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. 2017 Jul 25;8(41):69961-69971.
doi: 10.18632/oncotarget.19540. eCollection 2017 Sep 19.

Prognostic value of granulocyte colony-stimulating factor in patients with non-metastatic clear cell renal cell carcinoma

Zheng Liu  1   2 , Yu Zhu  1   2 , Yiwei Wang  3 , Qiang Fu  4 , Hangcheng Fu  1   2 , Zewei Wang  4 , Junyu Zhang  1   2 , Gaoxiang Li  1   2 , Jiejie Xu  4 , Bo Dai  1   2
Affiliations

Prognostic value of granulocyte colony-stimulating factor in patients with non-metastatic clear cell renal cell carcinoma

Zheng Liu et al. Oncotarget. .

Abstract

Granulocyte colony-stimulating factor is a well-known cytokine to stimulate inflammatory cells. We sought to investigate the prognostic value of its expression in patients with non-metastatic clear cell renal cell carcinoma. Enrolled in this study were 228 eligible patients treated with curative nephrectomy for clear cell renal cell carcinoma during 2008. Granulocyte colony-stimulating factor expression was detected by immunohistochemistry in patient specimens, and was divided into three groups according to the distribution of its immunohistochemistry score. Subgroup analyses were performed to evaluate its risk stratification ability. Cox regression models were applied to analyze the impact of prognostic factors. We found that high granulocyte colony-stimulating factor expression was associated with diminished recurrence-free survival (P<0.001). Its expression had stronger stratification ability in late disease patients, and was further identified as an independent prognosticator for recurrence-free survival. Moreover, nomogram based on granulocyte colony-stimulating factor expression presented a better prognostic ability compared with current prognostic systems (the concordance index = 0.874). To conclude, intratumoal granulocyte colony-stimulating factor expression could be a potential prognosticator for recurrence-free survival in non-metastatic clear cell renal cell carcinoma patients. Incorporating its expression into other pathologic factors provided a finer individual model for non-metastatic clear cell renal cell patients.

Keywords: carcinoma; granulocyte colony-stimulating factor; neoplasm recurrence; prognosis; renal cell.

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Conflict of interest statement

CONFLICTS OF INTEREST The authors declare that they have no competing financial interests.

Figures

Figure 1
Figure 1. G-CSF expression in ccRCC tissues and the result of immunohistochemistry score
(A) Flowchart of study patients’ inclusion. (B-D) Representative photographs of (B) low, (C) intermediate and (D) high G-CSF immunostaining in ccRCC tissues (original magnification ×200). (E) Frequency distribution of G-CSF immunohistochemistry score in 228 ccRCC tumor samples, showing tertiles of 80 and 140 used to divide low, intermediate and high expression subgroups.
Figure 2
Figure 2. Stratification ability for RFS of G-CSF expression in ccRCC patients
(A) Kaplan-Meier curve for RFS of ccRCC patients according to G-CSF expression. (B-C) Kaplan-Meier curves for RFS of ccRCC patients combined G-CSF expression with (B) T stage and (C) Leibovich score. Log-rank test P values.
Figure 3
Figure 3. Survival analyses for RFS of ccRCC patients within different risk groups
(A-D) Kaplan-Meier curves for RFS of ccRCC patients categorized in (A) T2-T3, (B) UISS intermediate and high risk, (C) SSIGN intermediate and high risk, and (D) Leibovich intermediate and high risk group according to G-CSF expression. Log-rank test P values.
See this image and copyright information in PMC

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