Clinicopathological and Prognostic values of Gankyrin, Snail1, and IDH1 Expression in Renal Cell Carcinoma Patients

Background: Gankyrin is an oncoprotein incriminated in cancer growth, invasion, and spread. Snail1 is associated with mesenchymal features acquisition that is related to invasion and metastasis of malignant cells. Isocitrate dehydrogenase 1(IDH1) has been found to be mutated in several cancers, which leads to altered cellular metabolism and tumorgenesis. The present study aimed to assess Gankyrin, Snail1, and IDH1 expression patterns and compare them to clinicopathological and prognostic parameters. Method: In our prospective cohort study, the samples taken from 60 RCC patients were processed, diagnosed, graded, staged, and subjected to immunohistochemistry for Gankyrin, Snail1, and IDH1. The patients were chosen, treated, and followed up from January 2015 to December 2019. Overall, the survival (OS) and progression-free survival (PFS) were assessed. Results: High expression levels of Gankyrin were positively associated with high grade (P=0.003), stage (P =0.033), and size of the tumor (P=0.049), in addition to lymph nodes metastasis (P =0.01), distant metastases (P=0.007), higher incidence of tumor progression, unfavorable 5-year progression-free survival, and overall survival rates (P<0.001). High expression levels of Snail1 were positively associated with high grade (P=0.004) and stage (P=0.023) of the tumors, on top of lymph nodes metastasis (P=0.003), distant metastases (P=0.002), higher incidence of tumor progression, poorer five-year progression-free survival, and overall survival rates (P<0.001). High expression levels of IDH1 were negatively associated with low grade (P = 0.002), stage, and size of the tumor and lymph nodes metastasis (P<0.001), distant metastases (P =0.041), lower incidence of tumor progression (P=0.013), better five-year progression-free survival, and overall survival rates (P<0.041). Conclusion: We indicated the associations between poor RCC pathological parameters, unfavorable patients’ outcome, high Gankyrin, high Snail1, and reduced IDH1 expression.