{"title":"Prognostic Value of <em>SOX9</em>, <em>E-Cadherin</em>, and <em>KLF4</em> Expressions in Clear Cell Renal Carcinoma.","authors":"Seyma Ozturk, Selma Erdogan Duzcu","doi":"10.29271/jcpsp.2025.04.457","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To analyse the immunohistochemical staining of stem cell-related factors SOX9 and KLF4 in radical and partial nephrectomy specimens and to determine their relationship to grade, metastasis, stage, other prognostic parameters, and their predictive value.</p><p><strong>Study design: </strong>Descriptive study. Place and Duration of the Study: Department of Pathology, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkiye, from 2015 to 2022.</p><p><strong>Methodology: </strong>The study included 92 cases diagnosed with clear cell renal cell carcinoma (ccRCC) from sections and blocks of partial and radical nephrectomies. Formalin-fixed and paraffin-embedded blocks were sliced. A Leica Bond Max staining device stained SOX9, E-cadherin, and KLF4 onto the slides. Nuclear staining for SOX9 and KLF4 and membranous staining for E-cadherin were evaluated. Since E-cadherin loss has an important role in the development of malignancy, the E-cadherin staining pattern was considered when evaluating the staining patterns of SOX9 and KLF4. The Mann-Whitney U and Kruskal-Wallis tests were applied to compare immunohistochemical data with prognostic factors such as gender, tumour size, grade, metastasis, and stage. The statistical analyses were conducted using the IBM SPSS version 20, with a p-value of less than 0.05 considered as statistically significant.</p><p><strong>Results: </strong>Significant correlations were observed between SOX9, KLF4, and E-cadherin expression levels and high nuclear grade, with p-values of 0.005, <0.001, and 0.002, respectively. In addition, the overexpression of SOX9 was significantly linked to distant metastasis and stage, with p-values of 0.010 and 0.025, respectively.</p><p><strong>Conclusion: </strong>SOX9, E-cadherin, and KLF4 expressions are linked to unfavourable prognostic factors in ccRCC. Thus, these immunohistochemical stains may serve as potential biomarkers in this cancer and aid in identifying prognosis and treatment response.</p><p><strong>Key words: </strong>Clear cell renal carcinoma, SOX9 transcription factor, E-cadherin, Kruppel-like transcription factors, Prognosis.</p>","PeriodicalId":54905,"journal":{"name":"Jcpsp-Journal of the College of Physicians and Surgeons Pakistan","volume":"35 4","pages":"457-462"},"PeriodicalIF":0.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jcpsp-Journal of the College of Physicians and Surgeons Pakistan","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.29271/jcpsp.2025.04.457","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To analyse the immunohistochemical staining of stem cell-related factors SOX9 and KLF4 in radical and partial nephrectomy specimens and to determine their relationship to grade, metastasis, stage, other prognostic parameters, and their predictive value.
Study design: Descriptive study. Place and Duration of the Study: Department of Pathology, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkiye, from 2015 to 2022.
Methodology: The study included 92 cases diagnosed with clear cell renal cell carcinoma (ccRCC) from sections and blocks of partial and radical nephrectomies. Formalin-fixed and paraffin-embedded blocks were sliced. A Leica Bond Max staining device stained SOX9, E-cadherin, and KLF4 onto the slides. Nuclear staining for SOX9 and KLF4 and membranous staining for E-cadherin were evaluated. Since E-cadherin loss has an important role in the development of malignancy, the E-cadherin staining pattern was considered when evaluating the staining patterns of SOX9 and KLF4. The Mann-Whitney U and Kruskal-Wallis tests were applied to compare immunohistochemical data with prognostic factors such as gender, tumour size, grade, metastasis, and stage. The statistical analyses were conducted using the IBM SPSS version 20, with a p-value of less than 0.05 considered as statistically significant.
Results: Significant correlations were observed between SOX9, KLF4, and E-cadherin expression levels and high nuclear grade, with p-values of 0.005, <0.001, and 0.002, respectively. In addition, the overexpression of SOX9 was significantly linked to distant metastasis and stage, with p-values of 0.010 and 0.025, respectively.
Conclusion: SOX9, E-cadherin, and KLF4 expressions are linked to unfavourable prognostic factors in ccRCC. Thus, these immunohistochemical stains may serve as potential biomarkers in this cancer and aid in identifying prognosis and treatment response.
目的：分析全肾和部分肾切除术标本中干细胞相关因子SOX9和KLF4的免疫组化染色，并探讨其与分级、转移、分期等预后参数的关系及其预测价值。研究设计：描述性研究。研究地点和时间：2015年至2022年，土耳其博卢Abant Izzet Baysal大学医学院病理学系。方法：本研究纳入92例透明细胞肾细胞癌（ccRCC）的病例，这些病例来自部分和根治性肾切除术的切片和块。切片取福尔马林固定块和石蜡包埋块。Leica Bond Max染色装置将SOX9、E-cadherin和KLF4染色到载玻片上。评价SOX9和KLF4的核染色和E-cadherin的膜染色。由于E-cadherin的丢失在恶性肿瘤的发生发展中具有重要作用，因此在评价SOX9和KLF4的染色模式时考虑了E-cadherin的染色模式。采用Mann-Whitney U和Kruskal-Wallis试验比较免疫组织化学数据与预后因素，如性别、肿瘤大小、分级、转移和分期。采用IBM SPSS version 20进行统计分析，p值小于0.05为具有统计学意义。结果：SOX9、KLF4和E-cadherin的表达水平与高核分级之间存在显著相关性，p值为0.005。结论：SOX9、E-cadherin和KLF4的表达与ccRCC的不良预后因素有关。因此，这些免疫组织化学染色可能作为这种癌症的潜在生物标志物，并有助于确定预后和治疗反应。关键词：透明细胞肾癌，SOX9转录因子，E-cadherin， kruppel样转录因子，预后
期刊介绍：
Journal of College of Physicians and Surgeons Pakistan (JCPSP), is the prestigious, peer reviewed monthly biomedical journal of the country published regularly since 1991.
Established with the primary aim of promotion and dissemination of medical research and contributed by scholars of biomedical sciences from Pakistan and abroad, it carries original research papers, , case reports, review articles, articles on medical education, commentaries, short communication, new technology, editorials and letters to the editor. It covers the core biomedical health science subjects, basic medical sciences and emerging community problems, prepared in accordance with the “Uniform requirements for submission to bio-medical journals” laid down by International Committee of Medical Journals Editors (ICMJE). All publications of JCPSP are peer reviewed by subject specialists from Pakistan and locally and abroad.
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