The prognostic value of serum cystatin-C (Cys-C) in renal cell carcinoma (RCC) remains unknown. The purpose of this study is to explore the prognostic value of Cys-C for RCC patients.
The levels of preoperative Cys-C, creatinine (CRE) and estimated glomerular filtration rate (e-GFR) were retrospectively collected in 325 RCC patients undergoing surgery. The cutoff values of Cys-C, CRE and e-GFR were determined by the standardized Cutoff Finder algorithm. The receiver operating characteristic (ROC) curve and pairwise comparison were performed to compare the three variables. Univariate and multivariate Cox regression analyses were performed to investigate the prognostic value of serum Cys-C in RCC.
Based on the analysis of Cutoff Finder algorithm, ROC curve and pairwise comparison, the preoperative Cys-C was superior to CRE and e-GFR as a predictive factor in RCC. Multivariate Cox regression analyses showed that high preoperative Cys-C (>1.09 mg/L) was significantly associated with shorter overall survival (OS) in all RCC patients (hazard ratio [HR], 1.59; P = 0.012), patients at pT1-2 (P<0.001), pN0 (P<0.001) and pM0 stages (P<0.001). Moreover, Multivariate Cox regression analyses also showed that in the 306 patients without metastasis, high preoperative Cys-C was also associated with shorter disease-free survival (DFS) (HR, 3.50; P = 0.013).
An elevated preoperative Cys-C level was demonstrated to be related with worse survival in patients with RCC. Measuring preoperative serum Cys-C might be a simple way for finding poor prognostic patients and patients with elevated preoperative Cys-C level should be more closely followed up.
PloS one. 2017 Jun 06*** epublish ***
Shengjie Guo, Yunfei Xue, Qiuming He, Xiaobo He, Kunbin Guo, Pei Dong, Kai Yao, Guangwei Yang, Dong Chen, Zaishang Li, Xiangdong Li, Zike Qin, Zhuowei Liu, Wenjie Cheng, Chao Guo, Meng Zhang, Hui Han, Fangjian Zhou
Department of Urology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China., Medicine school of Sun Yat-Sen University, Guangzhou, China., Department of Medical Oncology, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China., Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, China., Department of Urology, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China., The Jiangcheng Branch of Yangjiang People's Hospital, Yangjiang, Guangdong, China.