Clinical value of the markers of proliferation and apoptosis in patients with clear cell renal cell carcinoma

Renal cell carcinoma (RCC) is a heterogeneous disease in which the patients survive for months to years. At the present time the prognostic models have no sufficient information or exact prognostic value. Cell proliferation and apoptosis play a key role in cell cycle regulation; and impairment in these processes is commonly detected in different human tumors. The investigation enrolled 76 patients (49 men, 27 women) aged 32 to 73 years (mean age 56 +/- 7.6 years) diagnosed with RCC. The follow-up was 8 to 116 months (mean 36.5 months). All the patients underwent nephrectomy; antibodies against p53, Bcl 2, and Ki 67 were investigated by immunohistochemistry. The expression of p53 and none or reduced expression of Bcl 2 are poor prognostic factors and associated with the metastatic potential of a tumor and with low relapsefree survival. High Ki 67 levels are a risk factor for metastases. A combination of p53 expression and high proliferative activity reflects the aggressive potential of a tumor and suggests the high risk of metastases just at the disease diagnosis and early tumor dissemination.