S100A1: a powerful marker to differentiate chromophobe renal cell carcinoma from renal oncocytoma

S100A1: Structure, Function, and Therapeutic Potential

S100A1 is a member of the S100 family of calcium-binding proteins. As with most S100 proteins, S100A1 undergoes a large conformational change upon binding calcium as necessary to interact with numerous protein targets. Targets of S100A1 include proteins involved in calcium signaling (ryanidine receptors 1 & 2, Serca2a, phopholamban), neurotransmitter release (synapsins I & II), cytoskeletal and filament associated proteins (CapZ, microtubules, intermediate filaments, tau, mocrofilaments, desmin, tubulin, F-actin, titin, and the glial fibrillary acidic protein GFAP), transcription factors and their regulators (e.g. myoD, p53), enzymes (e.g. aldolase, phosphoglucomutase, malate dehydrogenase, glycogen phosphorylase, photoreceptor guanyl cyclases, adenylate cyclases, glyceraldehydes-3-phosphate dehydrogenase, twitchin kinase, Ndr kinase, and F1 ATP synthase), and other Ca2+-activated proteins (annexins V & VI, S100B, S100A4, S100P, and other S100 proteins). There is also a growing interest in developing inhibitors of S100A1 since they may be beneficial for treating a variety of human diseases including neurological diseases, diabetes mellitus, heart failure, and several types of cancer. The absence of significant phenotypes in S100A1 knockout mice provides some early indication that an S100A1 antagonist could have minimal side effects in normal tissues. However, development of S100A1-mediated therapies is complicated by S100A1's unusual ability to function as both an intracellular signaling molecule and as a secreted protein. Additionally, many S100A1 protein targets have only recently been identified, and so fully characterizing both these S100A1-target complexes and their resulting functions is a necessary prerequisite.

Differential expression of KAI1 metastasis suppressor protein in renal cell tumor histological subtypes

PURPOSE

The similar appearance of renal tumor histological subtypes can complicate differential diagnoses. This problem is most notable for the chromophobe subtype of renal cell carcinoma, which can be histologically indistinguishable from oncocytoma with investigational molecular markers failing to provide reliable differentiation. KAI1 is a metastasis suppressor gene whose expression correlates inversely with the metastatic potential of most solid tumor cancer types. We tested the hypothesis that KAI1 is differentially expressed among renal tumor histological subtypes.

MATERIALS AND METHODS

Immunohistochemical staining for KAI1 protein was performed in 152 nephrectomy specimens, including 48 clear cell, 35 papillary and 31 chromophobe renal cell carcinoma samples, 28 oncocytomas and 10 tumor-free kidneys. Staining was scored as none/minimal, low, moderate or high. KAI1 mRNA levels were compared by quantitative reverse transcriptase-polymerase chain reaction in an additional 22 chromophobe renal cell carcinoma and oncocytoma samples.

RESULTS

In all 10 tumor-free kidneys KAI1 protein was detected exclusively in distal tubule cell membranes. Of the tumor specimens KAI1 protein was absent in all papillary renal cell carcinoma specimens. It was present in only 1 of 48 clear cell renal cell carcinomas (2%) and 2 of 28 oncocytomas (7%) but only at low levels. In contrast, 27 of 31 chromophobe renal cell carcinoma specimens (87%) expressed KAI1 protein, most at moderate or high levels. The diagnostic accuracy of KAI1 immunostaining for discerning chromophobe renal cell carcinoma from oncocytoma was 90% with similar results observed at the RNA level.

CONCLUSIONS

KAI1 is an accurate biomarker for chromophobe renal cell carcinoma that may aid in the diagnostic differentiation of chromophobe renal cell carcinoma from oncocytoma. It remains to be determined whether KAI1 expression contributes to the low metastatic potential of chromophobe renal cell carcinoma.

Differential expression of S100 protein subtypes in malignant melanoma, and benign and malignant peripheral nerve sheath tumors

BACKGROUND

Desmoplastic melanoma (DM) may simulate various benign and malignant lesions, including benign peripheral nerve sheath tumors (BPNSTs) and malignant peripheral nerve sheath tumors (MPNSTs). The latter case is diagnostically challenging because DM generally show only S100 protein expression but no reaction to melanocytic markers. S100 family of proteins consists of over 20 members. We report on S100 subtypes in malignant melanomas (MMs), and BPNSTs and MPNSTs to investigate differential expression.

DESIGN

S100A1, S100A2, S100A4, S100A6 and S100B immunostains were performed on 80 MMs including conventional and desmoplastic types, 86 BPNSTs and 77 MPNSTs.

RESULTS

S100A1 expression was seen in > 91% of MMs in a diffuse reaction, whereas BPNSTs showed focal or no reaction. Sixteen percent of MPNSTs focally expressed S100A1 except for one case with diffuse reaction. S100A2 staining was negative or focal in all three groups whereas S100A4 reaction was variable in all three. S100A6 was diffusely expressed in MMs, BPNSTs and MPNSTs. S100B was stained diffusely in MMs and BPNSTs, but its reaction was observed in 30% of MPNSTs in a focal fashion.

CONCLUSION

S100A1 expression was diffuse in most of MMs but absent or focal in BPNSTs and MPNSTs. This may be helpful to distinguish between the two entities.

Molecular diagnosis of renal cell neoplasms: the usefulness of immunohistochemistry and fluorescence in situ hybridization

BACKGROUND

The classification of renal cell neoplasms includes different subtypes of tumors characterized by different outcome. Some overlapping morphological features and the increasing recognition of new entities are making the traditional histologic distinction of renal cell neoplasms difficult and more tools improving the specificity of the correct identification are needed. Among molecular analyses, immunohistochemistry and fluorescence in situ hybridization have become the most helpful procedures, solving many issues in the differential diagnosis of the renal cell neoplasms.

OBJECTIVE

The aim of this review is to merge the large amount of recent knowledge regarding molecular markers of renal cell neoplasms into a helpful diagnostic algorithm.

CONCLUSION

It is proposed that immunoreactions for CD10, Alpha-methylacyl-CoA racemase, cytokeratin 7, parvalbumin and S100A1, and the cytogenetical analysis of chromosomes 3p, 1, 2, 6, 7, 10, 17 and Y can now offer the most specific tools for the classification of renal cell tumors.

Bilateral perinephric diffuse large B-cell lymphoma and synchronous renal oncocytoma

An elderly patient who presented with bilateral perinephric diffuse large B-cell lymphoma and concomitant oncocytoma of the same location is reported. To our knowledge, the anatomic proximity of the two tumors at the level of kidneys has not been previously described. Because of the patient's other medical conditions, systemic chemotherapy was not deemed feasible. Subsequently, the proliferation had a favorable response to single-agent monoclonal antibody rituximab.