Background: Renal cell carcinoma (RCC) is the most aggressive urinary tract cancer. More than one third of patients experience metastasis. Metastasis is responsible for 90% of cancer deaths compared to the primary tumor itself. Factors that play a role in the occurrence of metastasis are chemokine CXC receptors type 4 (CXCR4) and autocrine motility factor receptor (AMFR). This study aims to determine the relationship of CXCR4 and AMFR expression with metastasis in RCC.
Methods: Case control research design was done to 44 Fixed Formalin Paraffin Embedded (FFPE) of RCC cases at the Department of Anatomical Pathology of Dr. Hasan Sadikin Hospital, Bandung, Indonesia. FFPE samples consist of 22 cases of metastatic RCC and 22 cases of non-metastatic RCC. Immunohistochemical staining of CXCR4 and AMFR was performed to all samples. All data were analyzed using Chi-Square test with p value < 0.05 of significant level and then processed using SPSS 24.0 for Windows.
Results: The result of this study shows a significantly different statistics of CXCR4 (p = 0.015) and AMFR (p = 0.014) expression between metastatic RCC and non-metastatic RCC. AMFR expression is the stronger factor that affects metastasis compared to CXCR4 expression ((Odds Ratio AMFR : OR CXCR4 = 4,911 : 4.667).
Conclusions: This study concluded that the incidence of metastatic RCC is influenced by factors of tumor cell migration, chemotaxis, and survival. The higher the CXCR4 and AMFR expression, the higher the possibility of metastasis in RCC.