602 EPITHELIAL-MESENCHYMAL TRANSITION (EMT) IN METASTATIC RENAL CELL CARCINOMA AND PROGNOSTIC RELEVANCE OF INVOLVED GENES

(GS), arteriosclerosis (AS) and interstitial fibrosis (IF)/tubular atrophy (TA), as well as Fas mRNA quantification and immunohistochemistry, were performed on surgically resected non-neoplastic parenchyma from 100 patients with RCC. The estimated glomerular filtration rates (eGFR) were determined using the Modification of Diet in Renal Disease study equations. The prognoses, which included the detailed cause of death, were collected. Several factors associated with comorbid disease and the assessments of non-neoplastic specimens were also analyzed. RESULTS: Median follow up period was 78.5 months (range 12.5-154.8). Mean (Standard deviation [SD]) 1 year post-operative percentage for eGFR decline was 30.2 (15.2). Severe renal functional deterioration (SRFD) was categorized as an approximate mean SD value for the eGFR decline greater than 45 percent, after 1 year post-operation. The GS extent percentage ( 15) and glomerular Fas protein expression were independent predictors for SRFD. These two predictors and the SRFD indicated the significantly increased mortality due to cardiovascular disease (each P value 0.05). CONCLUSIONS: This is the first report to indicate the predictors of progressive CKD after RN using the combination assessment of histopathology and the expression of an apoptotic molecule in surgically resected non-neoplastic tissues. Our results suggest that Fasinduced glomerular cell apoptosis and the subsequent GS that occurs in cortical cells cause the functional deterioration in the remaining kidney, and ultimately the increase in mortality caused by cardiovascular disease.