Higher APOA1 mRNA Levels Linked to Lower OS in Patients With KIRC

By Cecilia Brown - July 28, 2022

Higher levels of APOA1 mRNA expression at the time of surgery were associated with lower overall survival (OS) and lower disease-free survival (DFS) in patients with kidney renal clear cell carcinoma (KIRC), according to a recent study.

The results of the study, led by Wei Zeng, Guoguang Xiong and Li Hua of The Second Affiliated Hospital of Jianghan University, were published in Scientific Reports.

The study evaluated the prognostic significance of APOA1 mRNA and APOA1 protein in patients with KIRC using clinical data and RNA-sequencing data from the University of California Santa Cruz Xena database. The Human Protein Atlas database was used to gather data on APOA1 protein expression profiles in KIRC renal tissues and normal renal tissues. Investigators evaluated 91 patients with KIRC and 93 healthy participants who served as controls for clinical validation.

APOA1 mRNA Expression and DNA Methylation

APOA1 mRNA levels were significantly lower in tissues from patients with KIRC than in paired normal renal tissues (P=) and normal renal tissues (P=

Higher expression of APOA1 mRNA at the time of surgery was significantly associated with lower OS (hazard ratio [HR], 1.66; P=.037) and lower DFS in patients with KIRC (HR, 1.65; P =.047).

APOA1 DNA methylation was significantly associated with lower OS (HR, 2.1; P=.001) but not DFS (HR, 1.12; P=.624).

APOA1 Protein Expression in Patients With KIRC and Healthy Subjects

APOA1 protein serum concentrations were significantly lower in preoperative patients with KIRC compared to healthy participants who served as controls (P<.01).

A receiver operating characteristic (ROC) analysis showed serum APOA1 protein levels “exhibited a good diagnostic ability” to differentiate between patients with KIRC and healthy participants who served as controls, researchers reported (area under the ROC curve, 0.707; 95% CI, 0.644-0.790).

Lower levels of APOA1 protein were associated with lower OS in the 91 patients with KIRC (HR, 2.84, P=.0407).

Potential Prognostic Value and Clinical Utility

While the current clinical use of molecular biomarkers for KIRC outcome prediction is “limited,” APOA1 protein levels could be used as a biomarker for survival prognosis, as APOA1 “can be easily measured in blood plasma,” investigators wrote. APOA1 mRNA expression could also have a prognostic value for patients with KIRC, researchers reported.

“Low levels of APOA1 mRNA at the time of surgery predict favorable survival in KIRC patients,” the authors concluded. “Our results provide insights to identify a novel prognostic index with great clinical utility.”

Reference

APOA1 mRNA and protein in kidney renal clear cell carcinoma correlate with the disease outcome.

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