Nephroblastoma: Multidrug-resistance P-glycoprotein expression in tumor cells and intratumoral capillary endothelial cells

Francesca Diomedi Camassei, Giuseppe Arancia, Maurizio Cianfriglia, Cesare Bosman, Paola Francalanci, Lucilla Ravà, Alessandro Jenkner, Alberto Donfrancesco, Renata Boldrini

Research output: Contribution to journalArticlepeer-review


The development of chemoresistance in a variety of cancers seems related to overexpression of the P-glycoprotein (P-gp) drug pump. Nephroblastoma, the most common malignant renal tumor of childhood, usually is responsive to treatment, and prognosis is favorable in most cases. However, the disease in a subset of patients is refractory to treatment, and the disease follows an aggressive course. To study P-gp expression in this tumor and its correlation with outcome, tumor samples from 93 patients were examined by immunohistochemical analysis. P-gp expression was determined separately in both tumor cells and intratumoral capillary endothelium. The likelihood ratio test, the Kaplan-Meier method, and the log-rank test were used to evaluate its association with clinical course, grade, stage, and administration of preoperative chemotherapy. The results for the majority of nephroblastomas were variably positive; in 43 (46%) of them, newly formed capillary endothelial cells also stained positive. While no association of P-gp expression in tumor cells with clinical course, stage, and grade could be demonstrated, positivity in endothelial cells correlated significantly with unfavorable outcome, suggesting that chemoresistance depended on an active blood-tumor barrier. Previous chemotherapy induced P-gp overexpression in tumor cells.

Original languageEnglish
Pages (from-to)484-490
Number of pages7
JournalAmerican Journal of Clinical Pathology
Issue number3
Publication statusPublished - 2002


  • Chemoresistance
  • Immunohistochemistry
  • Intratumoral capillary endothelial cells
  • Nephroblastoma
  • P-glycoprotein

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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