Clinical utility of MCM2 and CD44 expression in clear cell renal cell carcinoma

Clear cell renal cell carcinoma (ccRCC) has an unpredictable clinical consequence even with the use of usual prognostic factors. To determine whether utilization of cell proliferation and cell adhesion by using MCM2 and CD44 immuno-expression could predict the biological performance of ccRCC. MCM2 and CD44 protein expression levels in tumor tissues from 120 ccRCC patients were evaluated by immunohistochemistry. The relationships between MCM2 and CD44 expression and clinicopathological parameters were evaluated. The overall survival (OS) was computed by the Kaplan-Meier method. The role of MCM2 and CD44 in the prognosis was estimated by univariate and multivariate Cox regressions. The results showed high MCM2 and CD44 protein expression levels in 63.3% and 55% of ccRCC cases, respectively. MCM2 and CD44 over-expression was significantly related to tumor grade (p = 0.001 and p = 0.003, respectively), T stage (p = 0.005 and p = 0.008, respectively), lymph node status (p = 0.015 and p = 0.040, respectively), AJCC stage (p = 0.000 and p = 0.002, respectively) and OS (p = 0.019 and p = 0.001, respectively). Multivariate Cox regression showed that high MCM2 and CD44 expression levels were independently associated with prognosis of ccRCC cases (HR = 2.687, 2.810, 95% CI: 1.217-5.920, 1.267- 6.233, respectively). MCM2 and CD44 are considered as independent risk and poor prognostic factors for the prognosis of ccRCC patients.