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Updated: Aug 6, 2026
The Use of Reverse Phase Protein Arrays (RPPA) to Explore Protein Expression Variation within Individual Renal Cell Cancers
Published on: January 22, 2013
Nuclear PML expression as a prognostic biomarker in localised clear cell renal cell carcinoma
Sakari Kosola1,2, Teemu D Laajala3,4, Iida Payne5,6
1Department of Oncology and Radiotherapy, FICAN West Cancer Centre University of Turku and Turku University Hospital Turku Finland.
Objectives:
To evaluate nuclear promyelocytic leukaemia protein (PML) expression as a prognostic biomarker in localised clear cell renal cell carcinoma (ccRCC), aiming to improve postoperative risk stratification.
Materials And Methods:
Two independent retrospective cohorts of patients undergoing surgery for localised ccRCC were analysed: an exploratory cohort (n = 191; Turku University Hospital) and a validation cohort (n = 173; Helsinki University Hospital). Patients underwent surgery between 2005 and 2014 and 2006-2013, respectively. Tissue microarrays from primary tumours were immunohistochemically stained and assessed for nuclear PML expression using both visual scoring and QuPath-assisted image analysis. Clinical data at the time of surgery and follow-up data were collected, with a median follow-up of 8 years in the exploratory cohort and 9 years in the validation cohort. Associations between nuclear PML expression and recurrence-free survival (RFS), cancer-specific survival (CSS), overall survival (OS) and diagnostic histopathological characteristics were evaluated.
Results:
High nuclear PML expression was associated with improved RFS (p = 0.022) and CSS (p = 0.027) in the exploratory cohort, with similar findings in the validation cohort in univariable analyses (both p < 0.0001). In the validation cohort, high nuclear PML expression remained independently associated with improved RFS (HR 0.38, 95% CI 0.21-0.70; p = 0.002), CSS (HR 0.30, 95% CI 0.13-0.68; p = 0.004) and OS (HR 0.34, 95% CI 0.18-0.68; p = 0.002) after adjustment for established histopathological risk factors in multivariable analyses.
Conclusions:
Nuclear PML expression is associated with favourable outcomes in localised ccRCC and may provide additional prognostic information. Independent validation and mechanistic studies are warranted.
