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Furukawa J, Hinata N, Teisima J, Takenaka A, Shiroki R, Kobayashi Y, Kanayama HO, Hattori K, Horie S, Tozawa K, Kato M, Ohyama C, Habuchi T, Kawamorita N, Eto M, Fujisawa M. Robot-assisted partial nephrectomy with minimum follow-up of 5 years: A multi-center prospective study in Japan. Int J Urol 2022; 29:1038-1045. [PMID: 35707848 DOI: 10.1111/iju.14960] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Robot-assisted partial nephrectomy is widely performed for small renal masses, achieving excellent perioperative and intermediate oncological outcomes. However, long-term oncological, functional, and quality of life outcomes after robot-assisted partial nephrectomy remain unclear. In this study, we aimed to evaluate quality of life at 1 year and oncological and functional outcomes of robot-assisted partial nephrectomy after a minimum follow-up of 5 years. METHODS Personal, perioperative, postoperative, functional, oncological, and quality of life data were evaluated. The EQ-5D-5L tool, which incorporates health profiles and a EuroQol Visual Analog Scale, was used to assess quality of life preoperatively and 365 days postoperatively. Regarding oncological and functional outcomes, overall survival, recurrence-free survival, and changes in estimated glomerular filtration rate were calculated. RESULTS There were few changes in levels between the two time points for all EQ-5D dimensions. The mean change in EQ-5D-5L was 0.020 (95% confidence interval 0.006-0.033, P = 0.006), and in EuroQol Visual Analog Scale score 4.60 (95% confidence interval 2.17-7.02, P = 0.0003). Overall and recurrence-free survival 5 years after robot-assisted partial nephrectomy were 97.9% and 92.8%, respectively. After an early postoperative decrease, the estimated glomerular filtration rate remained stable over time. CONCLUSIONS Robot-assisted partial nephrectomy in patients with a T1 renal tumor is safe, feasible, and effective from the perspective of quality of life and survival, even after 5 years. When making treatment decisions, perioperative and quality of life outcomes should be considered together with long-term oncological outcomes.
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Affiliation(s)
- Junya Furukawa
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobuyuki Hinata
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Jun Teisima
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Atsushi Takenaka
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Ryoichi Shiroki
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yasuyuki Kobayashi
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiro-Omi Kanayama
- Department of Urology, Institute of Biochemical Sciences, Tokushima University, Graduate School, Tokushima, Japan
| | - Kazunori Hattori
- Department of Urology, St. Luke's International Hospital, Tokyo, Japan
| | - Shigeo Horie
- Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Keiichi Tozawa
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masashi Kato
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Naoki Kawamorita
- Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
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Kang H, Xu W, Chang S, Yuan J, Bai X, Zhang J, Guo H, Ye H, Wang H. Mucinous tubular and spindle cell carcinomas of the kidney (MTSCC-Ks): CT and MR imaging characteristics. Jpn J Radiol 2022; 40:1175-1185. [PMID: 35644814 DOI: 10.1007/s11604-022-01294-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To strengthen the recognition of mucinous tubular and spindle cell carcinomas of the kidney (MTSCC-Ks) by analyzing CT and MR imaging findings of MTSCC-Ks. MATERIALS AND METHODS This study retrospectively enrolled ten patients with pathologically confirmed MTSCC-Ks from 2007 to 2020. The main observed imaging characteristics included growth pattern, signal characteristics on T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI), hemorrhage, necrosis, cystic degeneration, lipid component, pseudocapsule and the enhancement pattern. Apparent diffusion coefficient (ADC) value of MTSCC-Ks and normal renal cortex were measured, respectively. All imaging features were evaluated in consensus by two genitourinary radiologists. RESULTS All patients (53.1 ± 6.5 years, male to female, 3:7) presented with a solitary renal tumor with the mean diameter of 3.5 ± 0.4 cm. All lesions showed iso- or slight hypoattenuation on non-contrast CT with no hemorrhage but cystic degeneration (10%) and necrosis (10%). On T2WI, all lesions showed predominantly slight hypointensity with focal hyperintensity. The ADC value of MTSCC-Ks was 0.845 ± 0.017 × 10-3 mm2/s, and ADCtumor-to-ADCrenal cortex value was 0.376 ± 0.084. Pseudocapsules existed in all MTSCC-Ks on MRI. There were seven lesions showed heterogeneous enhancement, while three lesions showed homogeneous enhancement. Among them, six MTSCC-Ks showed slight multiple patchy enhancement (60%) in the corticomedullary phase, while the remaining MTSCC-Ks showed homogeneously slight enhancement (30%) or slightly stratified enhancement (10%). All MTSCC-Ks exhibited slow and progressive enhancement in the late phases. CONCLUSION Iso- or slight hypoattenuation on CT, slight hypointensity with focal hyperintensity on T2WI, marked diffusion restriction on DWI and ADC map, slight multiple patchy enhancement in the corticomedullary phase, and slow and progressive enhancement in the late phases are the imaging features of MTSCC-Ks, which may facilitate the diagnosis of MTSCC-Ks.
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Affiliation(s)
- Huanhuan Kang
- Medical School of Chinese PLA, Beijing, 100853, China.,Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Wei Xu
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Shuxiang Chang
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Jing Yuan
- Department of Pathology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Xu Bai
- Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Jing Zhang
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Huiping Guo
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Huiyi Ye
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Haiyi Wang
- Department of Radiology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
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Föll MC, Volkmann V, Enderle-Ammour K, Timme S, Wilhelm K, Guo D, Vitek O, Bronsert P, Schilling O. Moving translational mass spectrometry imaging towards transparent and reproducible data analyses: a case study of an urothelial cancer cohort analyzed in the Galaxy framework. Clin Proteomics 2022; 19:8. [PMID: 35439943 PMCID: PMC9016955 DOI: 10.1186/s12014-022-09347-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 04/04/2022] [Indexed: 11/24/2022] Open
Abstract
Background Mass spectrometry imaging (MSI) derives spatial molecular distribution maps directly from clinical tissue specimens and thus bears great potential for assisting pathologists with diagnostic decisions or personalized treatments. Unfortunately, progress in translational MSI is often hindered by insufficient quality control and lack of reproducible data analysis. Raw data and analysis scripts are rarely publicly shared. Here, we demonstrate the application of the Galaxy MSI tool set for the reproducible analysis of a urothelial carcinoma dataset. Methods Tryptic peptides were imaged in a cohort of 39 formalin-fixed, paraffin-embedded human urothelial cancer tissue cores with a MALDI-TOF/TOF device. The complete data analysis was performed in a fully transparent and reproducible manner on the European Galaxy Server. Annotations of tumor and stroma were performed by a pathologist and transferred to the MSI data to allow for supervised classifications of tumor vs. stroma tissue areas as well as for muscle-infiltrating and non-muscle infiltrating urothelial carcinomas. For putative peptide identifications, m/z features were matched to the MSiMass list. Results Rigorous quality control in combination with careful pre-processing enabled reduction of m/z shifts and intensity batch effects. High classification accuracy was found for both, tumor vs. stroma and muscle-infiltrating vs. non-muscle infiltrating urothelial tumors. Some of the most discriminative m/z features for each condition could be assigned a putative identity: stromal tissue was characterized by collagen peptides and tumor tissue by histone peptides. Immunohistochemistry confirmed an increased histone H2A abundance in the tumor compared to the stroma tissues. The muscle-infiltration status was distinguished via MSI by peptides from intermediate filaments such as cytokeratin 7 in non-muscle infiltrating carcinomas and vimentin in muscle-infiltrating urothelial carcinomas, which was confirmed by immunohistochemistry. To make the study fully reproducible and to advocate the criteria of FAIR (findability, accessibility, interoperability, and reusability) research data, we share the raw data, spectra annotations as well as all Galaxy histories and workflows. Data are available via ProteomeXchange with identifier PXD026459 and Galaxy results via https://github.com/foellmelanie/Bladder_MSI_Manuscript_Galaxy_links. Conclusion Here, we show that translational MSI data analysis in a fully transparent and reproducible manner is possible and we would like to encourage the community to join our efforts.
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Affiliation(s)
- Melanie Christine Föll
- Faculty of Medicine, Institute for Surgical Pathology, Medical Center - University of Freiburg, Breisacher Straße 115a, 79106, FreiburgFreiburg, Germany. .,Khoury College of Computer Sciences, Northeastern University, Boston, USA.
| | - Veronika Volkmann
- Faculty of Medicine, Institute for Surgical Pathology, Medical Center - University of Freiburg, Breisacher Straße 115a, 79106, FreiburgFreiburg, Germany
| | - Kathrin Enderle-Ammour
- Faculty of Medicine, Institute for Surgical Pathology, Medical Center - University of Freiburg, Breisacher Straße 115a, 79106, FreiburgFreiburg, Germany
| | - Sylvia Timme
- Faculty of Medicine, Institute for Surgical Pathology, Medical Center - University of Freiburg, Breisacher Straße 115a, 79106, FreiburgFreiburg, Germany.,Core Facility for Histopathology and Digital Pathology, Faculty of Medicine, Medical Center - University of Freiburg, 79106, Freiburg, Germany
| | - Konrad Wilhelm
- Department of Urology, Center for Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Dan Guo
- Khoury College of Computer Sciences, Northeastern University, Boston, USA
| | - Olga Vitek
- Khoury College of Computer Sciences, Northeastern University, Boston, USA
| | - Peter Bronsert
- Faculty of Medicine, Institute for Surgical Pathology, Medical Center - University of Freiburg, Breisacher Straße 115a, 79106, FreiburgFreiburg, Germany.,German Cancer Consortium (DKTK) and Cancer Research Center (DKFZ), Freiburg, Germany.,Tumorbank Comprehensive Cancer Center Freiburg, Freiburg, Germany
| | - Oliver Schilling
- Faculty of Medicine, Institute for Surgical Pathology, Medical Center - University of Freiburg, Breisacher Straße 115a, 79106, FreiburgFreiburg, Germany.,German Cancer Consortium (DKTK) and Cancer Research Center (DKFZ), Freiburg, Germany
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Xu X, Zhong J, Zhou X, Wei Z, Xia Q, Huang P, Shi C, Da J, Tang C, Cheng W, Ge J. Mucinous Tubular and Spindle Cell Carcinoma of the Kidney: A Study of Clinical, Imaging Features and Treatment Outcomes. Front Oncol 2022; 12:865263. [PMID: 35480124 PMCID: PMC9035933 DOI: 10.3389/fonc.2022.865263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To describe the clinical, imaging, pathological features and oncologic outcomes of mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney. Patients and Methods Twenty-two cases of MTSCC were pathologically identified between January 2004 and April 2021 at our institution. The clinical and imaging findings, pathological features, treatment methods and outcomes of the patients were reviewed. Results These cases included 17 women and 5 men, with a median age at diagnosis of 52.5 years. On contrast-enhanced CT, MTSCC was less enhanced than the adjacent renal parenchyma. Tumor attenuation values were 33.3 ± 6.8HU, 44.0 ± 9.1HU, 54.4 ± 13.9HU and 67.1 ± 11.8HU in the non-contrast, corticomedullary, nephrographic and excretory phases of CT, respectively. Contrast-enhanced ultrasonography and MRI also showed hypovascular features of the masses. On MRI, the tumors were isointense on T1-weighted images and slightly hypo- or hyperintense on T2-weighted images. Diffusion-weighted imaging revealed a low apparent diffusion coefficient of the tumor. The patients were managed with laparoscopic partial nephrectomy (n=5), radical nephrectomy (n=16), or robotic-assisted laparoscopic partial nephrectomy (n=1). The median follow-up time was 59.5 months. All the patients were free of local recurrence or distant metastasis. Conclusions MTSCC is generally indolent and has favorable outcomes. The imaging features of MTSCC are generally hypovascular, which is significantly different from clear cell renal cell carcinoma. However, it is still difficult to distinguish MTSCC from other hypovascular renal tumors preoperatively because their imaging features overlap. Further studies are essential to fully characterize the features of this rare RCC variant.
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Affiliation(s)
- Xiaofeng Xu
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Jing Zhong
- Department of Radiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Xiumin Zhou
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhifeng Wei
- Department of Urology, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qiuyuan Xia
- Department of Pathology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Pengfei Huang
- Department of Ultrasound Diagnosis, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Changjie Shi
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Jianping Da
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Chaopeng Tang
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Wen Cheng
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Jingping Ge
- Department of Urology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
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Schmid FA, Bausch K, Wettstein MS, Feicke A, Weltzien B, Schmid DM, Strebel RT, Poyet C, Rupp NJ, Sulser T, Seifert HH, Hermanns T. Long-Term Oncological Efficacy of Retroperitoneoscopic Radical Nephrectomy of Localized Renal Cell Cancer pT1-3 (≤ 12cm). Clin Genitourin Cancer 2022; 20:e411-e418. [DOI: 10.1016/j.clgc.2022.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 11/03/2022]
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Otaola-Arca H, Krebs A, Bermúdez H, Lyng R, Orvieto M, Bustamante A, Stein C, Labra A, Schultz M, Fernández MI. Long-Term Oncological and Functional Outcomes After Robot-Assisted Partial Nephrectomy for Clinically Localized Renal Cell Carcinoma. Ann Surg Oncol 2022; 29:2484-2494. [PMID: 34988833 DOI: 10.1245/s10434-021-11133-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/08/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND To evaluate long-term oncological and renal function outcomes in patients treated with robot-assisted partial nephrectomy (RAPN) for renal cell carcinoma (RCC). PATIENTS AND METHODS Patients undergoing RAPN for clinically localized RCC between January 2014 and December 2019 at a tertiary robotic reference center were evaluated. Clinical course, pathologic characteristics, and long-term outcomes were obtained from our institutional review board-approved RCC database. RESULTS A total of 234 patients were available for analysis. Median follow-up was 46 months (10.8-97.8 months), with 77 patients (32.9%) having at least 5-years of follow-up. Pathology revealed clear-cell RCC in 67.5% (n = 158). Among unfavorable factors, nuclear grades 3 or 4 were found in 67 (29.4%), lymphovascular invasion in 10 (4.3%), positive surgical margins in 22 (9.4%), necrosis in 21 (9%), and sarcomatoid pattern in 2 patients (0.9%). At 12 months, mean serum creatinine was 1.04 mg/dL and 12.9% of patients experienced upstaging in chronic kidney disease. Overall recurrence-free survival at 5-years was 97.8%. There were five local (2.1%) and two distant (0.9%) recurrences, none of them resulting in cancer-specific death. Median time to recurrence was 20 months (11-64 months). Warm ischemia time [hazard ratio (HR) = 1.14, p = 0.034] and sarcomatoid pattern (HR = 124.57, p = 0.001) were the only variables associated with local relapse. CONCLUSIONS Data from this large cohort demonstrate that patients undergoing RAPN have a low incidence of local and distant relapse, resulting in excellent long-term survival while preserving stable renal function in most patients.
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Affiliation(s)
- Hugo Otaola-Arca
- Department of Urology, Clínica Alemana de Santiago, Santiago, Chile.,Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Alfred Krebs
- Department of Urology, Clínica Alemana de Santiago, Santiago, Chile.,Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Hugo Bermúdez
- Department of Urology, Clínica Alemana de Santiago, Santiago, Chile.,Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Raúl Lyng
- Department of Urology, Clínica Alemana de Santiago, Santiago, Chile.,Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Marcelo Orvieto
- Department of Urology, Clínica Alemana de Santiago, Santiago, Chile.,Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Alberto Bustamante
- Department of Urology, Clínica Alemana de Santiago, Santiago, Chile.,Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Conrado Stein
- Department of Urology, Clínica Alemana de Santiago, Santiago, Chile.,Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Andrés Labra
- Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.,Department of Radiology, Clínica Alemana de Santiago, Santiago, Chile
| | - Marcela Schultz
- Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.,Department of Pathology, Clínica Alemana de Santiago, Santiago, Chile
| | - Mario I Fernández
- Department of Urology, Clínica Alemana de Santiago, Santiago, Chile. .,Faculty of Medicine, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.
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Uchida Y, Yoshida S, Arita Y, Shimoda H, Kimura K, Yamada I, Tanaka H, Yokoyama M, Matsuoka Y, Jinzaki M, Fujii Y. Apparent Diffusion Coefficient Map-Based Texture Analysis for the Differentiation of Chromophobe Renal Cell Carcinoma from Renal Oncocytoma. Diagnostics (Basel) 2022; 12:diagnostics12040817. [PMID: 35453866 PMCID: PMC9029773 DOI: 10.3390/diagnostics12040817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 12/29/2022] Open
Abstract
Preoperative imaging differentiation between ChRCC and RO is difficult with conventional subjective evaluation, and the development of quantitative analysis is a clinical challenge. Forty-nine patients underwent partial or radical nephrectomy preceded by MRI and followed by pathological diagnosis with ChRCC or RO (ChRCC: n = 41, RO: n = 8). The whole-lesion volume of interest was set on apparent diffusion coefficient (ADC) maps of 1.5T-MRI. The importance of selected texture features (TFs) was evaluated, and diagnostic models were created using random forest (RF) analysis. The Mean Decrease Gini as calculated through RF analysis was the highest for mean_ADC_value. ChRCC had a significantly lower mean_ADC_value than RO (1.26 vs. 1.79 × 10−3 mm2/s, p < 0.0001). Feature selection by the Boruta method identified the first-quartile ADC value and GLZLM_HGZE as important features. ROC curve analysis showed that there was no significant difference in the classification performances between the mean_ADC_value-only model and the Boruta model (AUC: 0.954 vs. 0.969, p = 0.236). The mean ADC value had good predictive ability for the distinction between ChRCC and RO, comparable to that of the combination of TFs optimized for the evaluated cohort. The mean ADC value may be useful in distinguishing between ChRCC and RO.
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Affiliation(s)
- Yusuke Uchida
- Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan; (Y.U.); (H.S.); (H.T.); (M.Y.); (Y.M.); (Y.F.)
| | - Soichiro Yoshida
- Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan; (Y.U.); (H.S.); (H.T.); (M.Y.); (Y.M.); (Y.F.)
- Correspondence:
| | - Yuki Arita
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan; (Y.A.); (M.J.)
| | - Hiroki Shimoda
- Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan; (Y.U.); (H.S.); (H.T.); (M.Y.); (Y.M.); (Y.F.)
| | - Koichiro Kimura
- Department of Diagnostic Radiology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan; (K.K.); (I.Y.)
| | - Ichiro Yamada
- Department of Diagnostic Radiology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan; (K.K.); (I.Y.)
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan; (Y.U.); (H.S.); (H.T.); (M.Y.); (Y.M.); (Y.F.)
| | - Minato Yokoyama
- Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan; (Y.U.); (H.S.); (H.T.); (M.Y.); (Y.M.); (Y.F.)
| | - Yoh Matsuoka
- Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan; (Y.U.); (H.S.); (H.T.); (M.Y.); (Y.M.); (Y.F.)
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan; (Y.A.); (M.J.)
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8510, Japan; (Y.U.); (H.S.); (H.T.); (M.Y.); (Y.M.); (Y.F.)
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Li C, Qiao G, Li J, Qi L, Wei X, Zhang T, Li X, Deng S, Wei X, Ma W. An Ultrasonic-Based Radiomics Nomogram for Distinguishing Between Benign and Malignant Solid Renal Masses. Front Oncol 2022; 12:847805. [PMID: 35311142 PMCID: PMC8931199 DOI: 10.3389/fonc.2022.847805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/11/2022] [Indexed: 12/11/2022] Open
Abstract
Objectives This study was conducted in order to develop and validate an ultrasonic-based radiomics nomogram for diagnosing solid renal masses. Methods Six hundred renal solid masses with benign renal lesions (n = 204) and malignant renal tumors (n = 396) were divided into a training set (n = 480) and a validation set (n = 120). Radiomics features were extracted from ultrasound (US) images preoperatively and then a radiomics score (RadScore) was calculated. By integrating the RadScore and independent clinical factors, a radiomics nomogram was constructed. The diagnostic performance of junior physician, senior physician, RadScore, and radiomics nomogram in identifying benign from malignant solid renal masses was evaluated based on the area under the receiver operating characteristic curve (ROC) in both the training and validation sets. The clinical usefulness of the nomogram was assessed using decision curve analysis (DCA). Results The radiomics signature model showed satisfactory discrimination in the training set [area under the ROC (AUC), 0.887; 95% confidence interval (CI), 0.860–0.915] and the validation set (AUC, 0.874; 95% CI, 0.816–0.932). The radiomics nomogram also demonstrated good calibration and discrimination in the training set (AUC, 0.911; 95% CI, 0.886–0.936) and the validation set (AUC, 0.861; 95% CI, 0.802–0.921). In addition, the radiomics nomogram model showed higher accuracy in discriminating benign and malignant renal masses compared with the evaluations by junior physician (DeLong p = 0.004), and the model also showed significantly higher specificity than the senior and junior physicians (0.93 vs. 0.57 vs. 0.46). Conclusions The ultrasonic-based radiomics nomogram shows favorable predictive efficacy in differentiating solid renal masses.
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Affiliation(s)
- Chunxiang Li
- Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Ge Qiao
- National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Jinghan Li
- Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Ninghe Hospital, Tianjin, China
| | - Lisha Qi
- National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Xueqing Wei
- Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Tan Zhang
- Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Xing Li
- Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Shu Deng
- Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xi Wei
- Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- *Correspondence: Xi Wei, ; Wenjuan Ma,
| | - Wenjuan Ma
- National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- Department of Breast Imaging, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- *Correspondence: Xi Wei, ; Wenjuan Ma,
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Li F, Feng Y, Jiang Q, Zhang J, Wu F, Li Q, Jing X, Wang X, Huang C. Pan-cancer analysis, cell and animal experiments revealing TEAD4 as a tumor promoter in ccRCC. Life Sci 2022; 293:120327. [DOI: 10.1016/j.lfs.2022.120327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/06/2022] [Accepted: 01/09/2022] [Indexed: 11/29/2022]
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Gopee-Ramanan P, Chin SS, Lim C, Shanbhogue KP, Schieda N, Krishna S. Renal Neoplasms in Young Adults. Radiographics 2022; 42:433-450. [PMID: 35230920 DOI: 10.1148/rg.210138] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Renal cell carcinoma (RCC) is usually diagnosed in older adults (the median age of diagnosis is 64 years). Although less common in patients younger than 45 years, RCCs in young adults differ in clinical manifestation, pathologic diagnosis, and prognosis. RCCs in young adults are typically smaller, are more organ confined, and manifest at lower stages of disease. The proportion of clear cell RCC is lower in young adults, while the prevalence of familial renal neoplastic syndromes is much higher, and genetic testing is routinely recommended. In such syndromic manifestations, benign-appearing renal cysts can harbor malignancy. Radiologists need to be familiar with the differences of RCCs in young adults and apply an altered approach to diagnosis, treatment, and surveillance. For sporadic renal neoplasms, biopsy and active surveillance are less often used in young adults than in older adults. RCCs in young adults are overall associated with better disease-specific survival after surgical treatment, and minimally invasive nephron-sparing treatment options are preferred. However, surveillance schedules, need for biopsy, decision for an initial period of active surveillance, type of surgery (enucleation or wide-margin partial nephrectomy), and utilization of ablative therapy depend on the presence and type of underlying familial renal neoplastic syndrome. In this pictorial review, syndromic, nonsyndromic, and newer RCC entities that are common in young adults are presented. Their associated unique epidemiology, characteristic imaging and pathologic traits, and key aspects of surveillance and management of renal neoplasms in young adults are discussed. The vital role of the informed radiologist in the multidisciplinary management of RCCs in young adults is highlighted. Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Prasaanthan Gopee-Ramanan
- From the Department of Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, 200 Elizabeth St, Toronto, ON, Canada M5G 2C4 (P.G.R., S.S.C., S.K.); Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont, Canada (C.L.); Department of Radiology, NYU Langone Medical Center, New York, NY (K.P.S.); and Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont, Canada (N.S.)
| | - Sook Suzy Chin
- From the Department of Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, 200 Elizabeth St, Toronto, ON, Canada M5G 2C4 (P.G.R., S.S.C., S.K.); Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont, Canada (C.L.); Department of Radiology, NYU Langone Medical Center, New York, NY (K.P.S.); and Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont, Canada (N.S.)
| | - Chris Lim
- From the Department of Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, 200 Elizabeth St, Toronto, ON, Canada M5G 2C4 (P.G.R., S.S.C., S.K.); Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont, Canada (C.L.); Department of Radiology, NYU Langone Medical Center, New York, NY (K.P.S.); and Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont, Canada (N.S.)
| | - Krishna P Shanbhogue
- From the Department of Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, 200 Elizabeth St, Toronto, ON, Canada M5G 2C4 (P.G.R., S.S.C., S.K.); Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont, Canada (C.L.); Department of Radiology, NYU Langone Medical Center, New York, NY (K.P.S.); and Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont, Canada (N.S.)
| | - Nicola Schieda
- From the Department of Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, 200 Elizabeth St, Toronto, ON, Canada M5G 2C4 (P.G.R., S.S.C., S.K.); Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont, Canada (C.L.); Department of Radiology, NYU Langone Medical Center, New York, NY (K.P.S.); and Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont, Canada (N.S.)
| | - Satheesh Krishna
- From the Department of Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, 200 Elizabeth St, Toronto, ON, Canada M5G 2C4 (P.G.R., S.S.C., S.K.); Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont, Canada (C.L.); Department of Radiology, NYU Langone Medical Center, New York, NY (K.P.S.); and Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont, Canada (N.S.)
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Neuroblastoma survivors at risk for developing subsequent neoplasms: A systematic review. Cancer Treat Rev 2022; 104:102355. [DOI: 10.1016/j.ctrv.2022.102355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/30/2022]
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Yan X, Zhou L, Li S, Wu X, Cui C, Chi Z, Si L, kong Y, Tang B, Li C, Mao L, Wang X, Lian B, Bai X, Dai J, Guo J, Sheng X. Systemic therapy in patients with metastatic Xp11.2 translocation renal cell carcinoma. Clin Genitourin Cancer 2022; 20:354-362. [DOI: 10.1016/j.clgc.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/03/2022] [Accepted: 03/06/2022] [Indexed: 11/25/2022]
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Xiang X, Guo Y, Chen Z, Mo Z. Molecular Characterization of m6A Modifications in Non-Clear Cell Renal Cell Carcinoma and Potential Relationship with Pathological Types. Int J Gen Med 2022; 15:1595-1608. [PMID: 35210831 PMCID: PMC8858024 DOI: 10.2147/ijgm.s348343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/27/2022] [Indexed: 12/24/2022] Open
Abstract
Background N6-Methyladenosine (m6A) modification is a eukaryotic mRNA modification that modulates the fate of modified RNA and, therefore, the expression of proteins. m6A modifications are associated with important roles in several cancers. Most studies related to m6A modification are based on clear cell renal cell carcinoma (ccRCC) and little is known about its role in non-ccRCC. Methods We summarized the molecular features of different m6A modification patterns in non-ccRCC based on The Cancer Genome Atlas database and correlated them with phenotypes such as immune patterns and prognosis. We also computed the m6Ascore and assessed its prognostic value using multivariate Cox regression analysis. Results We found the immune-excluded phenotype to be predominant in non-ccRCC patients. We also found that in non-clear cell carcinoma, different m6A modification profiles determine different immune patterns and are associated with different prognosis. m6AgeneCluser typing strongly associated with pathological status. Based on our findings, we suggest that the m6Ascore can be used as an independent prognostic value for prognostic assessment in non-ccRCC. Conclusion This study confirms the important role of m6A modifications in non-ccRCC, reveals the heterogeneity of tumor immunity, and highlights the promise of non-ccRCC therapy.
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Affiliation(s)
- Xuebao Xiang
- Center for Genomic and Personalized Medicine, Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Yi Guo
- Center for Genomic and Personalized Medicine, Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Zhongyuan Chen
- Center for Genomic and Personalized Medicine, Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
- Correspondence: Zengnan Mo, Email
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Park JS, Lee ME, Jang WS, Kim J, Park SM, Ham WS. Gene Expression Analysis of Aggressive Adult Xp11.2 Translocation Renal Cell Carcinoma at Clinical Stage T1N0M0 to Identify Potential Prognostic and Therapeutic Biomarkers. Biomedicines 2022; 10:biomedicines10020321. [PMID: 35203530 PMCID: PMC8869331 DOI: 10.3390/biomedicines10020321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/05/2023] Open
Abstract
Xp11.2 translocation renal cell carcinoma (tRCC), involving transcription factor E3 (TFE3) gene fusions, is a rare and aggressive RCC variant when present in adults and has been recently recognized as a unique entity in RCC. Biomarkers and treatment guidelines do not exist for patients with aggressive Xp11.2 tRCC. The aim was to identify and evaluate therapeutic biomarkers for aggressive Xp11.2 tRCC. RNA sequencing was performed using formalin-fixed, paraffin-embedded tissues from 11 adult patients with clinical T1N0M0 Xp11.2 tRCC, including three patients with aggressive characteristics (recurrence or cancer-specific death after nephrectomy). Thirty genes were differentially expressed between the aggressive and non-aggressive groups, even after adjustment, and were associated with KEGG pathways related to the aggressiveness of Xp11.2 tRCC. PIK3R2, involved in various KEGG pathways, including the PI3K/AKT/mTOR pathway, was overexpressed in the Xp11.2 tRCC cell lines UOK120 and UOK146. The PI3K pathway inhibitor LY294002 showed a significant therapeutic benefit. This study provides the first candidate biomarker, PIK3R2, for aggressive clinical T1N0M0 Xp11.2 tRCC. Furthermore, this study is the first to recommend a targeted drug, LY294002, for aggressive Xp11.2 tRCC based on the molecular pathophysiology.
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Affiliation(s)
- Jee Soo Park
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (J.S.P.); (M.E.L.); (W.S.J.); (J.K.); (S.M.P.)
- Department of Urology, Sorokdo National Hospital, Goheung 59562, Korea
| | - Myung Eun Lee
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (J.S.P.); (M.E.L.); (W.S.J.); (J.K.); (S.M.P.)
| | - Won Sik Jang
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (J.S.P.); (M.E.L.); (W.S.J.); (J.K.); (S.M.P.)
| | - Jongchan Kim
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (J.S.P.); (M.E.L.); (W.S.J.); (J.K.); (S.M.P.)
- Department of Urology, Yongin Severance Hospital, Yonsei University Health System, Seoul 03722, Korea
| | - Se Mi Park
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (J.S.P.); (M.E.L.); (W.S.J.); (J.K.); (S.M.P.)
| | - Won Sik Ham
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea; (J.S.P.); (M.E.L.); (W.S.J.); (J.K.); (S.M.P.)
- Correspondence: ; Tel.: +82-10-6242-7938
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Wang W, Xie S, Yuan D, He D, Fang L, Ge F. Systematic Review With Meta-Analysis: Diagnostic, Prognostic and Clinicopathological Significance of CircRNA Expression in Renal Cancer. Front Oncol 2022; 11:773236. [PMID: 35155185 PMCID: PMC8832283 DOI: 10.3389/fonc.2021.773236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/31/2021] [Indexed: 12/12/2022] Open
Abstract
Background Renal cancer (RC) is one of the most common malignant tumors of the urinary system, and molecular targets for the specific diagnosis and treatment of RC have been widely explored. The purpose of this study was to systematically analyze circular RNAs (circRNAs), which may serve as novel tumor markers in terms of the diagnosis, prognosis and clinicopathological characteristics of RC. Methods PubMed and Web of Science were systematically searched for literature as up to July 30, 2021. All included studies were evaluated by the evaluation system, and the results were satisfactory. Hazard ratios (HRs) and odds ratios (ORs) were used to assess the association of circRNAs with diagnostic and clinicopathological indicators. The sensitivity (SEN), specificity (SPE), positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the summary receiver operating characteristic curve (AUC) were combined to evaluate the diagnostic performance of circRNAs in RC. Results We included 22 studies that met the criteria, including 18 that were prognostic, 4 that were diagnostic, and 12 that were clinicopathologically relevant. In terms of prognosis, we found that upregulated circRNAs were positively associated with poor overall survival in patients with RC (HR=1.63, 95% CI=1.43–1.85). In terms of diagnosis, the combined SEN, SPE and AUC of circRNAs in the diagnosis of RC were 0.82, 0.84 and 0.89 (0.86–0.91), respectively. In terms of clinicopathological features, upregulated circRNAs were associated with the Fuhrman grade (OR=0.641, 95% CI=0.471–0.873), T stage (OR=0.236, 95% CI=0.141–0.396), TNM stage (OR=0.225, 95% CI=0.158–0.321) and lymphatic metastasis (OR=0.329, 95% CI=0.193–0.560). Conclusion Our meta-analysis confirms that circRNAs may be candidate biomarkers for the diagnosis, prognosis, and clinicopathological indicators of RC.
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Affiliation(s)
- Wujun Wang
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Shengfang Xie
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - Dongping Yuan
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Dandan He
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - Liming Fang
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
- *Correspondence: Liming Fang, ; Fengfeng Ge,
| | - Fengfeng Ge
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
- *Correspondence: Liming Fang, ; Fengfeng Ge,
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An J, Packiam VT, Chennamadhavuni A, Richards J, Jain J, Mott SL, Garje R. Patient Characteristics and Survival Outcomes of Non-Metastatic, Non-Clear Cell Renal Cell Carcinoma. Front Oncol 2022; 11:786307. [PMID: 35083144 PMCID: PMC8786111 DOI: 10.3389/fonc.2021.786307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background Non-clear cell renal cell carcinoma (ccRCC) includes histologically and molecularly distinct subtypes such as papillary, chromophobe, collecting duct, and sarcomatoid RCC, with an incidence ranging from 20% to 25%. Oncologic outcomes and the role of adjuvant systemic therapy [vascular endothelial growth factor inhibitor (VEGFi) or immunotherapy] for non-ccRCC are not well-described. Objective To assess the incidence and survival outcomes of non-ccRCC subtypes in comparison to ccRCC. Methods The National Cancer Database was utilized to identify patients with non-metastatic RCC (T1–T4, N0–N1) between 2004 and 2015. The non-ccRCC cohort was further stratified by histologic subtype: papillary, chromophobe, sarcomatoid, and collecting duct RCC. Multivariable Cox regression models were used to compare overall survival (OS). Results The 5-year OS for chromophobe, papillary, clear cell, collecting duct, and sarcomatoid RCC was 91%, 82%, 81%, 44%, and 40%, respectively. After adjusting for clinicopathologic and treatment characteristics, there was no significant difference in OS between papillary RCC and ccRCC (p = 0.17). Patients with collecting duct and sarcomatoid subtypes were at over two times increased risk of death compared to patients with clear cell (p < 0.01 and p < 0.01, respectively). Conversely, patients with chromophobe RCC were at 36% decreased risk of death compared to ccRCC (p < 0.01). Conclusions This hospital-based analysis confirms that collecting duct and sarcomatoid histologic subtypes are uncommon and associated with poor survival after surgery when compared to the other RCC subtypes. Further studies are needed to evaluate the role of neoadjuvant and adjuvant systemic therapies in these subtypes to improve oncologic outcomes.
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Affiliation(s)
- Josiah An
- Division of Hematology, Oncology, Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Vignesh T Packiam
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Adithya Chennamadhavuni
- Division of Hematology, Oncology, Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Jordan Richards
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Jayanshu Jain
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Rohan Garje
- Division of Hematology, Oncology, Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
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Zhu AH, Hou XY, Tian S, Zhang WF. Diagnostic value of 18F-FDG PET/CT versus contrast-enhanced MRI for venous tumour thrombus and venous bland thrombus in renal cell carcinoma. Sci Rep 2022; 12:587. [PMID: 35022440 PMCID: PMC8755813 DOI: 10.1038/s41598-021-04541-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/20/2021] [Indexed: 11/09/2022] Open
Abstract
The purpose of this study was to compare the ability of 18F-FDG PET/CT and contrast-enhanced MRI (CEMRI) to detect and grade venous tumour thrombus (VTT) and venous bland thrombus (VBT) in RCC and assess invasion of the venous wall by VTT. The PET/CT and CEMRI data of 41 patients with RCC were retrieved. The difference in maximum standardized uptake value (SUVmax) between VTT and VBT was analysed. According to their pathological diagnosis, the patients were divided into those with and without venous wall invasion. The PET/CT and CEMRI features, including the SUVmax of the primary lesion and VTT, maximum venous diameter, complete occlusion of the vein by VTT, and VTT morphology, were compared between the two groups. All 41 patients had VTT, and eleven of the 41 patients had VBT. The mean SUVmax of the VTT (6.33 ± 4. 68, n = 41) was significantly higher than that of the VBT (1.37 ± 0.26, n = 11; P < 0.001). Ten of the 11 cases of VBT were correctly diagnosed by 18F-FDG PET/CT, and all 11 were diagnosed by CEMRI. Both 18F-FDG PET/CT and CEMRI can effectively detect VTT and distinguish VTT from VBT. 18F-FDG PET/CT is less effective in grading VTT than CEMRI. Complete venous occlusion by VTT indicates venous wall invasion.
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Affiliation(s)
- An-Hui Zhu
- Department of Nuclear Medicine, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Xiao-Yan Hou
- Department of Nuclear Medicine, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China
| | - Shuai Tian
- Department of Radiology, Peking University Third Hospital, Beijing, 100191, China
| | - Wei-Fang Zhang
- Department of Nuclear Medicine, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China.
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Salama M, Mostafa A, Salama N, Alabrak M, Abdalaleem S, Hanafy A. Renal AML Surgically Treated 33 Cases. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Renal angiomyolipoma (RAML) is a rare benign neoplasm with a prevalence varying between 0.2% and 0.6% and a strong female predilection. They occur as sporadic, isolated entities in 80% of cases. The remaining 20% of angiomyolipomas (AMLs) develop in association with tuberous sclerosis complex or pulmonary lymphangioleiomyomatosis.
AIM: We describe our 10-year experience with AML and discuss the treatment strategies employed at our center.
METHODS: The medical records of all 33 patients with pathologically confirmed RAML treated either by nephrectomy or nephron-sparing surgery at our center over 10 years were reviewed for patient age and sex, tumor location and size, association with TBS.
RESULTS: There were 28 females (84.8%) and 5 males (15.2%) with a median age that was 52 (range 22–74) years at the time of surgery. Thirty patients (90.9%) had sporadic isolated AML, and 3 patients (9.1%) had AML with TBS. The tumor was in the right kidney in 15 (45.5%) patients, in the left kidney in 17 (51.5%) patients, and bilateral in only 1 patient (3%) who was diagnosed with TBS. At presentation, flank pain was the main symptom in 23 patients (69.7%).
CONCLUSIONS: Surgical resection of RAML provides short-term symptomatic relieve and long-term survival.
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Bajpai M, Pooja S, Tyagi M, Pathre A. Mucinous spindle and tubular renal cell cancer: A rare variant of renal cell cancer. J Cancer Res Ther 2022; 18:1168-1170. [DOI: 10.4103/jcrt.jcrt_99_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Zhong M, Zhang Z, Qi W, Zhou Y, Lv G, Jiang X. OUP accepted manuscript. J Surg Case Rep 2022; 2022:rjac185. [PMID: 35495080 PMCID: PMC9048658 DOI: 10.1093/jscr/rjac185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/05/2022] [Indexed: 11/14/2022] Open
Abstract
Mucinous tubule and spindle cell carcinoma (MTSCC) of the kidney is a rare renal pleomorphic tumor considered as low-grade malignant, with occurring mainly in female. Few mucin-poor MTSCC cases have been reported so far. A typical MTSCC is composed of closely arranged tubules with pale mucus matrix and spindle cell components. Mucin-poor MTSCC is difficult to distinguish from other renal cell carcinomas due to small amount of mucus. We reported a case of mucin-poor MTSCC in a 37-year-old male with detailed imaging, histology, immunohistochemical and next-generation sequencing information, looking forward to providing an insight into mucin-poor MTSCC.
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Affiliation(s)
- Minglei Zhong
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
| | - Zhaocun Zhang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
| | - Wenqiang Qi
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
| | - Yongheng Zhou
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
| | - Guangda Lv
- Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China
| | - Xianzhou Jiang
- Correspondence address. Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, China. Tel: +86 18560083895; E-mail:
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Zhang Y, Chen X, Fu Q, Wang F, Zhou X, Xiang J, He N, Hu Z, Jin X. Comprehensive analysis of pyroptosis regulators and tumor immune microenvironment in clear cell renal cell carcinoma. Cancer Cell Int 2021; 21:667. [PMID: 34906145 PMCID: PMC8670029 DOI: 10.1186/s12935-021-02384-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/30/2021] [Indexed: 01/05/2023] Open
Abstract
Background Increasing evidence has indicated that pyroptosis could regulate the tumor immune microenvironment (TIME) to affect the tumor development. As a highly immunogenic tumor, clear cell renal cell carcinoma (ccRCC) can benefit from immunotherapy, but related research on pyroptosis in the TIME of ccRCC is still deficient. Methods Available data derived from TCGA and GEO databases were analyzed to identify the different expression profiles of pyroptosis in ccRCC and normal tissues, and the correlation of pyroptosis regulators with TIME was evaluated in ccRCC. Results According to consensus clustering analysis, two differential expression levels of subtypes were identified to affect patient prognosis, and were related to histological tumor stage and grade. Immune cells were calculated by the CIBERSORT algorithm. Higher infiltrated levels of B cells naive, T cells CD4 memory resting, NK cells resting, monocytes, macrophages were observed in Cluster 1, while higher infiltrated levels of CD8+ T cells, T follicular helper cells, and Tregs were observed in Cluster 2. Gene set enrichment analysis indicated that Cluster 2 was enriched in multiple immune-related pathways, including the JAK-STAT signaling pathway. Moreover, overexpression of eight immune checkpoints was related to ccRCC development, especially in Cluster 2. As four potentially key pyroptosis regulators, AIM2, CASP5, NOD2, and GZMB were confirmed to be upregulated in ccRCC by RT-qPCR analysis and further verified by the HPA database. Further pan-cancer analysis suggested that these four pyroptosis regulators were differentially expressed and related to the TIME in multiple cancers. Conclusion The present study provided a comprehensive view of pyroptosis regulators in the TIME of ccRCC, which may provide potential value for immunotherapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12935-021-02384-y.
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Affiliation(s)
- Yan Zhang
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, People's Republic of China
| | - Xianwu Chen
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, People's Republic of China
| | - Qinghe Fu
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, People's Republic of China
| | - Feifan Wang
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, People's Republic of China
| | - Xuejian Zhou
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, People's Republic of China
| | - Jiayong Xiang
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, People's Republic of China
| | - Ning He
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, People's Republic of China
| | - Zhenghui Hu
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, People's Republic of China.
| | - Xiaodong Jin
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, People's Republic of China.
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Cui J, Yuan Y, Shanmugam MK, Anbalagan D, Tan TZ, Sethi G, Kumar AP, Lim LHK. MicroRNA-196a promotes renal cancer cell migration and invasion by targeting BRAM1 to regulate SMAD and MAPK signaling pathways. Int J Biol Sci 2021; 17:4254-4270. [PMID: 34803496 PMCID: PMC8579441 DOI: 10.7150/ijbs.60805] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/16/2021] [Indexed: 12/23/2022] Open
Abstract
Rationale: MicroRNAs (miRNAs) are endogenous ~22nt RNAs that play critical regulatory roles in various biological and pathological processes, including various cancers. Their function in renal cancer has not been fully elucidated. It has been reported that miR-196a can act as oncogenes or as tumor suppressors depending on their target genes. However, the molecular target for miR-196a and the underlying mechanism in miR-196a promoted cell migration and invasion in renal cancer is still not clear. Methods: The expression, survival and correlation between miR-196a and BRAM1 were investigated using TCGA analysis and validated by RT-PCR and western blot. To visualize the effect of Bram1 on tumor metastasis in vivo, NOD-SCID gamma (NSG) mice were intravenously injected with RCC4 cells (106 cells/mouse) or RCC4 overexpressing Bram1. In addition, cell proliferation assays, migration and invasion assays were performed to examine the role of miR-196a in renal cells in vitro. Furthermore, immunoprecipitation was done to explore the binding targets of Bram1. Results: TCGA gene expression data from renal clear cell carcinoma patients showed a lower level of Bram1 expression in patients' specimens compared to adjacent normal tissues. Moreover, Kaplan‑Meier survival data clearly show that high expression of Bram1correlates to poor prognosis in renal carcinoma patients. Our mouse metastasis model confirmed that Bram1 overexpression resulted in an inhibition in tumor metastasis. Target-prediction analysis and dual-luciferase reporter assay demonstrated that Bram1 is a direct target of miR-196a in renal cells. Further, our in vitro functional assays revealed that miR-196a promotes renal cell proliferation, migration, and invasion. Rescue of Bram1 expression reversed miR-196a-induced cell migration. MiR-196a promotes renal cancer cell migration by directly targeting Bram1 and inhibits Smad1/5/8 phosphorylation and MAPK pathways through BMPR1A and EGFR. Conclusions: Our findings thus provide a new mechanism on the oncogenic role of miR-196a and the tumor-suppressive role of Bram1 in renal cancer cells. Dysregulated miR-196a and Bram1 represent potential prognostic biomarkers and may have therapeutic applications in renal cancer.
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Affiliation(s)
- Jianzhou Cui
- Department of Physiology , Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore.,NUS Immunology Programme, Life Sciences Institute, National University of Singapore, Singapore 117456, Singapore.,Immunology Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Yi Yuan
- Department of Physiology , Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore.,NUS Immunology Programme, Life Sciences Institute, National University of Singapore, Singapore 117456, Singapore.,NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore.,Cancer Science Institute of Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117559, Singapore
| | - Muthu K Shanmugam
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117559, Singapore
| | - Durkeshwari Anbalagan
- Department of Physiology , Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore.,NUS Immunology Programme, Life Sciences Institute, National University of Singapore, Singapore 117456, Singapore
| | - Tuan Zea Tan
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore.,Cancer Science Institute of Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117559, Singapore
| | - Gautam Sethi
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117559, Singapore
| | - Alan Prem Kumar
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore.,Cancer Science Institute of Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117559, Singapore.,Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117559, Singapore.,National University Cancer Institute, Singapore 119074, Singapore
| | - Lina H K Lim
- Department of Physiology , Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore.,NUS Immunology Programme, Life Sciences Institute, National University of Singapore, Singapore 117456, Singapore.,Immunology Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
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Saoud R, Kristof TW, Judge C, Chumbalkar V, Antic T, Eggener S, Modi P. Clinical and pathological features of renal epithelioid angiomyolipoma (PEComa): A single institution series. Urol Oncol 2021; 40:18-24. [PMID: 34815169 DOI: 10.1016/j.urolonc.2021.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 07/20/2021] [Accepted: 09/20/2021] [Indexed: 10/19/2022]
Abstract
Renal angiomyolipomas are benign tumors of the kidney that belong to the 'PEComa: perivascular epithelioid cell' family. Epithelioid AMLs (eAML) are a rare monotypic subtype with malignant potential, that can occur sporadically or be associated with tuberous sclerosis (TSC). Due to their epithelioid nature, eAMLs can closely resemble high-grade renal cell carcinoma (RCC), which may result in misdiagnosis. Multiple clinicopathologic parameters are predictive of worse outcomes for patients with eAML. Those can be used to stratify patients into groups with low, intermediate and high risk for disease progression. A high index of suspicion and a thorough immunohistochemical study are required to correctly diagnose eAML. Radiographically, eAMLs are also a diagnostic challenge as they share features with RCC on CT and MR imaging. Due to this close mimicry, the true incidence of eAML is thought to be much higher than 200 cases as reported in the literature. We report a series of four patients diagnosed with eAML and compare their clinical courses. We also report on the successful treatment of a patient with pulmonary metastasis from eAML using the mTOR inhibitor, everolimus. By identifying eAML and recognizing its high-risk features, it is possible mTOR inhibitors may have a meaningful role in the adjuvant treatment of these patients.
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Affiliation(s)
- Ragheed Saoud
- Section of Urology, Department of Surgery, The University of Chicago Medicine, Chicago, IIllinois.
| | - Tanya W Kristof
- Section of Urology, Department of Surgery, The University of Chicago Medicine, Chicago, IIllinois
| | - Clark Judge
- Section of Urology, Department of Surgery, The University of Chicago Medicine, Chicago, IIllinois
| | - Vaibhav Chumbalkar
- Department of Pathology, The University of Chicago Medicine, Chicago, IIllinois
| | - Tatjana Antic
- Department of Pathology, The University of Chicago Medicine, Chicago, IIllinois
| | - Scott Eggener
- Section of Urology, Department of Surgery, The University of Chicago Medicine, Chicago, IIllinois
| | - Parth Modi
- Section of Urology, Department of Surgery, The University of Chicago Medicine, Chicago, IIllinois
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Pipitone S, Vitale MG, Baldessari C, Dominici M, Sabbatini R. Long survival of a young patient with Xp11.2 translocation metastatic clear cell renal carcinoma: case report. TUMORI JOURNAL 2021; 107:NP131-NP135. [PMID: 34696653 DOI: 10.1177/03008916211049275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Xp11.2 translocation is a rare subtype of renal cell carcinoma (RCC), identified as a single entity only from 2004 by World Health Organization (WHO). These tumors involve pediatric age group and rarely patients over 40 years old. Children show indolent disease; adult population has invasive tumor at diagnosis with rapid progression. CASE REPORT We describe a case report of a young woman affected by metastatic clear cell renal carcinoma with Xp11.2 translocation. She achieved a longer stable disease (SD) to first line treatment with atezolizumab plus bevacizumab, obtaining a progression free survival (PFS) of 21 months. After she received cabozantinib, sunitinib and then sorafenib. CONCLUSIONS The patient had an overall survival (OS) of 51 months, which is much higher than that reported in literature data. Unfortunately, the biology of Xp11.2 translocation RCC and its therapeutic management are still unclear.
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Affiliation(s)
- Stefania Pipitone
- Department of Oncology and Hematology, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria of Modena, Modena, Italy
| | - Maria Giuseppa Vitale
- Department of Oncology and Hematology, Azienda Ospedaliero Universitaria of Modena, Modena, Italy
| | - Cinzia Baldessari
- Department of Oncology and Hematology, Azienda Ospedaliero Universitaria of Modena, Modena, Italy
| | - Massimo Dominici
- Department of Oncology and Hematology, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria of Modena, Modena, Italy
| | - Roberto Sabbatini
- Department of Oncology and Hematology, Azienda Ospedaliero Universitaria of Modena, Modena, Italy
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75
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Kubiliute R, Zalimas A, Bakavicius A, Ulys A, Jankevicius F, Jarmalaite S. Clinical Significance of ADAMTS19, BMP7, SIM1, and SFRP1 Promoter Methylation in Renal Clear Cell Carcinoma. Onco Targets Ther 2021; 14:4979-4990. [PMID: 34675538 PMCID: PMC8502107 DOI: 10.2147/ott.s330341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/23/2021] [Indexed: 12/24/2022] Open
Abstract
Background Clear cell renal cell carcinoma (ccRCC) is the most common subtype of kidney tumors, accounting for the majority of deaths from genitourinary cancers. The currently used nomograms for predicting patient outcomes are based on clinical-pathological characteristics only; however, a significant number of ccRCC survivors with similar radiological and histological features still demonstrate a different clinical course of the disease. This study aimed at the identification of novel DNA methylation biomarkers for the monitoring of patients with ccRCC. Methods Gene expression profiling by SurePrint G3 Human GE 8×60K Microarrays was performed in 4 ccRCC tissues and adjacent non-cancerous renal tissue (NRT) samples. Four down-regulated genes were selected for further DNA methylation status analysis in 123 ccRCC and 45 NRT samples using methylation-specific PCR (MSP). Results DNA methylation changes of ADAMTS19, BMP7, SIM1, and SFRP1 were cancer-specific with significantly (P<0.050) higher methylation frequency (37%, 20%, 18%, and 42%, respectively) in tumor tissues. The methylated status of at least one gene was significantly related to various clinical-pathological parameters, including tumor size, Fuhrman and WHO/ISUP grades, intravascular invasion, and necrosis. Moreover, the methylated status of multimarker panel ADAMTS19, BMP7 & SFRP1 was predictive for poorer overall survival (HR, 4.11; 95% CI, 1.22–13.86). Conclusion In conclusion, DNA methylation of the three-gene panel consisting of ADAMTS19, BMP7 & SFRP1 supposedly predicts the outcome of patients diagnosed with ccRCC and possibly might be used to enrich the current prognostic tools.
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Affiliation(s)
- Raimonda Kubiliute
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania.,National Cancer Institute, Vilnius, Lithuania
| | - Algirdas Zalimas
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania.,National Cancer Institute, Vilnius, Lithuania
| | - Arnas Bakavicius
- National Cancer Institute, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Feliksas Jankevicius
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Sonata Jarmalaite
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania.,National Cancer Institute, Vilnius, Lithuania
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76
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Clinical significance of novel DNA methylation biomarkers for renal clear cell carcinoma. J Cancer Res Clin Oncol 2021; 148:361-375. [PMID: 34689221 DOI: 10.1007/s00432-021-03837-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/14/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Clear cell renal cell carcinoma (ccRCC) is the most common type of kidney tumor characterized by the highest mortality rate of the genitourinary cancers, and, therefore, new diagnostic and/or prognostic biomarkers are urgently needed. METHODS Based on genome-wide DNA methylation profiling in 11 pairs of ccRCC and non-cancerous renal tissues (NRT), the methylation at regulatory regions of ZNF677, FBN2, PCDH8, TFAP2B, TAC1, and FLRT2 was analyzed in 168 renal tissues and 307 urine samples using qualitative and quantitative methylation-specific PCR (MSP). RESULTS Significantly higher methylation frequencies for all genes were found in ccRCC tissues compared to NRT (33-60% vs. 0-11%). The best diagnostic performance demonstrated a panel of ZNF677, FBN2, PCDH8, TFAP2B & TAC1 with 82% sensitivity and 96% specificity. Hypermethylation of ZNF677 and PCDH8 in the tissue samples was significantly related to numerous adverse clinicopathologic parameters. For the urine-based ccRCC detection, the highest diagnostic power (AUC = 0.78) was observed for a panel of ZNF677 & PCDH8 (with or without FBN2 or FLRT2) with 69-78% sensitivity and 69-80% specificity, albeit with lower values in the validation cohort. Besides, methylation of PCDH8 was significantly related to higher tumor stage and fat invasion in the study and validation cohorts. Moreover, PCDH8 was strongly predictive for OS (HR, 5.7; 95% CI 1.16-28.12), and its prognostic power considerably increased in combination with ZNF677 (HR, 12.5; 95% CI 1.47-105.58). CONCLUSION In summary, our study revealed novel, potentially promising DNA methylation biomarkers of ccRCC with the possibility to be applied for non-invasive urine-based ccRCC detection and follow-up.
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Kim H, Kim JK, Kim JH, Choi JH, Hong SK, Lee S, Lee H, Byun SS. Comparison of Differential Functional Outcomes After Partial Nephrectomy Between Moderate and High Complex Renal Tumor Evaluated with Diethylenetriamine Pentaacetic Acid Scan: A Propensity Score Matched Analysis. Ann Surg Oncol 2021; 29:1476-1485. [PMID: 34635977 DOI: 10.1245/s10434-021-10718-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 08/12/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to compare functional outcomes after partial nephrectomy (PN) between moderate and high complex renal tumors evaluated with a diethylenetriamine pentaacetic acid (DTPA) scan [moderate vs. high: RENAL nephrometry score (RNS) 7-9 vs. 10-12]. METHODS From January 2004 to December 2019, 471 patients with an RNS of 7-9 (moderate) and 164 patients with an RNS of 10-12 (high) who underwent PN were analyzed for renal function outcomes. The glomerular filtration rate (GFR) was measured using a DTPA scan and calculated the GFR using the Modification of Diet in Renal Disease (MDRD) formula, respectively. Trifecta/pentafecta outcome, recurrence-free survival, and overall survival were compared after propensity score matched analysis (PSMA). RESULTS After PSMA, 156 cases in each group were matched without significant difference in the preoperative factor. At the postoperative first year, there was no significant difference in the trifecta (p = 0.320), MDRD-based (p = 0.729), or DTPA-based pentafecta achievement rate (p = 0.964) between groups. At postoperative 5 years, DTPA-based total GFR (93.6% vs. 93.8%) and the operated kidney GFR preservation rate (89.9% vs. 81.7%) did not differ significantly (p > 0.05). Kaplan-Meier survival analysis showed no significant differences in survival outcomes (p > 0.05). Significant predictors of de novo chronic kidney disease (CKD) stage 3 or higher at the postoperative first year were age [hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.03-1.17, p = 0.005] and preoperative DTPA-based total GFR (HR 0.94, 95% CI 0.91-0.98, p = 0.001). CONCLUSION High complex tumors can be treated with PN without significant deterioration in renal function. The postoperative function of the operated kidney was preserved by up to 80% in the long term compared with the preoperative period. However, PN should be selectively performed with caution to avoid the occurrence of postoperative CKD.
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Affiliation(s)
- Hwanik Kim
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jung Kwon Kim
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jin Hyuck Kim
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Joon Hyeok Choi
- Department of Chemistry, School of Arts and Science, Boston College, Chestnut Hill, MA, USA
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital & Seoul National University College of Medicine, Seongnam, South Korea
| | - Sangchul Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hakmin Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital & Seoul National University College of Medicine, Seongnam, South Korea.
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Dursun M, Ozbek E, Otunctemur A, Besiroglu H. Differentiating renal pelvic cancer from renal cell carcinoma with 18-fluorodeoxyglucose positron emission tomography-computed tomography. J Cancer Res Ther 2021; 17:901-905. [PMID: 34528539 DOI: 10.4103/jcrt.jcrt_217_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The differential diagnosis of pelvis renalis cancer (PRC) from renal cell cancer (RCC) is difficult. Because of that, in this study, we compared the standardized uptake value (SUV) with positron emission tomography-computed tomography (PET-CT) of the RCC and PRC. Methods Twenty-one patients (12 males, 9 females; age range: 33-74 years; mean age ± standard deviation [SD]: 57.14 ± 17.6) with suspected primary renal cell cancer as Group 1 and 8 patients (6 male, 2 female; age range, 61-81; mean age ± SD, 71.5 ± 5.65) with suspected renal pelvis cancer as Group 2 detected by conventional imaging techniques (CT, magnetic resonance [MR] imaging, ultrasound, intravenous urogram, CT urography, MR urography) underwent fluorine-18-fluorodeoxyglucose (18F-FDG) PET/CT imaging between August 2010 and October 2012. Results Mean age is 57.14 (33-74) years in Group 1 and 71.5 (61-81) years in Group 2, respectively. The mean maximum SUV (SUVmax) value was 4.6 ± 2.1 in RCC group and 16.6 ± 6.9 in PRC group. At the 18-FDG PET/CT scanning, SUVmax value higher in patients with PRC than in the patients with RCC. It was statistically different (P < 0.001). Conclusion We suggested that PET/CT can be used for the differential diagnosis of renal pelvis tumor and RCC. However, further studies with larger patient number are needed to confirm our suggestion. To clarify the mechanisms of underlying these differences, molecular advanced molecular studies are needed.
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Affiliation(s)
- Murat Dursun
- Department of Urology, Bahcelievler State Hospital, Istanbul, Turkey
| | - Emin Ozbek
- Department of Urology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Alper Otunctemur
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Huseyin Besiroglu
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
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Fuchizawa H, Kijima T, Takada‐Owada A, Nagashima Y, Okazaki A, Yokoyama M, Nishihara D, Ishida K, Kamai T. Metastatic mucinous tubular and spindle cell carcinoma of the kidney responding to nivolumab plus ipilimumab. IJU Case Rep 2021; 4:333-337. [PMID: 34497997 PMCID: PMC8413205 DOI: 10.1002/iju5.12342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/12/2021] [Accepted: 06/16/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Mucinous tubular and spindle cell carcinoma is a rare subtype of renal cell carcinoma. Little is known regarding the efficacy of systemic therapy on its metastatic form because of its rarity. CASE PRESENTATION We present the case of a patient with metastatic mucinous tubular and spindle cell carcinoma who achieved durable complete remission of multiple osseous metastases after undergoing cytoreductive nephrectomy followed by combination immunotherapy (ipilimumab plus nivolumab). Immunohistochemical analyses of the primary tumor revealed the presence of the tumor-infiltrating immune cells, including activated CD8+ T cells and PD-L1 expression, suggesting an immunologically hot tumor. CONCLUSION Combination immunotherapy was a viable treatment option for this disease. Immunohistochemical analyses of the tumor-infiltrating immune cells predicted the efficacy of immune checkpoint inhibitors against rare renal cancers.
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Affiliation(s)
| | - Toshiki Kijima
- Department ofUrologyDokkyo Medical UniversityShimotsugaTochigiJapan
| | - Atsuko Takada‐Owada
- Department ofDiagnostic PathologyDokkyo Medical UniversityShimotsugaTochigiJapan
| | - Yoji Nagashima
- Department of Surgical PathologyTokyo Women’s Medical UniversityTokyoJapan
| | - Akihito Okazaki
- Department ofUrologyDokkyo Medical UniversityShimotsugaTochigiJapan
| | - Megumi Yokoyama
- Department ofUrologyDokkyo Medical UniversityShimotsugaTochigiJapan
| | | | - Kazuyuki Ishida
- Department ofDiagnostic PathologyDokkyo Medical UniversityShimotsugaTochigiJapan
| | - Takao Kamai
- Department ofUrologyDokkyo Medical UniversityShimotsugaTochigiJapan
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Integrated mRNA and miRNA Transcriptomic Analyses Reveals Divergent Mechanisms of Sunitinib Resistance in Clear Cell Renal Cell Carcinoma (ccRCC). Cancers (Basel) 2021; 13:cancers13174401. [PMID: 34503211 PMCID: PMC8430814 DOI: 10.3390/cancers13174401] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/31/2022] Open
Abstract
Simple Summary Clear cell renal cell carcinoma (ccRCC) is a frequent cancer that causes more than 100,000 deaths every year. Treatment with drugs that target enzymes that help tumours grow such as sunitinib have greatly improved the prospects for ccRCC patients, however a large proportion of patients become resistant. We created sunitinib resistant cell lines and identified consequent changes in gene (and miRNA) expression by microarray analyses. Using this approach, we identified different pathways of resistance suggesting that tumour cells have many ways to overcome sunitinib treatment. We were able to overcome resistance in cells by inhibiting a protein, PD-L1, that is targeted by many immunotherapeutics currently in use for ccRCC patients suggesting a combination of immunotherapy and sunitinib may benefit patients. In addition, we identified miRNAs that are common to multiple resistance mechanisms suggesting they may be useful targets for future studies. Abstract The anti-angiogenic therapy sunitinib remains the standard first-line treatment for meta static clear cell renal cell carcinoma (ccRCC). However, acquired resistance develops in nearly all responsive patients and represents a major source of treatment failure. We used an integrated miRNA and mRNA transcriptomic approach to identify miRNA:target gene interactions involved in sunitinib resistance. Through the generation of stably resistant clones in three ccRCC cell lines (786-O, A498 and Caki-1), we identified non-overlapping miRNA:target gene networks, suggesting divergent mechanisms of sunitinib resistance. Surprisingly, even though the genes involved in these networks were different, they shared targeting by multiple members of the miR-17~92 cluster. In 786-O cells, targeted genes were related to hypoxia/angiogenic pathways, whereas, in Caki-1 cells, they were related to inflammatory/proliferation pathways. The immunotherapy target PD-L1 was consistently up-regulated in resistant cells, and we demonstrated that the silencing of this gene resulted in an increase in sensitivity to sunitinib treatment only in 786-O-resistant cells, suggesting that some ccRCC patients might benefit from combination therapy with PD-L1 checkpoint inhibitors. In summary, we demonstrate that, although there are clearly divergent mechanisms of sunitinib resistance in ccRCC subtypes, the commonality of miRNAs in multiple pathways could be targeted to overcome sunitinib resistance.
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81
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Patel RM, Okhunov Z, Jiang P, Tapiero S, Landman J. Office-Based Renal Tumor Biopsy: a Paradigm Change in the Management of a Small Renal Mass? Curr Urol Rep 2021; 22:43. [PMID: 34357476 DOI: 10.1007/s11934-021-01059-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE OF REVIEW The goal of this paper is to evaluate the use of an office-based renal mass biopsy (RMB), whose feasibility could represent a paradigm shift in clinical practice. RECENT FINDINGS Despite the earlier diagnosis of patients with renal masses, the lack of evidence showing a reduction in cancer-specific mortality warrants an examination in treatment practices. RMB is underutilized when compared to biopsy practice for all other neoplasms in every other solid organ (except testis), and the majority of RMB performed are outsourced to interventional radiologists. Performing an ultrasound-guided, office-based RMB is safe, reproducible, and has a meaningful impact on management decisions. The use of percutaneous RMB in clinical practice is growing, and the use of RMB has meaningful impact on management decisions for renal masses. Incorporating ultrasound-guided biopsy of a renal mass into clinical practice is feasible, and in contemporary practice, the urologist has the skill set to perform the procedure reliably, with low morbidity, and with minimal patient discomfort.
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Affiliation(s)
- Roshan M Patel
- Department of Urology, University of California, Orange, CA, USA.
| | - Zhamshid Okhunov
- Department of Urology, University of California, Orange, CA, USA
| | - Pengbo Jiang
- Department of Urology, University of California, Orange, CA, USA
| | - Shlomi Tapiero
- Department of Urology, University of California, Orange, CA, USA
| | - Jaime Landman
- Department of Urology, University of California, Orange, CA, USA
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82
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Alves AS, Gaivão AM, Marques RC, Matos C. Two Rare Entities in One Patient: Mucinous Tubular and Spindle Cell Carcinoma of the Kidney and Peritoneal Adenomyomas. Radiol Case Rep 2021; 16:1974-1979. [PMID: 34158877 PMCID: PMC8203568 DOI: 10.1016/j.radcr.2021.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/01/2021] [Accepted: 05/02/2021] [Indexed: 12/22/2022] Open
Abstract
Mucinous tubular and spindle cell carcinoma of the kidney is a rare subtype of renal cell carcinoma, that is believed to portend a favorable prognosis. Adenomyomas are benign tumors that typically arise from the myometrium. Extrauterine adenomyomas are extremely rare, with only a few cases reported in the literature. Here, we present an unusual case of a 46-year-old woman, with an incidentally detected bulky interpolar left kidney mass measuring 12 cm and multiple lobulated coalescent peritoneal nodules in the large epiploon suspicious for peritoneal carcinomatosis. A biopsy of the lesions revealed a mucinous tubular and spindle cell carcinoma of the kidney and extrauterine adenomyomas of the peritoneum. A left radical nephrectomy was performed and long-term hormone therapy with gonadotropin-releasing hormone agonists was prescribed. The purpose of this article is to focus on these two rare lesions, review the current literature, illustrate their key imaging findings along with pathologic correlation, as well as to discuss the differential diagnosis and clinical management.
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Affiliation(s)
- Ana Sofia Alves
- Radiology Department, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | | | | | - Celso Matos
- Radiology Department, Fundação Champalimaud, Lisbon, Portugal
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83
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Sari ZB, Açikalin MF, Arik D, Özen A, Can C, Çolak E. The Role of CK7, S100A1, and CD82 (KAI1) Expression in the Differential Diagnosis of Chromophobe Renal Cell Carcinoma and Renal Oncocytoma. Appl Immunohistochem Mol Morphol 2021; 29:534-540. [PMID: 33605572 DOI: 10.1097/pai.0000000000000916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 12/29/2020] [Indexed: 11/25/2022]
Abstract
Renal oncocytoma is a benign renal tumor originated from intercalated cells of collecting ducts like chromophobe renal cell carcinoma (RCC). The differential diagnosis of these 2 tumors is important because while they are histologically and cytologically similar, they show different biological behavior. For the differential diagnosis, several immunohistochemical markers have been investigated. But, differential diagnostic challenges remain and the identification of additional markers is needed. Cytokeratin 7 (CK7) is one of ductal-type keratins, which is expressed in tumors of breast, pancreas, lung, thyroid, ovary, endometrium, urinary bladder, and the kidney. S100A1 is the first defined member of the calcium-binding S100 protein family and it organizes several cellular functions including cell cycle progression and cell differentiation.CD82 is a tetraspanin membrane protein, which functions as a metastasis supressor. In this study, we immunohistochemically investigated the expressions of CK7, S100A1, and CD82 in 30 chromophobe RCC (23 classic and 7 eosinophilic variant) and 19 oncocytomas. When these markers were evaluated separately and together, their expressions in chromophobe RCC and renal oncocytoma show statistically significant difference (P<0.001). Similar statistically significant results were also seen between eosinophilic chromophobe RCC and oncocytoma (P<0.001). For both classic and eosinophilic-variant chromophobe RCCs, CK7+/S100A1-/CD82+ profile being the most common. In oncocytomas, the most frequently observed profile was CK7-/S100A1+/CD82-. Our results showed that the application of a panel consisting of CK7, S100A1, and CD82 may provide accurate categorization of the tumors in difficult cases.
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Affiliation(s)
- Zeliha B Sari
- Department of Pathology; University of Health Sciences, Eskisehir City Hospital
| | | | | | | | | | - Ertuğrul Çolak
- Biostatistics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
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84
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Abstract
With the ever increasing trend of using cross-section imaging in today's era, incidental detection of small solid renal masses has dramatically multiplied. Coincidentally, the number of asymptomatic benign lesions being detected has also increased. The role of radiologists is not only to identify these lesions, but also go a one step further and accurately characterize various renal masses. Earlier detection of small renal cell carcinomas means identifying at the initial stage which has an impact on prognosis, patient management and healthcare costs. In this review article we share our experience with the typical and atypical solid renal masses encountered in adults in routine daily practice.
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Affiliation(s)
- Mahesh Kumar Mittal
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Binit Sureka
- Department of Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
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85
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Srivastava A, Uzzo RN, Lee J, Cho E, Grieco A, Masic S, Handorf E, Chen DYT, Viterbo R, Greenberg RE, Smaldone MC, Kutikov A, Uzzo RG. Renal mass biopsy: A strategy to reduce associated costs and morbidity when managing localized renal masses. Urol Oncol 2021; 39:790.e9-790.e15. [PMID: 34301455 DOI: 10.1016/j.urolonc.2021.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/31/2021] [Accepted: 06/21/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES Renal mass biopsy (RMB) has not been widely adopted in evaluating small renal mass due to concerns for safety, efficacy, and its perceived lack of consequence on management decisions. We assess the potential cost savings and morbidity avoidance of routine RMB on cT1 renal masses undergoing robotic-assisted partial nephrectomy (RAPN). METHODS We identified n = 920 consecutive RAPN pT1 renal masses and n = 429 consecutive RMBs for cT1 renal masses over 12 years. Using a novel pathological-based risk classification system for cT1 renal masses, we evaluated the morbidity and costs of our RAPN and RMB cohorts. We then define four clinical scenarios where RMB could potentially delay and/or avoid intervention in our pT1 RAPN cohort and model potential complications prevented and cost savings utilizing common clinical scenarios. RESULTS Using our risk stratification system in RAPN patients, final histology was classified as benign in n=174 (18.9%) cases, very low-risk (n = 62 [7%]), low-risk (n = 383 [42%]), and high-risk (n = 301 [33%]), respectively. We identified n = 116 (12.6%) Clavien graded peri-operative complications. In our RMB patients, 120 (27.9%), 17 (3.9%), 240 (55.9%), 52(12.1%) were benign, very low, low and high-risk tumors. The median total direct cost for RAPN was $6955/case compared to $1312/case for RMB. If we established a primary goal to avoid immediate extirpative surgery in benign renal tumors, in the elderly (>70 y) with very low-risk tumors and/or those with high renal functional risks (≥ CKD3b), or competing risks (ASA ≥ 3), RMB could have reduced direct costs by approximately 20% and avoided n = 39 Clavien graded complications, seven readmissions, three transfusions, and two returns to the OR. With the additional cost of performing RMB on those not initially biopsied, the net cost saving would be approximately $1.2 million with minimal added complications while still treating high-risk tumors. CONCLUSIONS Routine RMB before intervention results in cost-saving and complication avoidance. Given the limitations of biopsy, shared decision-making is mandatory. Biopsy should be considered prior to intervention in at-risk populations.
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Affiliation(s)
- Abhishek Srivastava
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA.
| | - Robert N Uzzo
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Jennifer Lee
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Eric Cho
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Alex Grieco
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Selma Masic
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Elizabeth Handorf
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - David Y T Chen
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Rosalia Viterbo
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Richard E Greenberg
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Marc C Smaldone
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Alexander Kutikov
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Robert G Uzzo
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
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86
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Chen C, Zheng H. LncRNA LINC00944 Promotes Tumorigenesis but Suppresses Akt Phosphorylation in Renal Cell Carcinoma. Front Mol Biosci 2021; 8:697962. [PMID: 34291088 PMCID: PMC8287069 DOI: 10.3389/fmolb.2021.697962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/25/2021] [Indexed: 11/23/2022] Open
Abstract
Long non-coding RNA (lncRNA) is a kind of RNA that possesses longer than 200 nucleotides and lacks protein coding function. It was recognized as a junk sequence for a long time. Recent studies have found that lncRNAs are actively functioning in almost every aspect of cell biology and involved in a variety of biological functions. LncRNAs are closely related to a variety of human diseases, especially tumors. Recently, lncRNAs are being increasingly reported in renal cancer. In our study, we identified the expression of lncRNA LINC00944 is significantly elevated in renal cell carcinoma (RCC) tissues and cell lines and high LINC00944 expression is significantly correlated with the tumor stage and prognosis of RCC. The knockdown of LINC00944 by CRISPR/dCas9-KRAB in higher expressing 786-O and 769-P RCC cells could significantly decrease proliferation and migration and also promote phosphorylation of Akt compared with the control group. Our study is the first to report the function of lncRNA LINC00944 in RCC. And we provide clinicopathological and experimental evidence that lncRNA LINC00944 acts as an oncogene in RCC, suggesting that targeting lncRNA LINC00944 expression might be a promising therapeutic strategy for the treatment of RCC.
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Affiliation(s)
- Chiheng Chen
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Hanxiong Zheng
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
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87
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Salvador R, Sebastià M, Cárdenas G, Páez-Carpio A, Paño B, Solé M, Nicolau C. CT differentiation of fat-poor angiomyolipomas from papillary renal cell carcinomas: development of a predictive model. Abdom Radiol (NY) 2021; 46:3280-3287. [PMID: 33674961 DOI: 10.1007/s00261-021-02988-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/19/2021] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To identify specific contrast-enhanced CT (CECT) findings and develop a predictive model with logistic regression to differentiate fat-poor angiomyolipomas (fpAML) from papillary renal cell carcinomas (pRCC). METHODS This is a single-institution retrospective study that assess CT features of histologically proven 67 pRCC and 13 fpAML. CECT variables were studied by means of univariate logistic regression. Variables included patients' demographics, tumor attenuation (unenhanced and at arterial, venous and excretory post-contrast phases), type of enhancement, morphological features (axial long and short diameters, long-short axis ratio (LSR) and tumor to kidney angle interface) and presence of visible calcifications or vessels. Those variables with a p ≤ 0.05 underwent standard stepwise logistic regression to find predictive combinations of clinical variables. Best models were evaluated by AUROC curves and were subjected to Leave-one-out cross validation to assess their robustness. RESULTS Odds ratio (OR) between pRCC and fpAML was statistically significant for patient's gender, tumor attenuation in arterial, venous and excretory phases, tumor's long diameter, short diameter, LSR, type of enhancement, presence of intratumoral vessels and tumor-kidney angle interface. The best predictive model resulted in an area under the curve (AUC) of 0.971 and included gender, tumor-kidney angle interface and venous attenuation with the following equation: Log(p/1 - p) = - 2.834 + 4.052 * gender + - 0.066 * AngleInterface + 0.074 * VenousphaseHU. CONCLUSIONS The combination of patients' gender, tumor to kidney angle interface and venous enhancement helps to distinguish fpAML from pRCC.
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Affiliation(s)
- R Salvador
- Department of Radiology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain.
| | - M Sebastià
- Department of Radiology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain
| | - G Cárdenas
- Department of Radiology, Hospital Clínico de la Universidad de Chile, Dr. Carlos Lorca Tobar 999, Independencia, Región Metropolitana, Chile
| | - A Páez-Carpio
- Department of Radiology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain
| | - B Paño
- Department of Radiology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain
| | - M Solé
- Department of Pathology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain
| | - C Nicolau
- Department of Radiology, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
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88
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Solano C, Thapa S, Chisti MM. Adult Xp11.2 translocation renal cell carcinoma managed effectively with pazopanib. BMJ Case Rep 2021; 14:14/6/e243058. [PMID: 34172479 DOI: 10.1136/bcr-2021-243058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Xp11.2 translocation renal cell carcinoma (TRCC) is a rare and aggressive variant of renal cell carcinoma (RCC) when presenting in adults. We report a case of a man in his early 40s who was diagnosed with stage III Xp11.2 TRCC and underwent radical nephrectomy. Seven months following the surgery, an adrenal nodule and bilateral pulmonary nodules were discovered. He underwent cryoablation of the adrenal nodule and systemic treatment with daily pazopanib. He displayed stable disease for approximately 6 years. Following this period, multiple hospitalisations interrupted daily pazopanib therapy resulting in progression of disease. His regimen was then changed to ipilimumab and nivolumab, followed by current daily therapy with axitinib. The patient now shows stable disease in his 10th year after diagnosis. This case study demonstrates the efficacy of pazopanib for metastatic Xp11.2 TRCC and warrants further investigation to supplement the guidelines regarding the use of targeted therapy for TRCC.
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Affiliation(s)
- Cristian Solano
- William Beaumont School of Medicine, Oakland University, Rochester, Michigan, USA
| | - Shrinjaya Thapa
- Internal Medicine, Beaumont Hospital, Royal Oak, Michigan, USA
| | - Mohammad Muhsin Chisti
- Hematology and Medical Oncology, William Beaumont School of Medicine, Oakland University, Troy, Michigan, USA
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89
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Wagner H, Kenk M, Fraser M, Berlin A, Fleshner N. Biorepositories and Databanks for the Development of Novel Biomarkers for Genitourinary Cancer Prevention and Management. Eur Urol Focus 2021; 7:513-521. [PMID: 34167926 DOI: 10.1016/j.euf.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/15/2021] [Accepted: 06/04/2021] [Indexed: 11/27/2022]
Abstract
CONTEXT Translational research in uro-oncology depends on the availability of high-quality biospecimens and associated data to advance precision medicine and improve clinical outcomes. Procurement, storage, and annotation of these specimens represent critical steps towards this end. OBJECTIVE To review best-practice experiences gained via the McCain GU BioBank, a repository of more than 750 000 biospecimens obtained from more than 16 000 patients attending clinics at the University Health Network in Toronto, Canada. EVIDENCE ACQUISITION The review summarizes our experiences at a large single-institution genitourinary oncology biorepository. EVIDENCE SYNTHESIS Key findings are placed in the context of emerging trends in genitourinary oncology, with a focus on integration of molecular profiling and clinical data with traditional biorepository management. Proposed approaches provide high-quality biospecimens with comprehensive and reliable clinical data that can fuel innovation and discovery in research. CONCLUSIONS Biorepositories are vital for improving clinical outcomes and advancing personalized medicine. High-quality biospecimens and their associated clinical data are crucial for validation of biomarkers in oncology. Efforts to procure, store, and annotate clinical specimens represent critical steps in translational research. Elements such as biobank size, biospecimen types, disease cohorts, predetermined collection protocols, broad informed consent, sample handling and storage protocols, and available infrastructure directly influence the effectiveness and capacity of a biobank. PATIENT SUMMARY Biorepositories, or biobanks, are facilities that store biospecimens such as blood, urine, or tissue (usually collected from humans) for use in research. Biobanks have become an important resource in medical research, as they provide high-quality specimens to support different types of contemporary research such as genomics, biomarker discovery, and personalized medicine. Clinical management and treatment of genitourinary cancers, such as prostate, kidney, and bladder cancers, are particularly suited for biomarker research. The provision of biospecimens and their associated clinical data have become crucial for validation of biomarkers in these cancers.
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Affiliation(s)
- Heidi Wagner
- McCain GU BioBank, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
| | - Miran Kenk
- McCain GU BioBank, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Michael Fraser
- McCain GU BioBank, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Faculty of Medicine, University of Toronto, Toronto, Canada; Canadian Prostate Cancer Genome Network, Toronto, Canada
| | - Alejandro Berlin
- Faculty of Medicine, University of Toronto, Toronto, Canada; Canadian Prostate Cancer Genome Network, Toronto, Canada; Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Neil Fleshner
- McCain GU BioBank, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Faculty of Medicine, University of Toronto, Toronto, Canada
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90
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EZR-ROS1 fusion renal cell carcinoma mimicking urothelial carcinoma: report of a previously undescribed gene fusion in renal cell carcinoma. Virchows Arch 2021; 480:487-492. [PMID: 34128116 DOI: 10.1007/s00428-021-03138-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
A subset of renal cell carcinomas harbor gene fusions, and we report the first case of an EZR-ROS1 fusion in renal cell carcinoma. A 47-year-old female presented with hematuria and a mass involving the renal pelvis. Renal biopsy revealed a tumor with solid and tubular architecture that was diffusely positive for PAX8, CK7, and vimentin; retained expression of INI1; focally positive for P504S; and negative for GATA3 and TFE3. Partial nephrectomy was performed, and histologically, the tumor had solid and tubular architecture with mucin-like content within tubules. The nuclei corresponded to WHO/ISUP grade 2 and 3. The morphology was neither specific nor diagnostic, and a final diagnosis of unclassified renal cell carcinoma with solid and tubular architecture was rendered. Molecular sequencing revealed an EZR-ROS1 fusion: a fusion that has never been reported in renal cell carcinoma. Recognition of this fusion is of significance if the tumor becomes metastatic as treatment with crizotinib may be considered.
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91
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Marchetti A, Rosellini M, Mollica V, Rizzo A, Tassinari E, Nuvola G, Cimadamore A, Santoni M, Fiorentino M, Montironi R, Massari F. The Molecular Characteristics of Non-Clear Cell Renal Cell Carcinoma: What's the Story Morning Glory? Int J Mol Sci 2021; 22:6237. [PMID: 34207825 PMCID: PMC8226484 DOI: 10.3390/ijms22126237] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/06/2021] [Accepted: 06/08/2021] [Indexed: 01/05/2023] Open
Abstract
Non-clear cell renal cell carcinomas are a miscellaneous group of tumors that include different histological subtypes, each one characterized by peculiarity in terms of genetic alteration, clinical behavior, prognosis, and treatment response. Because of their low incidence and poor enrollment in clinical trials, alongside their heterogeneity, additional efforts are required to better unveil the pathogenetic mechanisms and, consequently, to improve the treatment algorithm. Nowadays, tyrosine kinase inhibitors, mTOR and MET inhibitors, and even cisplatin-based chemotherapy and immunotherapy are potential weapons that are still under evaluation in this setting. Various biomarkers have been evaluated for detecting progression and monitoring renal cell carcinoma, but more studies are necessary to improve this field. In this review, we provide an overview on the molecular characteristics of this group of tumors and the recently published trials, giving an insight into what might become the future therapeutic standard in this complex world of non-clear cell kidney cancers.
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Affiliation(s)
- Andrea Marchetti
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni—15, 40138 Bologna, Italy; (A.M.); (M.R.); (V.M.); (A.R.); (E.T.); (G.N.)
| | - Matteo Rosellini
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni—15, 40138 Bologna, Italy; (A.M.); (M.R.); (V.M.); (A.R.); (E.T.); (G.N.)
| | - Veronica Mollica
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni—15, 40138 Bologna, Italy; (A.M.); (M.R.); (V.M.); (A.R.); (E.T.); (G.N.)
| | - Alessandro Rizzo
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni—15, 40138 Bologna, Italy; (A.M.); (M.R.); (V.M.); (A.R.); (E.T.); (G.N.)
| | - Elisa Tassinari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni—15, 40138 Bologna, Italy; (A.M.); (M.R.); (V.M.); (A.R.); (E.T.); (G.N.)
| | - Giacomo Nuvola
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni—15, 40138 Bologna, Italy; (A.M.); (M.R.); (V.M.); (A.R.); (E.T.); (G.N.)
| | - Alessia Cimadamore
- Section of Pathological Anatomy, School of Medicine, Polytechnic University of the Marche Region, United Hospitals, 60126 Ancona, Italy; (A.C.); (R.M.)
| | - Matteo Santoni
- Oncology Unit, Macerata Hospital, 62100 Macerata, Italy;
| | - Michelangelo Fiorentino
- Department of Specialistic Diagnostic and Experimental Medicine, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy;
| | - Rodolfo Montironi
- Section of Pathological Anatomy, School of Medicine, Polytechnic University of the Marche Region, United Hospitals, 60126 Ancona, Italy; (A.C.); (R.M.)
| | - Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni—15, 40138 Bologna, Italy; (A.M.); (M.R.); (V.M.); (A.R.); (E.T.); (G.N.)
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92
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Gao S, Wang Z. Comprehensive Analysis of Regulatory Network for LINC00472 in Clear Cell Renal Cell Carcinoma. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:3533608. [PMID: 34221297 PMCID: PMC8211516 DOI: 10.1155/2021/3533608] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/13/2021] [Accepted: 05/24/2021] [Indexed: 12/19/2022]
Abstract
Renal cell carcinoma (RCC) accounts for about 2% to 3% of adult malignancies, and clear cell renal cell carcinoma (ccRCC) is the most common and aggressive type of kidney cancer. It accounts for 75% of all kidney tumors. Although new targeted drugs continue to appear, they are still not suitable for all patients. Therefore, an in-depth study of the molecular mechanism of the development of ccRCC and exploration of new targets for the treatment of ccRCC will help to achieve precise treatment for ccRCC. With the development of molecular research, the study of long noncoding RNA (LncRNA) has given us a new understanding of tumors. Although LncRNA does not encode proteins, it directly interacts with proteins in various signaling pathways and affects cell functions. Therefore, it is of great significance to study the mechanism of LncRNA in ccRCC. The expression level of Linc00472 in ccRCC tissues is significantly lower than adjacent normal tissues, and its low expression is closely related to Furman's high grade. The low expression of Linc00472 is associated with poor prognosis in patients with ccRCC. The results of protein interaction and functional enrichment analysis indicate that genes upregulated in renal clear cell carcinoma may play a major role. Analysis of target gene prediction results showed that Linc00472 may be used as ceRNA in the miR-24-3p-HLA-DPB1 pathway, miR-24-3p-CXCL9 pathway, miR-221-3p-C3aR1-VEGFR2 pathway, miR-17-5p-HLA-DQA1/HLA-DQB1 pathway, and miR-17-5p-C3aR1/C5aR1-VEGFR2 pathway which play important functions. In addition, the regulatory relationship between miR-24-3p and TNFR2 (TNFRSF1B), CD36, and COL4A1 should also be noted. The value of Linc00472 in the diagnosis and treatment of ccRCC is worthy of further study.
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Affiliation(s)
- Shuoze Gao
- Institute of Gansu Nephro-Urological Clinical Center, Department of Urology, Institute of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou, China
| | - Zhiping Wang
- Institute of Gansu Nephro-Urological Clinical Center, Department of Urology, Institute of Urology, Key Laboratory of Urological Disease of Gansu Province, Lanzhou University Second Hospital, Lanzhou, China
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93
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Uncommon Localization of Extrarenal Xp11.2 Translocation-associated Renal Cell Carcinoma (RCC): Case Report. Appl Immunohistochem Mol Morphol 2021; 28:e33-e35. [PMID: 28877071 DOI: 10.1097/pai.0000000000000576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The World Health Organization has recognized Xp11.2 translocation-associated renal cell carcinoma (RCC) as a distinct neoplasm that arises within the kidney. Although many reports of extrarenal carcinoma may be found in the literature, to the best of our knowledge, Xp11 translocation-associated RCC with intact kidneys has not been documented. This report describes a multilobulated right retroperitoneal soft tissue mass (7.9×5.3×12.6 cm) of a 37-year-old man complaining of abdominal pain in the right side. The patient underwent a computed tomography-guided biopsy. Microscopic evaluation reveals a tumor with papillary and sheaths architectures with cells revealing clear to eosinophilic cytoplasm. Immunohistochemical evaluation on the biopsy reveals that the tumor is positive for PAX-8, CD10, and TFE3. It is negative for CK7, EMA, Vimentin, RCC, CK8/18, D20, CD3, PLAP, OCT4, CD30, MART-1, Inhibin, S-100, HMB-45, Desmin, SMA, and DOG-1. The diagnosis was malignant epithelioid neoplasm and the diagnosis of translocation RCC was suggested. Excision was recommended. The patient underwent right radical nephrectomy with removal of this large mass. Pathologic examination showed a large cystic and solid, nonhomogenous mass with some necrotic areas, originating from the perirenal fat between the adrenal gland and the kidney. Microscopic features showed a tumor with papillary, rhabdoid, and clear cell features. Immunohistochemical stains showed that the tumor cells positively expressed AMACR, PAX-8, CD10, RCC, and TFE3, but were negative for cytokeratins, vimentin, HMB-45, desmin, SMA, EMA, and MSA. Cytogenetic studies confirmed the diagnosis of Xp11.2 translocation-associated RCC with positive TFE3 gene rearrangement. To the best of our knowledge, this type of extrarenal tumor has never been reported.
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94
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Kim JK, Kim H, Lee H, Oh JJ, Lee S, Hong SK, Kwak C, Byun SS. Evaluation of functional outcome of bilateral kidney tumors after sequential surgery. BMC Cancer 2021; 21:592. [PMID: 34024273 PMCID: PMC8142506 DOI: 10.1186/s12885-021-08324-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background There are limited data concerning patients treated with sequential bilateral kidney surgery. Current guidelines still lack an optimal surgical sequencing approach. We evaluated renal functional outcomes after sequential partial nephrectomy (PN) and radical nephrectomy (RN) in patients with bilateral renal cell carcinoma (RCC). Methods A propensity score matched cohort of 267 patients (synchronous bilateral RCCs, N = 44 [88 lesions]; metachronous bilateral, N = 45 [90 lesions]; unilateral, N = 178) from two tertiary institutions were retrospectively analyzed. Synchronous bilateral RCCs were defined as diagnosis concomitantly or within 3 months of former tumor. Renal functional outcomes were defined as estimated glomerular filtration rate (eGFR) changes and de novo chronic kidney disease (CKD, stage ≥3) after surgery. Renal functional outcomes and clinical factors predicting de novo CKD were assessed using descriptive statistics and Cox regression analysis. Results In subgroup of bilateral RCCs, patients underwent sequential PN (N = 48), PN followed by RN (N = 8), or RN followed by PN (N = 25). Final postoperative estimated glomerular filtration rates (eGFRs) were 79.4, 41.4, and 61.2 ml/minute/1.73 m2, respectively (p = 0.003). There were significant differences in eGFR decline from baseline and de novo chronic kidney disease (CKD stage ≥ III) among groups, with PN followed by RN group showing the worst functional outcomes (all p < 0.05). Moreover, sequential PN subgroup in bilateral RCC showed significantly higher rate of de novo CKD than unilateral RCC group (13.8% vs. 6.9%, p = 0.016). On multivariate analysis, hypertension (p = 0.010) and surgery sequence (PN followed by RN, p < 0.001) were significant predictors of de novo CKD. Conclusions The surgery sequence should be prudently determined in bilateral renal tumors. PN followed by RN showed a negative impact on renal functional preservation. Nephron-sparing surgery should be considered for all amenable bilateral RCCs. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08324-3.
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Affiliation(s)
- Jung Kwon Kim
- Department of Urology, Seoul National University Bundang Hospital (SNUBH), 166 Gumi-Ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea
| | - Hwanik Kim
- Department of Urology, Seoul National University Bundang Hospital (SNUBH), 166 Gumi-Ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea
| | - Hakmin Lee
- Department of Urology, Seoul National University Bundang Hospital (SNUBH), 166 Gumi-Ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea
| | - Jong Jin Oh
- Department of Urology, Seoul National University Bundang Hospital (SNUBH), 166 Gumi-Ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.,Department of Urology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Sangchul Lee
- Department of Urology, Seoul National University Bundang Hospital (SNUBH), 166 Gumi-Ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital (SNUBH), 166 Gumi-Ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.,Department of Urology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.,Department of Urology, Seoul National University Hospital (SNUH), Seoul, Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital (SNUBH), 166 Gumi-Ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea. .,Department of Urology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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95
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Han B, Sun Z, Yu T, Wang Y, Kuang L, Li T, Cai J, Cao Q, Xu Y, Gao B, Cheng SY, Yue S, Liu C. SPOP-PTEN-SUFU axis promotes progression of clear cell renal cell carcinoma via activating SHH and WNT pathway. Cell Death Discov 2021; 7:120. [PMID: 34021128 PMCID: PMC8140158 DOI: 10.1038/s41420-021-00484-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/02/2021] [Accepted: 04/19/2021] [Indexed: 11/15/2022] Open
Abstract
Although E3 ligase Speckle type BTB/POZ protein (SPOP) promotes tumorigenesis by acting as a key regulatory hub in clear cell renal cell carcinoma (ccRCC), the detailed molecular mechanism remains unclear. Here, we demonstrate that a well-known tumor suppressor, Suppressor of Fused (SUFU), is downregulated by SPOP. Interestingly, this downregulation depends on cullin-3(Cul3)-SPOP E3 ligase, but SUFU is not a direct substrate of SPOP. Phosphatase and tensin homolog (PTEN), a ubiquitinated substrate of SPOP, is involved in SPOP-mediated SUFU reduction. Importantly, inhibition of SUFU leads to elevated SHH and WNT signaling, consequently rescuing the reduced proliferation, migration, and invasion abilities of ccRCC cells caused by SPOP-knockdown. Moreover, combinatorial treatment with SHH and WNT inhibitors shows more effective for suppressing ccRCC cell proliferation and aggressiveness. These findings demonstrate that a novel SPOP–PTEN–SUFU axis promotes ccRCC carcinogenesis by activating SHH and WNT pathway, providing a new treatment strategy for ccRCC.
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Affiliation(s)
- Bo'ang Han
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, 211166, Nanjing, China.,Jiangsu Key Laboratory of Xenotransplantation, Nanjing Medical University, 211166, Nanjing, China
| | - Zhen Sun
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China.,Department of Pathology, Affiliated Zhongshan Hospital of Dalian University, 116001, Dalian, China
| | - Tingting Yu
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China.,Jiangsu Key Laboratory of Xenotransplantation, Nanjing Medical University, 211166, Nanjing, China
| | - Yu Wang
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China
| | - Lun Kuang
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China
| | - Tianyuan Li
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China
| | - Jing Cai
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China
| | - Qing Cao
- College of Medicine, Henan University of Science and Technology, 471023, Luoyang, China
| | - Yuan Xu
- The First School of Clinical Medicine, Nanjing Medical University, 211166, Nanjing, China
| | - Binbin Gao
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China
| | - Steven Y Cheng
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China. .,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, 211166, Nanjing, China. .,Jiangsu Key Laboratory of Xenotransplantation, Nanjing Medical University, 211166, Nanjing, China.
| | - Shen Yue
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China. .,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, 211166, Nanjing, China. .,Jiangsu Key Laboratory of Xenotransplantation, Nanjing Medical University, 211166, Nanjing, China.
| | - Chen Liu
- Department of Medical Genetics, Nanjing Medical University, 211166, Nanjing, China. .,Jiangsu Key Laboratory of Xenotransplantation, Nanjing Medical University, 211166, Nanjing, China.
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96
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Torcivia JP, Mazumder R. Scanning window analysis of non-coding regions within normal-tumor whole-genome sequence samples. Brief Bioinform 2021; 22:bbaa203. [PMID: 32940334 PMCID: PMC8138877 DOI: 10.1093/bib/bbaa203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 11/15/2022] Open
Abstract
Genomics has benefited from an explosion in affordable high-throughput technology for whole-genome sequencing. The regulatory and functional aspects in non-coding regions may be an important contributor to oncogenesis. Whole-genome tumor-normal paired alignments were used to examine the non-coding regions in five cancer types and two races. Both a sliding window and a binning strategy were introduced to uncover areas of higher than expected variation for additional study. We show that the majority of cancer associated mutations in 154 whole-genome sequences covering breast invasive carcinoma, colon adenocarcinoma, kidney renal papillary cell carcinoma, lung adenocarcinoma and uterine corpus endometrial carcinoma cancers and two races are found outside of the coding region (4 432 885 in non-gene regions versus 1 412 731 in gene regions). A pan-cancer analysis found significantly mutated windows (292 to 3881 in count) demonstrating that there are significant numbers of large mutated regions in the non-coding genome. The 59 significantly mutated windows were found in all studied races and cancers. These offer 16 regions ripe for additional study within 12 different chromosomes-2, 4, 5, 7, 10, 11, 16, 18, 20, 21 and X. Many of these regions were found in centromeric locations. The X chromosome had the largest set of universal windows that cluster almost exclusively in Xq11.1-an area linked to chromosomal instability and oncogenesis. Large consecutive clusters (super windows) were found (19 to 114 in count) providing further evidence that large mutated regions in the genome are influencing cancer development. We show remarkable similarity in highly mutated non-coding regions across both cancer and race.
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Affiliation(s)
- J P Torcivia
- The Department of Biochemistry and Molecular Medicine, The George Washington University Medical Center, Washington, DC, USA
| | - R Mazumder
- The Department of Biochemistry and Molecular Medicine, The George Washington University Medical Center, Washington, DC, USA
- McCormick Genomic and Proteomic Center, The George Washington University, Washington, DC, USA
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97
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Xing X, Yuan X, Liu T, Dai M, Fan Y, Liu C, Strååt K, Björkholm M, Xu D. Regulatory region mutations of TERT, PLEKHS1 and GPR126 genes as urinary biomarkers in upper tract urothelial carcinomas. J Cancer 2021; 12:3853-3861. [PMID: 34093793 PMCID: PMC8176235 DOI: 10.7150/jca.56779] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 04/22/2021] [Indexed: 12/16/2022] Open
Abstract
Background: The hotspot regulatory region mutations of the TERT, PLEKHS1 and GPR126 genes have been shown to occur frequently in urothelial bladder carcinoma (UBC). However, it is currently unclear whether these mutations are all present in upper tract urothelial carcinomas (UTUC) including renal pelvic carcinoma (RPC) and ureter carcinoma (UC), although TERT promoter mutations were previously observed in these malignancies. Methods: The hotspot mutations of TERT and PLEKHS1 promoters and GPR126 intron 6 (enhancer) in tumors derived from 164 patients with UTUC were determined using Sanger sequencing, and the obtained results were further compared with the mutation frequency in 106 UBCs. The mutations were also assessed in urine from patients with UTUC and UBC. Results: The mutation frequencies in UTUC tumors were 28%, 5.8% and 11% for TERT and PLEKHS1 promoters and GPR126 intron 6, respectively, which were lower than those (44.3%, 26.4%, and 31.4%, respectively) in UBCs. The total frequencies for the presence of any of these mutations were 50.8% and 34.4% for RPCs and UCs, respectively. All these mutated DNA sequences were detectable in urine from both UTUC and UBC patients and disappeared rapidly in most patients after surgery. Conclusions: This proof-of-concept study demonstrates that the hotspot mutations in the TERT, PLEKHS1 and GPR126 non-coding regions are present in UTUCs, and that urinary assays of these mutated sequences serve as potential biomarkers for UTUC diagnostics and disease monitoring.
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Affiliation(s)
- Xiangling Xing
- Department of Medicine, Division of Hematology, Bioclinicum and Center for Molecular Medicine (CMM), Karolinsk Institutet and Karolinska University Hospital Solna, SE-17176 Stockholm, Sweden
| | - Xiaotian Yuan
- Department of Medicine, Division of Hematology, Bioclinicum and Center for Molecular Medicine (CMM), Karolinsk Institutet and Karolinska University Hospital Solna, SE-17176 Stockholm, Sweden
| | - Tiantian Liu
- Pathology Department, School of Basic Medical Science, Shandong University, Jinan, PR China
| | - Mingkai Dai
- Central Research Laboratory, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, PR China
| | - Yidong Fan
- Department of Urology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, PR China
| | - Cheng Liu
- Department of Urology, Peking University Third Hospital, Beijing, PR China
| | - Klas Strååt
- Department of Medicine, Division of Hematology, Bioclinicum and Center for Molecular Medicine (CMM), Karolinsk Institutet and Karolinska University Hospital Solna, SE-17176 Stockholm, Sweden
| | - Magnus Björkholm
- Department of Medicine, Division of Hematology, Bioclinicum and Center for Molecular Medicine (CMM), Karolinsk Institutet and Karolinska University Hospital Solna, SE-17176 Stockholm, Sweden
| | - Dawei Xu
- Department of Medicine, Division of Hematology, Bioclinicum and Center for Molecular Medicine (CMM), Karolinsk Institutet and Karolinska University Hospital Solna, SE-17176 Stockholm, Sweden
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98
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Integrated Analysis to Identify a Redox-Related Prognostic Signature for Clear Cell Renal Cell Carcinoma. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6648093. [PMID: 33968297 PMCID: PMC8084660 DOI: 10.1155/2021/6648093] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/03/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023]
Abstract
The imbalance of the redox system has been shown to be closely related to the occurrence and progression of many cancers. However, the biological function and clinical significance of redox-related genes (RRGs) in clear cell renal cell carcinoma (ccRCC) are unclear. In our current study, we downloaded transcriptome data from The Cancer Genome Atlas (TCGA) database of ccRCC patients and identified the differential expression of RRGs in tumor and normal kidney tissues. Then, we identified a total of 344 differentially expressed RRGs, including 234 upregulated and 110 downregulated RRGs. Fourteen prognosis-related RRGs (ADAM8, CGN, EIF4EBP1, FOXM1, G6PC, HAMP, HTR2C, ITIH4, LTB4R, MMP3, PLG, PRKCG, SAA1, and VWF) were selected out, and a prognosis-related signature was constructed based on these RRGs. Survival analysis showed that overall survival was lower in the high-risk group than in the low-risk group. The area under the receiver operating characteristic curve of the risk score signature was 0.728 at three years and 0.759 at five years in the TCGA cohort and 0.804 at three years and 0.829 at five years in the E-MTAB-1980 cohort, showing good predictive performance. In addition, we explored the regulatory relationships of these RRGs with upstream miRNA, their biological functions and molecular mechanisms, and their relationship with immune cell infiltration. We also established a nomogram based on these prognostic RRGs and performed internal and external validation in the TCGA and E-MTAB-1980 cohorts, respectively, showing an accurate prediction of ccRCC prognosis. Moreover, a stratified analysis showed a significant correlation between the prognostic signature and ccRCC progression.
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99
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Bernard A, Teddy J, Asad H, Zarouhie B, Fatme G, Michel J. Oncocytic Papillary Renal Cell Carcinoma in an 11-year-old girl. Urology 2021; 156:e134-e136. [PMID: 33891928 DOI: 10.1016/j.urology.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/29/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022]
Abstract
Oncocytic Papillary Renal Cell Carcinoma (OPRCC) is a rare variant of renal cell carcinoma with overlapping characteristics type 1 and 2 of papillary renal carcinoma. Based on the literature, OPRCC is predominantly present in adult males. OPRCC has a specific genetic affiliation with the Fumarate Hydratase gene requiring all patients diagnosed with OPRCC to undergo genetic testing. There isn't any agreement for the treatment of OPRCC due to the rarity of the disease; however, a radical nephrectomy poses as a possible modality. Therefore, we present the rare case of an 11-year-old female found to have OPRCC.
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Affiliation(s)
- Akl Bernard
- Department of Urology, University of Balamand, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Jabbour Teddy
- Department of Urology, University of Balamand, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Haydar Asad
- University of Balamand, Faculty of Medicine and Medical Sciences, Beirut, Lebanon
| | - Bedoyan Zarouhie
- Department of Pathology, University of Balamand, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Ghandour Fatme
- Department of Pathology, University of Balamand, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Jabbour Michel
- Department of Urology, University of Balamand, Saint George Hospital University Medical Center, Beirut, Lebanon.
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100
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Deng T, He Z, Duan X, Gu D, Cai C, Wu W, Liu Y, Zeng G. STAM Prolongs Clear Cell Renal Cell Carcinoma Patients' Survival via Inhibiting Cell Growth and Invasion. Front Oncol 2021; 11:611081. [PMID: 33959493 PMCID: PMC8093442 DOI: 10.3389/fonc.2021.611081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/18/2021] [Indexed: 01/04/2023] Open
Abstract
Background: Signal transducing adaptor molecule 1 (STAM1) was considered to mediate cell growth and be involved in multiple signaling pathways; however, no research on the role of STAM1 in any tumors has been published yet. Our study aimed to investigate the prognostic value of STAM1 for clear cell renal cell carcinoma (ccRCC) and its role in modulating cancer cell function. Methods: Data from The Cancer Genome Atlas (TCGA) in December 2019 were used to examine the role of STAM1 in indicating ccRCC patients' survival. A purchased tissue microarray (TM) and fresh ccRCC renal tissues were used for further validation. Then, STAM1 was overexpressed in human ccRCC cell lines for in vitro assays. Finally, bioinformatics was performed for STAM1 protein–protein interaction (PPI) network construction and functional analyses. Results: A total of 539 ccRCC and 72 control samples were included for the TCGA cohort, and 149 ccRCC and 29 control slices were included for the TM cohort. In the TCGA and TM cohorts, we found that STAM1 expression was lower in ccRCC compared with normal adjacent non-cancerous renal tissues (P < 0.0001 for both cohorts). STAM1 downregulation was also related to significantly shorter overall survival (OS) (P < 0.0001 for both cohorts). In the TCGA cohort, reduced STAM1 expression was also associated with aggressive features of the tumor. Under multivariate analyses, STAM1 was demonstrated to be an independent prognostic factor for ccRCC survival in both TCGA (HR = 0.52, 95% CI: 0.33–0.84, P = 0.007) and TM cohorts (HR = 0.12, 95% CI: 0.04–0.32, P < 0.001). Our in vitro experiments showed that STAM1 inhibited cell viability, invasion, and migration in ccRCC cell lines. In PPI network, 10 candidate genes categorized into five biological processes were found to be closely related to STAM1. Conclusion: STAM1 is a promising prognostic biomarker for predicting ccRCC survival outcomes. Preliminary pathogenesis is demonstrated by our in vitro experiments. Further pathological mechanisms of STAM1 in modulating ccRCC require comprehensive laboratory and clinical studies.
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Affiliation(s)
- Tuo Deng
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Zihao He
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Xiaolu Duan
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Di Gu
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Chao Cai
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Wenqi Wu
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Yongda Liu
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Guohua Zeng
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
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