Enrichment of C5a-C5aR axis predicts poor postoperative prognosis of patients with clear cell renal cell carcinoma
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Wei Xi1,*, Li Liu1,*, Jiajun Wang1,*, Yu Xia1, Qi Bai1, Ying Xiong1, Yang Qu1, Qilai Long1, Jiejie Xu2, Jianming Guo1
1Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
2Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
*These authors contributed equally to this work
Jiejie Xu, email: [email protected]
Jianming Guo, email: [email protected]
Keywords: ccRCC, C5aR, C5a-C5aR axis, prognosis, nomogram
Received: September 20, 2016 Accepted: October 28, 2016 Published: November 04, 2016
Anaphylatoxin C5a and its receptor C5aR on cancer cells constitute a vital axis to cancer progression. In this study, we measured C5aR level by immunohistochemistry in the same cohort of our previous C5a research, and C5a-C5aR axis status was determined by synthesizing C5a and C5aR data. C5aR was an adverse independent prognostic factor for ccRCC patients. Kaplan-Meier analyses revealed the unique position of both C5a and C5aR high population in postoperative survival, based on which patients were then shunted into C5a-C5aR enriched and non-enriched groups. Obviously, C5a-C5aR enriched patients significantly had a poorer overall survival (OS) and recurrence free survival (RFS) compared with non-enriched ones, and the independence of C5a-C5aR axis was verified by multivariable analyses (HR 2.118, P = 0.001 for OS, HR 1.715, P = 0.035 for RFS). Established nomograms based on our findings reflected much better predicting accuracy in contrast with most common used TNM and Fuhrman systems. Meanwhile, consistent with HR, C5a-C5aR axis in this study held its advantages over C5a and C5aR for OS prediction by c-index analyses, rather than RFS prediction.
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