Prognostic value of the expression of carbonic anhydrase 9 in combination with other markers in patients with clear cell renal cell carcinoma

Background. The proportion of renal cell carcinoma (RCC) in the structure of oncological incidence in Russia is 3.9 %. This nosology has a leading position by the growth rate. The number of new cases of RCC from 2004 to 2014 increased by 42.9 %. Carbonic anhydrase (CA) enzymes are transmembrane enzymes that play an important role in pH regulation catalyzing reversible reactions of carbonic acid to carbon dioxide and water. Recently we have seen studies on prognostic and predictive value of CA9 expression in clear cell RCC. Objective - reveal relationship between CA9 expression and proliferative activity, apoptosis, morphological picture and clinical course of a tumor. Materials and methods. The study included 67 patients (47 men and 20 women) aged from 32 to 73 years (55.0 +/- 7.6 years), suffering from clear cell RCC. All the patients were treated at the Medical Radiological Research Center. Follow-up period lasted from 8 to 116 months (mean - 36.5 months). Patients underwent nephrectomy, histological study with Fuhrman nuclear grading, immunohistochemistry with antibodies against p53, bcl-2, Ki-67 and CA9. Results and conclusions. CA9 expression is associated with the expression of bcl-2, while the lack of CA9 expression is associated with p53. Loss of CA9 expression is a poor prognostic factor and it is associated with the development of metastasis and recurrence of the disease, as well as lower disease-free survival.