High expression of Aldolase A predicts poor survival in patients with clear-cell renal cell carcinoma

Background: Aldolase A (ALDOA) is a glycolytic enzyme that drives the glycolytic metabolic pathway in mammalian cells. The overexpression of ALDOA was observed in a variety of cancers including clear-cell renal cell carcinoma (ccRCC). However, little was known about the clinicopathological significance and prognostic value of ALDOA in ccRCC patients. Methods: The expression of ALDOA was detected using immunohistochemical staining in 162 formalin-fixed, paraffin-embedded ccRCC sections. Prognostic outcomes correlated with ALDOA were examined using Kaplan-Meier analysis and the Cox proportional hazards model. Results: In patients with ccRCC, increased cytoplasmic ALDOA expression was positively associated with tumor size (P= 0.021), TNM stages (P= 0.034), lymph node metastasis (P= 0.020), and overall survival (OS) (P < 0.001). Kaplan-Meier analysis showed that high cytoplasmic expression of ALDOA was associated with a statistically significant lower OS ( P < 0.001). Multivariate analysis demonstrated that ALDOA expression was an independent and significant prognostic factor (HR = 3.561, 95% CI = 1.715-7.396, P= 0.001). ALDOA expression was not associated with significant prognostic deference in the subgroups of TNM stage I patients or pT1 patients. Conclusion: Our results suggest that ALDOA expression is an independent prognostic factor for OS in patients with ccRCC.