The altered expression and activation of the mammalian target of rapamycin (mTOR) promotes the invasiveness and metastatic potential in a variety of malignancies. The aim of the present pilot study was to determine mTOR expression in clear cell renal cell carcinoma (RCC) and to evaluate mTOR activation and phosphorylation at Ser2448. Tissue microarray immunohistochemistry and Western blot analysis of tumor and benign tissue from 10 patients subjected to tumor nephrectomy were investigated. Staining of mTOR and phosphorylated-mTOR (p-mTOR) was documented and determined as percentage of the maximum. Western blots were evaluated densitometrically. Ratios of tumor versus benign tissue were calculated and compared by the Wilcoxon/Kruskal-Wallis test. Immunohistochemical expressions of mTOR and p-mTOR were 49 and 40% in benign renal parenchyma, whereas it was 20 and 42% in tumor tissue. Ratios of tumor versus benign tissue revealed a reduction to 0.44 for mTOR and corresponding elevation to 1.29 for p-mTOR (p<0.05). The rate of p-mTOR to mTOR was 1.19 in benign, whereas it was 5.30 in tumor tissue. Western blot densitometry detected lower expressions of mTOR in tumor compared to benign tissues. Ratio of p-mTOR to mTOR were significantly different in benign versus tumor tissue (0.86 vs. 1.37; p<0.04). The observation that RCC specimens exhibit higher levels of p-mTOR in RCC compared to benign renal parenchyma indicate the role of mTOR phosphorylation in RCC tumor development and progression. This study found a concomitant reduction of the RCC mTOR protein expression, which suggests that elevated levels of activated p-mTOR result predominantly from an increased mTOR phosphorylation rather than from protein overexpression. These pilot study results may contribute to the clarification of mTOR-pathway regulation processes in RCC on the way to the protein profiling-predicted targeted therapy.

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