The Predictive Value of Endoglin for Fatal Outcomes in Renal Cell Carcinoma

Endoglin (CD105) is an endothelial marker used for detection of tumors, prognostic assessment, and evaluation of the efficacy of chemotherapy protocols. Endoglin is a biomarker involved in angiogenesis, which plays a fundamental role in the growth and metastasis of tumor. To determine the predictive significance of endoglin expression for the occurrence of fatal outcomes in patients with renal cell carcinoma (RCC). Endoglin expression was determined by immunohistochemical staining of endothelial cells in tissue samples obtained from 120 patients who underwent nephrectomy for RCC at the Urology Clinic of the Clinical Center, University of Sarajevo, Bosnia and Herzegovina. The association between CD105 expression and mortality was evaluated over a 5-year follow-up period. In the univariable Cox proportional hazards regression analysis, patients with low and moderate endothelial CD105 expression had an increased risk of death compared to those with high expression, although this association did not reach conventional statistical significance (hazards ratio (HR) = 2.08, 95% Confidence Interval (CI): 1.12–3.85, P = 0.052). In contrast, the multivariable model adjusted for clinicopathological features demonstrated that low and moderate endothelial CD105 expression was independently associated with a significantly higher risk of death, corresponding to a 2.87-fold increase, compared to high expression (HR = 2.87, 95% CI: 1.25–6.59, P = 0.013). Regression diagnostics confirmed the absence of problematic multicollinearity, supporting the robustness of the model. This research demonstrates that endothelial endoglin expression is an independent predictive factor for fatal outcomes in patients with renal cancer. Based on these results, high endothelial endoglin expression is associated with longer survival in patients with RCC.