Significance of sex-determining region Y box family members (SOX6 and SOX9) in clear cell renal cell carcinoma: immunohistochemical study

Abstract

Background Renal cell carcinoma (RCC) ranks as the third most common urological malignancy worldwide, comprising ~2.2% of all cancers. The clear cell subtype, which accounts for 80–90% of RCC cases, is characterized by a wide spectrum of survival outcomes. The sex-determining region Y box (SOX) family of proteins, expressed in multiple cell types, plays a crucial role in regulating cell differentiation and fate in various physiological contexts. Among them, SOX6 and SOX9 have been implicated in the regulation of carcinogenesis in several human cancers. Aim The primary objective of this study is to investigate the immunohistochemical expression of SOX6 and SOX9 in clear cell RCC, with a focus on their potential role in tumor progression and as predictors of patient prognosis and survival. This retrospective analysis included 50 cases of clear cell RCC. Immunostaining for SOX6 and SOX9 was performed, and the results were correlated with clinicopathological features. Results SOX6 and SOX9 expression was significantly altered in RCC compared with normal renal tissue ( P <0.001). SOX9 expression showed a strong positive association with key clinicopathological factors such as tumor size, Fuhrman grade, tumor, nodal, metastasis (TNM) stage, and lymphovascular invasion ( P <0.05). Conversely, SOX6 expression exhibited a significant negative correlation with these same parameters ( P <0.05). Conclusion SOX9 and SOX6 are potentially involved in the progression of clear cell RCC and may serve as useful biomarkers for this malignancy.