Research article

Collecting duct carcinoma of the kidney: an immunohistochemical study of 11 cases

Andrea Vecchione^1,2 , Tommaso Prayer Galetti³ , Marina Gardiman⁴ , Hideshi Ishii^5,6 , Enrico Giarnieri^1,2 , Francesco Pagano³ , Leonard G Gomella¹ , Carlo M Croce⁵ and Raffaele Baffa⁵

¹Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA, 19107, USA

²University of Rome "La Sapienza", Ospedale Santo Andrea, Rome, Italy

³Department of Urology, University of Padova, Via Giustiniani 25, Padova, Italy

⁴Department of Pathology, University of Padova, Via Gabelli 3, Padova, Italy

⁵Department of Microbiology/Immunology, Kimmel Cancer Center, Thomas Jefferson University, 220 10^th South Street, Philadelphia, PA, 19107, USA

⁶Jichi Medical School, Center for Molecular Medicine, Division of Stem Cell Regulation/Molecular Hematopoiesis, 3311-1 Yakushiji, Minami-Kawachi, Tochigi, 329-0498, Japan

author email corresponding author email

BMC Urology 2004, 4:11doi:10.1186/1471-2490-4-11

Published:	9 September 2004

Abstract

Background

Collecting duct carcinoma (CDC) is a rare but very aggressive variant of kidney carcinoma that arises from the epithelium of Bellini's ducts, in the distal portion of the nephron. In order to gain an insight into the biology of this tumor we evaluated the expression of five genes involved in the development of renal cancer (FEZ1/LZTS1, FHIT, TP53, P27^kip1, and BCL2).

Methods

We studied eleven patients who underwent radical nephrectomy for primary CDC. All patients had an adequate clinical follow-up and none of them received any systemic therapy before surgery. The expression of the five markers for tumor initiation and/or progression were assessed by immunohistochemistry and correlated to the clinicopathological parameters, and survival by univariate analysis.

Results

Results showed that Fez1 protein expression was undetectable or substantially reduced in 7 of the 11 (64%) cases. Fhit protein was absent in three cases (27%). The overexpression of p53 protein was predominantly nuclear and detected in 4 of 11 cases (36%). Immunostaining for p27 was absent in 5 of 11 cases (45.5%). Five of the six remaining cases (90%) showed exclusively cytoplasmic protein expression, where, in the last case, p27 protein was detected in both nucleus and cytoplasm. Bcl2 expression with 100% of the tumor cells positive was observed in 4 of 11 (36%) cases. Statistical analysis showed a statistical trend (P = 0.06) between loss and reduction of Fez1 and presence of lymph node metastases.

Conclusions

These findings suggest that Fez1 may represent not only a molecular diagnostic marker but also a prognostic marker in CDC.