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Objectives . To clarify what kind of pathological factor is necessary for the extension of tumor diameter in localized RCC, we studied localized RCC patients.  Methods . We retrospectively reviewed medical records of 237 RCC patients in our institute who underwent nephrectomy. We performed immune histological analysis of MMP-2, MMP-9, TIMP-1, TIMP-2, and MT-MMP-1 for all samples.  Results . Among the clinicopathological factors, multivariate analysis revealed nuclear grade; TIMP-2 and MT-MMP-1 were independent prognostic factors of localized RCC (risk ratio 1.50,  p  = 0.037, risk ratio 1.12,  p  = 0.008, and risk ratio 1.84,  p  = 0.045, resp.). By the multiple logistic regression analysis among pT1a versus pT1b, TIMP-1 was an independent factor (risk ratio 3.30,  p  = 0.010) whereas all pT1 versus pT2a and all pT1 + pT2a versus pT2b high nuclear grade (risk ratio 5.15,  p  = 0.0015) and Micro vessel invasion (MVI, risk ratio 3.08,  p  = 0.002) were independent factors. For all pT1 + pT2a versus pT2b, nuclear grade (risk ratio 3.39,  p  = 0.020) and MVI (risk ratio 2.91,  p  = 0.018) were independent factors.  Conclusion . Higher expression of TIMP-1 is necessary for advancement tumor diameter from pT1a to pT1b, and a process of tumor diameter extension beyond pT1 and pT2a category needs presence of MVI and high nuclear grade.

TIMP-1 as well as Microvessel Invasion and High Nuclear Grade Is a Significant Determinant Factor for Extension of Tumor Diameter in Localized RCC