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The Use of Immunohistochemical Staining for the Prediction of Wilms Tumour Progression and Recurrence

Primary Purpose

Wilms Tumor, Relapse, Death

Status
Unknown status
Phase
Not Applicable
Locations
Egypt
Study Type
Interventional
Intervention
P53, Ki67 and Cyclin A IHC.
Sponsored by
Mansoura University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Wilms Tumor

Eligibility Criteria

undefined - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • All children presented with Wilms' tumour at the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt from 2000 to 2014.

Exclusion Criteria:

  • Preoperative chemotherapy (due to areas of necrosis and haemorrhage hindering immunohistochemical staining).
  • Patients with incomplete follow-up data.

Sites / Locations

  • Mansoura Urology and Nephrology Center. Faculty of Medicine, Mansoura UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

P53 IHC

Ki67 IHC

Cyclin A IHC

Arm Description

P53 staining density and intensity will be calculated. To assess P53 density in a semiquantitative way, a score of 0 will be given assigned if less than 5% of tumour cells expressed p53, 1 if 5% to 50% expressed p53 and 2 if more than 50% stained positive for p53. To evaluate P53 intensity, a score of 0 means weak or absent staining, 1 refers to the intermediate intensity and 2 stands for strong intensity.

Ki67 proliferation index will be used to detect rapidly proliferating cells which means the percentage of positive Ki67 cells over 5 high power fields. It will be semiquantitatively graded as low, moderate, or high and correlated with histological staging.

Regarding Cyclin A, a standard peroxidase-conjugated streptavidin-biotin labelling was used for visualization, with 3,3 diaminobenzidine as chromogen. Level of cyclin A expression will be classified as absent (-), focal (+), moderate (++) diffuse (+++).

Outcomes

Primary Outcome Measures

To test the ability of P53, Ki67 and cyclin A to predict Wilms' tumour recurrence and progression.
By correlating P53, Ki67 and cyclin A IHC to tumor stage, histopathology and patients' follow-up.

Secondary Outcome Measures

Full Information

First Posted
February 14, 2021
Last Updated
February 16, 2021
Sponsor
Mansoura University
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1. Study Identification

Unique Protocol Identification Number
NCT04758455
Brief Title
The Use of Immunohistochemical Staining for the Prediction of Wilms Tumour Progression and Recurrence
Official Title
P53, Ki67 and Cyclin A Immunohistochemical Staining as Predictors for Wilms' Tumour Aggressiveness and Recurrence
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Unknown status
Study Start Date
February 14, 2021 (Actual)
Primary Completion Date
March 2021 (Anticipated)
Study Completion Date
April 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Mansoura University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Wilms' tumour staging and grading are used to give an idea about the prognosis. Advanced staging, diffuse anaplasia, predominant blastemal elements and lymph node invasion are indicators of poor prognosis. In spite of using the previously mentioned parameters, some tumours which were considered of low risk did not respond to therapy and eventually resulted in mortality. In contrast, other tumours assumed to be of poor prognosis responded dramatically to treatment. In light of the above, it is crucial to search for predictors of Wilms' tumour prognosis other than tumour staging and grading. Many immunohistochemical (IHC) stains have been studied as prognostic markers for nephroblastoma in literature.
Detailed Description
P53 is a tumour suppressor gene, and its mutation is identified in various types of human cancer. P53 protein accumulation in certain tumours is associated with tumour aggressiveness. The role of P53 expression in Wilms' tumour is not clear; however, most studies confirmed its correlation with advanced stages and anaplasia. Ki67 is a nuclear antigen related to cell proliferation, and high Ki67 proliferation index (PI) is accompanied by tumour aggressiveness, distant metastasis and death. Advanced stages and clinical progression of WT were found to be associated with high Ki67 PI. On the other hand, some authors concluded that it may not be a dependable prognostic marker. The cyclin-dependent kinases (CDKs) have a role in transitions between cell cycle phases with the need of cyclins association for their activity. IHC assessment of cell cycle proteins has a diagnostic use in histopathology. Correlation between poor prognosis and overexpression of cyclin A was confirmed in different entities of human cancer such as medulloblastoma and ovarian carcinoma. A recent study deduced that cyclin A overexpression may be associated with the poor prognosis of WT.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Wilms Tumor, Relapse, Death

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
Investigator
Allocation
Non-Randomized
Enrollment
75 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
P53 IHC
Arm Type
Experimental
Arm Description
P53 staining density and intensity will be calculated. To assess P53 density in a semiquantitative way, a score of 0 will be given assigned if less than 5% of tumour cells expressed p53, 1 if 5% to 50% expressed p53 and 2 if more than 50% stained positive for p53. To evaluate P53 intensity, a score of 0 means weak or absent staining, 1 refers to the intermediate intensity and 2 stands for strong intensity.
Arm Title
Ki67 IHC
Arm Type
Experimental
Arm Description
Ki67 proliferation index will be used to detect rapidly proliferating cells which means the percentage of positive Ki67 cells over 5 high power fields. It will be semiquantitatively graded as low, moderate, or high and correlated with histological staging.
Arm Title
Cyclin A IHC
Arm Type
Experimental
Arm Description
Regarding Cyclin A, a standard peroxidase-conjugated streptavidin-biotin labelling was used for visualization, with 3,3 diaminobenzidine as chromogen. Level of cyclin A expression will be classified as absent (-), focal (+), moderate (++) diffuse (+++).
Intervention Type
Diagnostic Test
Intervention Name(s)
P53, Ki67 and Cyclin A IHC.
Intervention Description
P53, Ki67 and Cyclin A immunohistochemical staining of formalin-fixed paraffin-embedded specimens of Wilms' tumour.
Primary Outcome Measure Information:
Title
To test the ability of P53, Ki67 and cyclin A to predict Wilms' tumour recurrence and progression.
Description
By correlating P53, Ki67 and cyclin A IHC to tumor stage, histopathology and patients' follow-up.
Time Frame
2 months

10. Eligibility

Sex
All
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: All children presented with Wilms' tumour at the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt from 2000 to 2014. Exclusion Criteria: Preoperative chemotherapy (due to areas of necrosis and haemorrhage hindering immunohistochemical staining). Patients with incomplete follow-up data.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ahmed Atwa, MSc
Phone
01009440128
Email
Ahmed_Atwa_88@yahoo.com
First Name & Middle Initial & Last Name or Official Title & Degree
Ahmed I Atwa, MSc
Phone
0502362383
Email
ahmedatwa@mans.edu.eg
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mohamed Abdelhameed, MSc
Organizational Affiliation
Mansoura University
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Tamer Helmy, MD
Organizational Affiliation
Mansoura University
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Ashraf Hafez, MD
Organizational Affiliation
Mansoura University
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Adel Nabeeh, MD
Organizational Affiliation
Mansoura University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mansoura Urology and Nephrology Center. Faculty of Medicine, Mansoura University
City
Mansoura
State/Province
Dakahlia
ZIP/Postal Code
35516
Country
Egypt
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ahmed I Atwa, MSc
Phone
01009440128
Email
ahmedatwa@mans.edu.eg

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

The Use of Immunohistochemical Staining for the Prediction of Wilms Tumour Progression and Recurrence

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