Cancer - Kidney(구연) (E-077) 공격적인 작은 투명세포 신세포암의 예측 인자로서 내장 지방과 DDX11의 연관성 연세의대 신촌세브란스병원 박지수, 장원식, 김종찬, 이승환, 나군호, 함원식 BACKGROUND: Visceral fat produces several hormones and cytokines associated with carcinogenesis and tumor progression. OBJECTIVES: Herein, we investigated the association between visceral adiposity and target-gene mRNA expression in patients with localized small clear-cell renal-cell carcinoma. (ccRCC). MATERIALS & METHODS: We included 105 patients with localized clinical T1a stage ccRCC who had undergone nephrectomy from November 2018 to November 2019 in a prospective clinical trial (NCT03694912). Visceral, subcutaneous, and total adipose tissue in these patients was measured using preoperative computerized tomography of the mid-third lumbar vertebra region. We then examined the association between adiposity and the mRNA levels of PBRM1, BAP1, SETD2, KDM5C, FOXC2, CLIP4, AQP1, DDX11, BAIAP2L1, and TMEM38B in matched frozen tumor tissues and plasma. RESULTS: When patients were stratified into quartiles according to their relative visceral adiposity, high visceral adiposity was significantly associated with low ISUP grade (P = 0.004). Multivariate logistic regression analysis revealed a significant association between visceral adiposity and body mass index [odds ratio (OR) 1.462, 95% confidence interval (CI) 1.175–1.820, P = 0.017], plasma levels of DDX11 mRNA (OR 0.928, 95% CI 0.870–0.989, P = 0.022), and ISUP nuclear grade (OR 0.258, 95% CI 0.069–0.965, P = 0.044). The plasma mRNA expression of DDX11 was identified as a visceral adiposity biomarker. CONCLUSIONS: The results obtained herein will aid in inferring the aggressiveness of small ccRCCs represented by ISUP nuclear grade in clinical practice. Our findings indicated that DDX11 and visceral fat play active roles in small ccRCC. These roles should be examined in future studies for possible use as prognostic biomarkers in the treatment of patients with ccRCC. keywords : DDX11, visceral adiposity, renal cell carcinoma