Vascular Cell Adhesion Molecule 1 Predicts Cancer-Free Survival in Clear Cell Renal Carcinoma Patients
Purpose: Vascular cell adhesion molecule 1 (VCAM1) is a cell surface glycoprotein implicated in various pathophysiologic conditions. We measured VCAM1 expression levels in tumor tissues and evaluated its significance and prognostic use in renal cell carcinoma (RCC). Experimental Design: We used real...
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creator | SHIOI, Ko-Ichi KOMIYA, Atsushi YAO, Masahiro HATTORI, Keiko YING HUANG SANO, Futoshi MURAKAMI, Takayuki NAKAIGAWA, Noboru KISHIDA, Takeshi KUBOTA, Yoshinobu NAGASHIMA, Yoji |
description | Purpose: Vascular cell adhesion molecule 1 (VCAM1) is a cell surface glycoprotein implicated in various pathophysiologic conditions.
We measured VCAM1 expression levels in tumor tissues and evaluated its significance and prognostic use in renal cell carcinoma (RCC).
Experimental Design: We used real-time quantitative PCR to examine the VCAM1 expression levels of a total of 485 sporadic renal tumors, including 429 clear cell, 21 papillary, 17 chromophobe, 11 oncocytomas,
and 7 collecting duct carcinomas. We retrospectively examined the relationship of this expression to various clinicopathologic
variables and the von Hippel-Lindau alteration status. We evaluated its significance with respect to patient survival rates using the Cox regression model combined
with the split-sample method.
Results: Compared with normal kidney samples ( n = 43), VCAM1 was significantly up-regulated in clear cell RCC and papillary RCC, whereas it was down-regulated in chromophobe RCC and
oncocytoma. In clear cell RCC, VCAM1 expression levels were apparently high in patients asymptomatic at presentation and in patients with small tumor size, low-stage,
low-grade, microvascular invasion–negative, and von Hippel-Lindau alteration-positive tumors. Univariate analyses showed that VCAM1 high expression is strongly associated with better outcomes in clear cell and papillary RCCs. Further, Cox multivariate analysis
models combined with the split-sample method revealed that this association is significant only in cancer-free survival for
patients with clear cell RCC after curative surgical resection.
Conclusions: VCAM1 expression levels were found to be histologically subtype specific in renal tumors. Determination of the VCAM1 expression level as a biomarker can provide useful prognostic information for patients with clear cell RCC. |
doi_str_mv | 10.1158/1078-0432.CCR-06-1737 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68264020</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>19502593</sourcerecordid><originalsourceid>FETCH-LOGICAL-c515t-812925a47d4e3e844b04635d79793902776d6e63d6a930a6e8df41a60866ffd63</originalsourceid><addsrcrecordid>eNqFkU1rFTEUhoMotlZ_gpKNgoupOfnOsgytChVL_diGNDnjjcydqclMxX9vrveWLl0lHJ43OTwvIS-BnQIo-w6YsR2Tgp_2_XXHdAdGmEfkGJQyneBaPW73e-aIPKv1J2Mggcmn5AgMWCeZOibD91DjOoZCexxHepY2WPM80U_ziG2OFOhVwZTjUmkfpoiluyiI9Mta7vJdGGmeaD_iff4apzbrQ4l5mreBXoUl47TU5-TJEMaKLw7nCfl2cf61_9Bdfn7_sT-77KICtXQWuOMqSJMkCrRS3jCphUrGGScc48bopFGLpIMTLGi0aZAQNLNaD0PS4oS82b97W-ZfK9bFb3ONbbMw4bxWry3XknH2XxCcYlw50UC1B2OZay04-NuSt6H88cD8rgm_s-x3ln1rwjPtd0203KvDB-vNFtND6qC-Aa8PQGsgjENpdnN94KwUbVVo3Ns9t8k_Nr9zQR__9VCwNu1x44F7Lr0Rwom_HlWdZg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>19502593</pqid></control><display><type>article</type><title>Vascular Cell Adhesion Molecule 1 Predicts Cancer-Free Survival in Clear Cell Renal Carcinoma Patients</title><source>MEDLINE</source><source>American Association for Cancer Research</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>SHIOI, Ko-Ichi ; KOMIYA, Atsushi ; YAO, Masahiro ; HATTORI, Keiko ; YING HUANG ; SANO, Futoshi ; MURAKAMI, Takayuki ; NAKAIGAWA, Noboru ; KISHIDA, Takeshi ; KUBOTA, Yoshinobu ; NAGASHIMA, Yoji</creator><creatorcontrib>SHIOI, Ko-Ichi ; KOMIYA, Atsushi ; YAO, Masahiro ; HATTORI, Keiko ; YING HUANG ; SANO, Futoshi ; MURAKAMI, Takayuki ; NAKAIGAWA, Noboru ; KISHIDA, Takeshi ; KUBOTA, Yoshinobu ; NAGASHIMA, Yoji</creatorcontrib><description>Purpose: Vascular cell adhesion molecule 1 (VCAM1) is a cell surface glycoprotein implicated in various pathophysiologic conditions.
We measured VCAM1 expression levels in tumor tissues and evaluated its significance and prognostic use in renal cell carcinoma (RCC).
Experimental Design: We used real-time quantitative PCR to examine the VCAM1 expression levels of a total of 485 sporadic renal tumors, including 429 clear cell, 21 papillary, 17 chromophobe, 11 oncocytomas,
and 7 collecting duct carcinomas. We retrospectively examined the relationship of this expression to various clinicopathologic
variables and the von Hippel-Lindau alteration status. We evaluated its significance with respect to patient survival rates using the Cox regression model combined
with the split-sample method.
Results: Compared with normal kidney samples ( n = 43), VCAM1 was significantly up-regulated in clear cell RCC and papillary RCC, whereas it was down-regulated in chromophobe RCC and
oncocytoma. In clear cell RCC, VCAM1 expression levels were apparently high in patients asymptomatic at presentation and in patients with small tumor size, low-stage,
low-grade, microvascular invasion–negative, and von Hippel-Lindau alteration-positive tumors. Univariate analyses showed that VCAM1 high expression is strongly associated with better outcomes in clear cell and papillary RCCs. Further, Cox multivariate analysis
models combined with the split-sample method revealed that this association is significant only in cancer-free survival for
patients with clear cell RCC after curative surgical resection.
Conclusions: VCAM1 expression levels were found to be histologically subtype specific in renal tumors. Determination of the VCAM1 expression level as a biomarker can provide useful prognostic information for patients with clear cell RCC.</description><identifier>ISSN: 1078-0432</identifier><identifier>EISSN: 1557-3265</identifier><identifier>DOI: 10.1158/1078-0432.CCR-06-1737</identifier><identifier>PMID: 17189405</identifier><language>eng</language><publisher>Philadelphia, PA: American Association for Cancer Research</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antineoplastic agents ; Biological and medical sciences ; Biomarkers, Tumor - metabolism ; Biomarkers, Tumor - physiology ; Carcinoma, Papillary - metabolism ; Carcinoma, Papillary - mortality ; Carcinoma, Papillary - pathology ; Carcinoma, Renal Cell - diagnosis ; Carcinoma, Renal Cell - mortality ; Carcinoma, Renal Cell - pathology ; Carcinoma, Renal Cell - therapy ; Disease-Free Survival ; Female ; Gene Expression ; Humans ; Kidney Neoplasms - diagnosis ; Kidney Neoplasms - mortality ; Kidney Neoplasms - pathology ; Kidney Neoplasms - therapy ; Kidneys ; Male ; Medical sciences ; Middle Aged ; Mutation ; Neoplasm Metastasis - pathology ; Neoplasm Staging ; Nephrology. Urinary tract diseases ; Pharmacology. Drug treatments ; Prognosis ; real-time PCR ; renal cell carcinoma ; split-sample method ; Survival Analysis ; Treatment Outcome ; Tumors of the urinary system ; Vascular Cell Adhesion Molecule-1 - metabolism ; Vascular Cell Adhesion Molecule-1 - physiology ; VCAM1 ; Von Hippel-Lindau Tumor Suppressor Protein - genetics</subject><ispartof>Clinical cancer research, 2006-12, Vol.12 (24), p.7339-7346</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c515t-812925a47d4e3e844b04635d79793902776d6e63d6a930a6e8df41a60866ffd63</citedby><cites>FETCH-LOGICAL-c515t-812925a47d4e3e844b04635d79793902776d6e63d6a930a6e8df41a60866ffd63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3343,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18436401$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17189405$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SHIOI, Ko-Ichi</creatorcontrib><creatorcontrib>KOMIYA, Atsushi</creatorcontrib><creatorcontrib>YAO, Masahiro</creatorcontrib><creatorcontrib>HATTORI, Keiko</creatorcontrib><creatorcontrib>YING HUANG</creatorcontrib><creatorcontrib>SANO, Futoshi</creatorcontrib><creatorcontrib>MURAKAMI, Takayuki</creatorcontrib><creatorcontrib>NAKAIGAWA, Noboru</creatorcontrib><creatorcontrib>KISHIDA, Takeshi</creatorcontrib><creatorcontrib>KUBOTA, Yoshinobu</creatorcontrib><creatorcontrib>NAGASHIMA, Yoji</creatorcontrib><title>Vascular Cell Adhesion Molecule 1 Predicts Cancer-Free Survival in Clear Cell Renal Carcinoma Patients</title><title>Clinical cancer research</title><addtitle>Clin Cancer Res</addtitle><description>Purpose: Vascular cell adhesion molecule 1 (VCAM1) is a cell surface glycoprotein implicated in various pathophysiologic conditions.
We measured VCAM1 expression levels in tumor tissues and evaluated its significance and prognostic use in renal cell carcinoma (RCC).
Experimental Design: We used real-time quantitative PCR to examine the VCAM1 expression levels of a total of 485 sporadic renal tumors, including 429 clear cell, 21 papillary, 17 chromophobe, 11 oncocytomas,
and 7 collecting duct carcinomas. We retrospectively examined the relationship of this expression to various clinicopathologic
variables and the von Hippel-Lindau alteration status. We evaluated its significance with respect to patient survival rates using the Cox regression model combined
with the split-sample method.
Results: Compared with normal kidney samples ( n = 43), VCAM1 was significantly up-regulated in clear cell RCC and papillary RCC, whereas it was down-regulated in chromophobe RCC and
oncocytoma. In clear cell RCC, VCAM1 expression levels were apparently high in patients asymptomatic at presentation and in patients with small tumor size, low-stage,
low-grade, microvascular invasion–negative, and von Hippel-Lindau alteration-positive tumors. Univariate analyses showed that VCAM1 high expression is strongly associated with better outcomes in clear cell and papillary RCCs. Further, Cox multivariate analysis
models combined with the split-sample method revealed that this association is significant only in cancer-free survival for
patients with clear cell RCC after curative surgical resection.
Conclusions: VCAM1 expression levels were found to be histologically subtype specific in renal tumors. Determination of the VCAM1 expression level as a biomarker can provide useful prognostic information for patients with clear cell RCC.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>Biomarkers, Tumor - metabolism</subject><subject>Biomarkers, Tumor - physiology</subject><subject>Carcinoma, Papillary - metabolism</subject><subject>Carcinoma, Papillary - mortality</subject><subject>Carcinoma, Papillary - pathology</subject><subject>Carcinoma, Renal Cell - diagnosis</subject><subject>Carcinoma, Renal Cell - mortality</subject><subject>Carcinoma, Renal Cell - pathology</subject><subject>Carcinoma, Renal Cell - therapy</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Gene Expression</subject><subject>Humans</subject><subject>Kidney Neoplasms - diagnosis</subject><subject>Kidney Neoplasms - mortality</subject><subject>Kidney Neoplasms - pathology</subject><subject>Kidney Neoplasms - therapy</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Neoplasm Metastasis - pathology</subject><subject>Neoplasm Staging</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Pharmacology. Drug treatments</subject><subject>Prognosis</subject><subject>real-time PCR</subject><subject>renal cell carcinoma</subject><subject>split-sample method</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Tumors of the urinary system</subject><subject>Vascular Cell Adhesion Molecule-1 - metabolism</subject><subject>Vascular Cell Adhesion Molecule-1 - physiology</subject><subject>VCAM1</subject><subject>Von Hippel-Lindau Tumor Suppressor Protein - genetics</subject><issn>1078-0432</issn><issn>1557-3265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1rFTEUhoMotlZ_gpKNgoupOfnOsgytChVL_diGNDnjjcydqclMxX9vrveWLl0lHJ43OTwvIS-BnQIo-w6YsR2Tgp_2_XXHdAdGmEfkGJQyneBaPW73e-aIPKv1J2Mggcmn5AgMWCeZOibD91DjOoZCexxHepY2WPM80U_ziG2OFOhVwZTjUmkfpoiluyiI9Mta7vJdGGmeaD_iff4apzbrQ4l5mreBXoUl47TU5-TJEMaKLw7nCfl2cf61_9Bdfn7_sT-77KICtXQWuOMqSJMkCrRS3jCphUrGGScc48bopFGLpIMTLGi0aZAQNLNaD0PS4oS82b97W-ZfK9bFb3ONbbMw4bxWry3XknH2XxCcYlw50UC1B2OZay04-NuSt6H88cD8rgm_s-x3ln1rwjPtd0203KvDB-vNFtND6qC-Aa8PQGsgjENpdnN94KwUbVVo3Ns9t8k_Nr9zQR__9VCwNu1x44F7Lr0Rwom_HlWdZg</recordid><startdate>20061215</startdate><enddate>20061215</enddate><creator>SHIOI, Ko-Ichi</creator><creator>KOMIYA, Atsushi</creator><creator>YAO, Masahiro</creator><creator>HATTORI, Keiko</creator><creator>YING HUANG</creator><creator>SANO, Futoshi</creator><creator>MURAKAMI, Takayuki</creator><creator>NAKAIGAWA, Noboru</creator><creator>KISHIDA, Takeshi</creator><creator>KUBOTA, Yoshinobu</creator><creator>NAGASHIMA, Yoji</creator><general>American Association for Cancer Research</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20061215</creationdate><title>Vascular Cell Adhesion Molecule 1 Predicts Cancer-Free Survival in Clear Cell Renal Carcinoma Patients</title><author>SHIOI, Ko-Ichi ; KOMIYA, Atsushi ; YAO, Masahiro ; HATTORI, Keiko ; YING HUANG ; SANO, Futoshi ; MURAKAMI, Takayuki ; NAKAIGAWA, Noboru ; KISHIDA, Takeshi ; KUBOTA, Yoshinobu ; NAGASHIMA, Yoji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c515t-812925a47d4e3e844b04635d79793902776d6e63d6a930a6e8df41a60866ffd63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic agents</topic><topic>Biological and medical sciences</topic><topic>Biomarkers, Tumor - metabolism</topic><topic>Biomarkers, Tumor - physiology</topic><topic>Carcinoma, Papillary - metabolism</topic><topic>Carcinoma, Papillary - mortality</topic><topic>Carcinoma, Papillary - pathology</topic><topic>Carcinoma, Renal Cell - diagnosis</topic><topic>Carcinoma, Renal Cell - mortality</topic><topic>Carcinoma, Renal Cell - pathology</topic><topic>Carcinoma, Renal Cell - therapy</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Gene Expression</topic><topic>Humans</topic><topic>Kidney Neoplasms - diagnosis</topic><topic>Kidney Neoplasms - mortality</topic><topic>Kidney Neoplasms - pathology</topic><topic>Kidney Neoplasms - therapy</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Neoplasm Metastasis - pathology</topic><topic>Neoplasm Staging</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Pharmacology. Drug treatments</topic><topic>Prognosis</topic><topic>real-time PCR</topic><topic>renal cell carcinoma</topic><topic>split-sample method</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>Tumors of the urinary system</topic><topic>Vascular Cell Adhesion Molecule-1 - metabolism</topic><topic>Vascular Cell Adhesion Molecule-1 - physiology</topic><topic>VCAM1</topic><topic>Von Hippel-Lindau Tumor Suppressor Protein - genetics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SHIOI, Ko-Ichi</creatorcontrib><creatorcontrib>KOMIYA, Atsushi</creatorcontrib><creatorcontrib>YAO, Masahiro</creatorcontrib><creatorcontrib>HATTORI, Keiko</creatorcontrib><creatorcontrib>YING HUANG</creatorcontrib><creatorcontrib>SANO, Futoshi</creatorcontrib><creatorcontrib>MURAKAMI, Takayuki</creatorcontrib><creatorcontrib>NAKAIGAWA, Noboru</creatorcontrib><creatorcontrib>KISHIDA, Takeshi</creatorcontrib><creatorcontrib>KUBOTA, Yoshinobu</creatorcontrib><creatorcontrib>NAGASHIMA, Yoji</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical cancer research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SHIOI, Ko-Ichi</au><au>KOMIYA, Atsushi</au><au>YAO, Masahiro</au><au>HATTORI, Keiko</au><au>YING HUANG</au><au>SANO, Futoshi</au><au>MURAKAMI, Takayuki</au><au>NAKAIGAWA, Noboru</au><au>KISHIDA, Takeshi</au><au>KUBOTA, Yoshinobu</au><au>NAGASHIMA, Yoji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vascular Cell Adhesion Molecule 1 Predicts Cancer-Free Survival in Clear Cell Renal Carcinoma Patients</atitle><jtitle>Clinical cancer research</jtitle><addtitle>Clin Cancer Res</addtitle><date>2006-12-15</date><risdate>2006</risdate><volume>12</volume><issue>24</issue><spage>7339</spage><epage>7346</epage><pages>7339-7346</pages><issn>1078-0432</issn><eissn>1557-3265</eissn><abstract>Purpose: Vascular cell adhesion molecule 1 (VCAM1) is a cell surface glycoprotein implicated in various pathophysiologic conditions.
We measured VCAM1 expression levels in tumor tissues and evaluated its significance and prognostic use in renal cell carcinoma (RCC).
Experimental Design: We used real-time quantitative PCR to examine the VCAM1 expression levels of a total of 485 sporadic renal tumors, including 429 clear cell, 21 papillary, 17 chromophobe, 11 oncocytomas,
and 7 collecting duct carcinomas. We retrospectively examined the relationship of this expression to various clinicopathologic
variables and the von Hippel-Lindau alteration status. We evaluated its significance with respect to patient survival rates using the Cox regression model combined
with the split-sample method.
Results: Compared with normal kidney samples ( n = 43), VCAM1 was significantly up-regulated in clear cell RCC and papillary RCC, whereas it was down-regulated in chromophobe RCC and
oncocytoma. In clear cell RCC, VCAM1 expression levels were apparently high in patients asymptomatic at presentation and in patients with small tumor size, low-stage,
low-grade, microvascular invasion–negative, and von Hippel-Lindau alteration-positive tumors. Univariate analyses showed that VCAM1 high expression is strongly associated with better outcomes in clear cell and papillary RCCs. Further, Cox multivariate analysis
models combined with the split-sample method revealed that this association is significant only in cancer-free survival for
patients with clear cell RCC after curative surgical resection.
Conclusions: VCAM1 expression levels were found to be histologically subtype specific in renal tumors. Determination of the VCAM1 expression level as a biomarker can provide useful prognostic information for patients with clear cell RCC.</abstract><cop>Philadelphia, PA</cop><pub>American Association for Cancer Research</pub><pmid>17189405</pmid><doi>10.1158/1078-0432.CCR-06-1737</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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ispartof | Clinical cancer research, 2006-12, Vol.12 (24), p.7339-7346 |
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source | MEDLINE; American Association for Cancer Research; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
subjects | Adult Aged Aged, 80 and over Antineoplastic agents Biological and medical sciences Biomarkers, Tumor - metabolism Biomarkers, Tumor - physiology Carcinoma, Papillary - metabolism Carcinoma, Papillary - mortality Carcinoma, Papillary - pathology Carcinoma, Renal Cell - diagnosis Carcinoma, Renal Cell - mortality Carcinoma, Renal Cell - pathology Carcinoma, Renal Cell - therapy Disease-Free Survival Female Gene Expression Humans Kidney Neoplasms - diagnosis Kidney Neoplasms - mortality Kidney Neoplasms - pathology Kidney Neoplasms - therapy Kidneys Male Medical sciences Middle Aged Mutation Neoplasm Metastasis - pathology Neoplasm Staging Nephrology. Urinary tract diseases Pharmacology. Drug treatments Prognosis real-time PCR renal cell carcinoma split-sample method Survival Analysis Treatment Outcome Tumors of the urinary system Vascular Cell Adhesion Molecule-1 - metabolism Vascular Cell Adhesion Molecule-1 - physiology VCAM1 Von Hippel-Lindau Tumor Suppressor Protein - genetics |
title | Vascular Cell Adhesion Molecule 1 Predicts Cancer-Free Survival in Clear Cell Renal Carcinoma Patients |
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