A nomogram based on TFE3 IHC results and clinical factors as a preliminary screening scheme for TFE3-rearranged renal...

Area of Science:

• Oncology
• Pathology
• Genetics

Background:

• TFE3 immunohistochemistry (IHC) is controversial for diagnosing TFE3-rearranged renal cell carcinoma (RCC).
• Accurate diagnosis is crucial for effective treatment of TFE3-rearranged RCC.

Purpose of the Study:

• To investigate the accuracy and sensitivity of TFE3 IHC in diagnosing TFE3-rearranged RCC.
• To establish a predictive model for diagnosing TFE3-rearranged RCC.

Main Methods:

• Retrospective analysis of 228 patients with IHC and FISH results.
• Evaluation of IHC using three scoring systems and logistic regression for risk factor identification.
• Construction and validation of a nomogram model using clinical information and IHC results.

Main Results:

• TFE3 IHC demonstrated high accuracy (0.829, 0.772, 0.807) across different scoring systems.
• A predictive model incorporating age, gender, lymph node metastasis, and IHC results achieved AUC values of 0.935 (training) and 0.916 (external validation).

Conclusions:

• TFE3 IHC is a valuable tool for diagnosing TFE3-rearranged RCC.
• Clinical factors like age and lymph node metastasis are independent risk factors that complement IHC results.
• Integrating TFE3 IHC with clinical risk factors enhances diagnostic accuracy for TFE3-rearranged RCC.