, with higher PC predicting a poorer outcome. The combination of PC and MVD was better at distinguishing the outcome of patients with CCRCC. PC combined with differentiated MVD or with the MVD:PC ratio provided additional, independent prognostic information to the Leibovich risk model, and that information was used to generate improved risk models.
The authors consistently observed that higher PC was correlated with more aggressive clinicopathologic characteristics. PC was an independent unfavorable prognostic factor. The authors concluded that pericytes should be considered for therapeutic targeting. Cancer 2013. © 2012 American Cancer Society.