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Bai J, Li X, Wen Y, Lu Q, Chen R, Liu R, Shangguan T, Ye Y, Lin J, Cai W, Kang D, Chen J. The clinicopathologic and molecular features, and treatment outcome of fumarate hydratase-deficient renal cell carcinoma: a retrospective comparison with type 2 papillary renal cell carcinoma. Aging (Albany NY) 2024; 16:3631-3646. [PMID: 38376408 PMCID: PMC10929833 DOI: 10.18632/aging.205549] [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: 10/03/2023] [Accepted: 12/27/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND To compare clinicopathologic, molecular features, and treatment outcome between fumarate hydratase-deficient renal cell carcinoma (FH-dRCC) and type 2 papillary renal cell carcinoma (T2 pRCC). METHODS Data of T2 pRCC patients and FH-dRCC patients with additional next-generation sequencing information were retrospectively analyzed. The cancer-specific survival (CSS) and disease-free survival (DFS) were primary endpoint. RESULTS A combination of FH and 2-succino-cysteine (2-SC) increased the rate of negative predictive value of FH-dRCC. Compared with T2 pRCC cases, FH-dRCC cases displayed a greater prevalence in young patients, a higher frequency of radical nephrectomy. Seven FH-dRCC and two T2 pRCC cases received systemic therapy. The VEGF treatment was prescribed most frequently, with an objective response rate (ORR) of 22.2% and a disease control rate (DCR) of 30%. A combined therapy with VEGF and checkpoint inhibitor reported an ORR of 40% and a DCR of 100%. FH-dRCC cases showed a shortened CSS (P = 0.042) and DFS (P < 0.001). The genomic sequencing revealed 9 novel mutations. CONCLUSIONS Coupled with genetic detection, immunohistochemical biomarkers (FH and 2-SC) can distinguish the aggressive FH-dRCC from T2 pRCC. Future research is awaited to illuminate the association between the novel mutations and the clinical phenotypes of FH-dRCC in the disease progression.
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Affiliation(s)
- Junjie Bai
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
- The Graduate School of Fujian Medical University, Fuzhou 350000, Fujian, P.R. China
| | - Xiaoyan Li
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Yahui Wen
- The Graduate School of Fujian Medical University, Fuzhou 350000, Fujian, P.R. China
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Qing Lu
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Ru Chen
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Rong Liu
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Tong Shangguan
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
- The Graduate School of Fujian Medical University, Fuzhou 350000, Fujian, P.R. China
| | - Yushi Ye
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
- The Graduate School of Fujian Medical University, Fuzhou 350000, Fujian, P.R. China
| | - Jun Lin
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
- The Graduate School of Fujian Medical University, Fuzhou 350000, Fujian, P.R. China
| | - Weizhong Cai
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Deyong Kang
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
| | - Jianhui Chen
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian, P.R. China
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102
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Bumbasirevic U, Petrovic M, Zekovic M, Coric V, Milojevic B, Lisicic N, Obucina D, Vasilic N, Bulat P, Zivkovic M, Cekerevac M, Bojanic N, Janicic A. Multifocality in Testicular Cancer: Clinicopathological Correlations and Prognostic Implications. Life (Basel) 2024; 14:257. [PMID: 38398766 PMCID: PMC10890071 DOI: 10.3390/life14020257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
There are limited data regarding the significance of multifocality in testicular cancer patients. This study evaluated the relationship between multifocality and clinicopathological features determined at the time of radical orchiectomy. The study involved 280 consecutive patients who underwent radical orchiectomy between 2018 and 2023. Multifocality was defined as a distinct tumor focus characterized by a group of malignant cells > 1 mm, clearly differentiated from the primary tumor mass. Uni- and multivariate logistic regression analyses were employed to investigate the association between multifocality and histopathological parameters along with potential risk factors for clinical stages II + III. Multifocality was identified in 44 (15.7%) patients. Significantly smaller primary tumors were observed in subjects with multifocality (20.0 mm vs. 30.0 mm, p = 0.0001), while those exhibiting monofocality presented a markedly elevated rate of tumors exceeding 4 cm (40.3% vs. 18.2%, p = 0.005). Furthermore, multifocality was associated with a significantly higher rate of primary tumors < 2 cm (52.3% vs. 29.2%, p = 0.003). Univariate logistic regression analysis revealed a substantial decrease in the likelihood of multifocality occurrence in seminoma patients with tumors > 4 cm (OR = 0.38, p = 0.017). Meanwhile, in multivariate logistic regression, multifocality did not emerge as a significant risk factor for clinical stages II + III in either seminoma (p = 0.381) or non-seminoma (p = 0.672) cases. Our study suggests that multifocality holds no substantial prognostic relevance for clinically advanced disease in testicular cancer patients. The findings indicate that multifocality is associated with smaller primary tumors, particularly those measuring less than 2 cm.
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Affiliation(s)
- Uros Bumbasirevic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milos Petrovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - Milica Zekovic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia;
| | - Vesna Coric
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- Center of Excellence for Redox Medicine, 11000 Belgrade, Serbia
| | - Bogomir Milojevic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nikola Lisicic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - David Obucina
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - Nenad Vasilic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - Petar Bulat
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - Marko Zivkovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - Milica Cekerevac
- Department of Pathology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Nebojsa Bojanic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Aleksandar Janicic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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103
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Hayden JP, Wiggins A, Sullivan T, Kalantzakos T, Hooper K, Moinzadeh A, Rieger-Christ K. Use of Droplet Digital Polymerase Chain Reaction to Identify Biomarkers for Differentiation of Benign and Malignant Renal Masses. Cancers (Basel) 2024; 16:787. [PMID: 38398177 PMCID: PMC10886675 DOI: 10.3390/cancers16040787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Several microRNAs (miRNAs) have been identified as cell-free biomarkers for detecting renal cell carcinoma (RCC). Droplet digital polymerase chain reaction (ddPCR) is a unique technology for nucleic acid quantification. It has the potential for superior precision, reproducibility, and diagnostic performance in identifying circulating miRNA biomarkers compared to conventional quantitative real-time PCR (qRT-PCR). This study aims to evaluate the performance of ddPCR compared to qRT- PCR in identifying miRNA biomarkers that differentiate malignant from benign renal masses. Potential biomarkers of RCC were identified from a literature review. RNA was extracted from the plasma of 56 patients. All the samples underwent analysis via ddPCR as well as qRT-PCR, and expression levels were recorded for the following miRNAs: miR-93, -144, -210, -221, and -222. Tumors were grouped into low-grade ccRCC, high-grade ccRCC, papillary RCC, and benign masses (primarily angiomyolipoma). The miRNA miR-210 (p = 0.034) and the combination of miRs-210 and miR-222 (p = 0.003) were expressed at significantly higher rates among those with RCC than those with benign masses, as measured by ddPCR. Using the combination of miR-210 and miR-222, ddPCR identified significant differences between the subgroups: papillary RCC versus benign (p = 0.03), low-grade ccRCC versus benign (p = 0.026), and high-grade ccRCC versus benign (p = 0.002). The only significant difference between these subgroups using qRT-PCR was between high-grade ccRCC and benign (p = 0.045). All the AUCs were significant when comparing each RCC subgroup with benign for both PCR technologies. Using a combination of miR-210 and miR-222, ddPCR identified significant differences between benign and malignant renal masses that were not identified as significant by conventional qRT-PCR.
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Affiliation(s)
- Joshua P. Hayden
- Department of Urology, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (J.P.H.); (A.W.); (A.M.)
| | - Adam Wiggins
- Department of Urology, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (J.P.H.); (A.W.); (A.M.)
| | - Travis Sullivan
- Department of Translational Research, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (T.S.); (T.K.); (K.H.)
| | - Thomas Kalantzakos
- Department of Translational Research, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (T.S.); (T.K.); (K.H.)
| | - Kailey Hooper
- Department of Translational Research, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (T.S.); (T.K.); (K.H.)
| | - Alireza Moinzadeh
- Department of Urology, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (J.P.H.); (A.W.); (A.M.)
| | - Kimberly Rieger-Christ
- Department of Urology, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (J.P.H.); (A.W.); (A.M.)
- Department of Translational Research, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (T.S.); (T.K.); (K.H.)
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104
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Zhang W, Su Y, Yue G, Zhao L, Li H, Jia M, Wang Y, Liu D, Wang H, Gao Y. Correlations of SDF-1ɑ and XRCC1 gene polymorphisms with the risk of renal cancer development and bioinformatics studies of SDF-1α and XRCC1 and the prognosis of renal cancer. Sci Rep 2024; 14:3367. [PMID: 38337001 PMCID: PMC10858090 DOI: 10.1038/s41598-024-53808-4] [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: 08/15/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
To study the relationships between stromal cell-derived factor-1 (SDF-1ɑ) and renal cell carcinoma (RCC) susceptibility and the presence of single nucleotide polymorphisms in the human X-ray cross-complementary repair gene (XRCC1). Compare SDF-1 based on RCC related data in the TCGA database α, The expression difference of XRCC1 between RCC tissue and normal tissue; Collect 166 newly diagnosed RCC cases and 166 healthy individuals who underwent physical examinations during the same period, and detect genotype using iMLDR method. The results The rs1801157 locus (C:T) of the SDF-1α gene was not significantly associated with the pathohistological type, the rs1799782 locus (G:A) of the XRCC1 gene was associated with the pathohistological type of RCC, and there were interactions between rs1799782 and smoking, alcohol consumption, pesticide exposure, hair dye, and urine holding. The rs1799782 locus of the XRCC1 gene may be a key factor in the pathogenesis and pathological development of RCC. High SDF-1ɑ expression is a protective factor for the overall survival of patients with RCC, and SDF-1ɑ and XRCC1 may be important for the treatment of RCC.
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Affiliation(s)
- Wenjing Zhang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Yubo Su
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Genquan Yue
- Department of Urology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Lingyan Zhao
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
- Key Laboratory of Molecular Epidemiology of Chronic Diseases, Inner Mongolia Medical University, Hohhot, China
| | - Hailing Li
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
- Key Laboratory of Molecular Epidemiology of Chronic Diseases, Inner Mongolia Medical University, Hohhot, China
| | - Min Jia
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Yuqi Wang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Dongyang Liu
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Haisheng Wang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China.
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Inner Mongolia Medical University, Hohhot, China.
| | - Yumin Gao
- School of Public Health, Inner Mongolia Medical University, Hohhot, China.
- Key Laboratory of Molecular Epidemiology of Chronic Diseases, Inner Mongolia Medical University, Hohhot, China.
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105
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Chen X, Xu Z, Wu C, Xie L, Wang P, Liu X. Efficacy and toxicity of immune checkpoint inhibitors combination therapy for advanced renal cell carcinoma: a systematic review and network meta-analysis. Front Immunol 2024; 15:1255577. [PMID: 38390328 PMCID: PMC10881808 DOI: 10.3389/fimmu.2024.1255577] [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: 07/09/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Background Although immune checkpoint inhibitors (ICIs) show a significant overall survival advantage over standard advanced renal cell carcinoma (aRCC) therapies, tumor response to these agents remains poor. Some studies have shown that combination therapy including an ICI appears to be the best treatment; however, the overall benefit in terms of efficacy and toxicity still needs to be assessed. Thus, we performed a network meta-analysis to evaluate the differences in the efficacy of several combinations that include an ICI to provide a basis for clinical treatment selection. Methods We conducted a thorough search of PubMed, EMBASE, and the Cochrane Library for articles from January 2010 to June 2023. R 4.4.2 and STATA 16.0 were used to analyze data; hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals (CI) were used to assess the results. Results An indirect comparison showed that nivolumab plus cabozantinib and pembrolizumab plus lenvatinib were the most effective treatments for progression-free survival (PFS), with no significant differences between the two interventions (HR, 1.31; 95% CI, 0.96-1.78; P=0.08); rank probability showed that pembrolizumab plus lenvatinib had a 57.1% chance of being the preferred treatment. In the absence of indirect comparisons between pembrolizumab plus axitinib, nivolumab plus ipilimumab, avelumab plus axitinib, nivolumab plus cabozantinib, and pembrolizumab plus lenvatinib, pembrolizumab plus axitinib (40.2%) was the best treatment option for overall survival (OS). Compared to pembrolizumab plus lenvatinib, nivolumab plus ipilimumab (OR, 0.07; 95% CI, 0.01-0.65; P=0.02) and pembrolizumab plus axitinib (OR, 0.05; 95% CI, 0.00-0.78; P<0.001) had a lower incidence of overall adverse events (AEs). Conclusion Pembrolizumab plus lenvatinib and pembrolizumab plus axitinib resulted in the highest PFS and OS rates, respectively. Pembrolizumab plus axitinib may be the best option when AEs are a concern. Systematic review registration https://inplasy.com/, identifier INPLASY202410078.
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Affiliation(s)
| | | | | | | | | | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
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106
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Xiao J, Chen H, Ge J, Liu T. Clinical efficacy analysis of partial cystectomy and radical cystectomy in the treatment of muscle-invasive sarcomatoid carcinoma of the urinary bladder. Front Oncol 2024; 14:1324487. [PMID: 38371629 PMCID: PMC10869453 DOI: 10.3389/fonc.2024.1324487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Objective This study compares the clinical efficacy of partial cystectomy (PC) versus radical cystectomy (RC) in the treatment of muscle-invasive bladder urothelial carcinoma (SCUB) through a retrospective analysis. Methods We retrospectively analyzed the clinical data of 20 patients diagnosed with muscle-invasive SCUB from July 2015 to August 2023 at Ganzhou People's Hospital. All patients underwent surgical treatment followed by chemotherapy, with 9 receiving PC and 11 undergoing RC. We compared the average survival time of deceased patients for both treatments and conducted survival and multivariate analyses using the Kaplan-Meier method and Cox proportional hazards model, respectively. Results All 20 patients were postoperatively diagnosed with muscle-invasive SCUB and were followed up for 4 to 60 months. The average survival time for patients undergoing PC was 11.5 months, with survival rates at 1 year, 2 years, and 5 years of 55.56%, 22.22%, and 11.11%, respectively. In contrast, patients receiving RC had an extended average survival time of 22.5 months, and their 1-year, 2-year, and 5-year survival rates increased to 63.64%, 36.36%, and 18.18%, respectively. Survival analysis revealed statistically significant differences in prognosis between PC and RC for the treatment of muscle-invasive SCUB (P<0.05). Conclusion SCUB is a rare malignant tumor with unique biological characteristics often associated with poor prognosis. Upon diagnosis, RC should be considered as an early treatment approach when the patient's overall condition permits.
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Affiliation(s)
| | | | | | - Tairong Liu
- Department of Urology Surgery, Ganzhou People’s Hospital, Jiangxi Medical College, Nanchang University, Ganzhou, Jiangxi, China
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107
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Alvarado-Cabrero I, Fernández-Nestosa MJ, Valencia-Cedillo R, Urizar C, Cañete-Portillo S, Sánchez DF, Cubilla AL. Gradual and synergistic correlation of tumor thickness and histological grade in penile invasive carcinomas. Hum Pathol 2024; 144:77-82. [PMID: 38278449 DOI: 10.1016/j.humpath.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 01/28/2024]
Abstract
Histological grade and depth of invasion are among the best outcome pathological predictors in penile cancer. The TNM system is based on a combination of both for some stages. It is assumed that high-grade and deep tumors carry the worst prognosis, and the opposite occurs with superficial and low-grade neoplasms. However, there is no systematic evaluation of the phenomenon. We studied 147 patients from the Hospital de Oncologia - Instituto Mexicano del Seguro Social (period 2000 to 2013). They were treated by total or partial penectomies. Lymph node involvement was evaluated by bilateral inguinal node dissection (126 cases) or ultrasonography (21 cases). Tumor thickness was measured in mm from tumor surface to deepest invasion point, using a cut-point for superficial (≤10 mm) vs deep (>10 mm) tumors. Histological grade was from 1 to 3 according to WHO and AFIP criteria and considering G1 and G2 as low-grade and G3 as high-grade. Average age was 62 (26-98) years old. Tumor thickness mean was 15 mm (2-30 mm). G1, G2 and G3 tumors corresponded to 19 (13 %), 48 (33 %), and 80 (54 %) cases, respectively. Follow-up ranged from 10 to 82 months (median: 57 months). Fifty-three (36 %) patients died of disease. There was an overall correlation of tumor thickness and grade in most of the cases. Low-grade tumors were encountered in 92 % (12/13 cases) of superficial tumors. Deep tumors showed high-grade in 75 % of cases (73/97 cases). Superficial tumors with low histological grade had negative inguinal nodes and no mortality whereas deep tumors showing high histological grade were associated with high metastatic risk to lymph nodes (62/73 cases) and mortality (52/73 cases). Out of 24 deep tumors with low histological grade, seven had nodal spread (29 %) but only one died of disease. No outcome difference was found in HPV associated vs HPV independent tumors. Tumor thickness and grade are important synergistic and predictive pathological factors in relation to prognosis.
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Affiliation(s)
- Isabel Alvarado-Cabrero
- Hospital de Oncología, Centro Médico Nacional Siglo XXI, 06600, Alc. Cuauhtémoc, Ciudad de México, Mexico
| | | | - Raquel Valencia-Cedillo
- Hospital de Oncología, Centro Médico Nacional Siglo XXI, 06600, Alc. Cuauhtémoc, Ciudad de México, Mexico
| | - César Urizar
- Instituto de Patología e Investigación, Asunción, 1228, Paraguay
| | - Sofía Cañete-Portillo
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - Diego F Sánchez
- Instituto de Patología e Investigación, Asunción, 1228, Paraguay; Translational Oncogenomics Group, Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester, M20 4GJ, UK
| | - Antonio L Cubilla
- Universidad Nacional de Asunción, San Lorenzo, 2111, Paraguay; Instituto de Patología e Investigación, Asunción, 1228, Paraguay.
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108
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Zhang X, Bolck HA, Rupp NJ, Moch H. Genomic alterations and diagnosis of renal cancer. Virchows Arch 2024; 484:323-337. [PMID: 37999735 PMCID: PMC10948545 DOI: 10.1007/s00428-023-03700-9] [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: 08/28/2023] [Revised: 10/24/2023] [Accepted: 11/04/2023] [Indexed: 11/25/2023]
Abstract
The application of molecular profiling has made substantial impact on the classification of urogenital tumors. Therefore, the 2022 World Health Organization incorporated the concept of molecularly defined renal tumor entities into its classification, including succinate dehydrogenase-deficient renal cell carcinoma (RCC), FH-deficient RCC, TFE3-rearranged RCC, TFEB-altered RCC, ALK-rearranged RCC, ELOC-mutated RCC, and renal medullary RCC, which are characterized by SMARCB1-deficiency. This review aims to provide an overview of the most important molecular alterations in renal cancer, with a specific focus on the diagnostic value of characteristic genomic aberrations, their chromosomal localization, and associations with renal tumor subtypes. It may not yet be the time to completely shift to a molecular RCC classification, but undoubtedly, the application of molecular profiling will enhance the accuracy of renal cancer diagnosis, and ultimately guide personalized treatment strategies for patients.
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Affiliation(s)
- Xingming Zhang
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstr. 12, 8091, Zurich, Switzerland
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Hella A Bolck
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstr. 12, 8091, Zurich, Switzerland
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstr. 12, 8091, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Holger Moch
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstr. 12, 8091, Zurich, Switzerland.
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
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109
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Civan C, Kuyumcu S, Has Simsek D, Sanli O, Isik EG, Ozkan ZG, Hurdogan O, Sanli Y. The role of [ 68 Ga]Ga-FAPI-04 PET/CT in renal cell carcinoma: a preliminary study. Eur J Nucl Med Mol Imaging 2024; 51:852-861. [PMID: 37803246 DOI: 10.1007/s00259-023-06461-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/27/2023] [Indexed: 10/08/2023]
Abstract
PURPOSE We aimed to investigate the role of [68 Ga]Ga-FAPI-04 PET/CT and uptake patterns of primary and metastatic lesions in patients with renal cell carcinoma (RCC). METHODS Twenty patients with a suspicious lesion considered primary renal malignancy or a history of RCC were included in our study. Two patients were excluded from further analyses due to other confirmed malignancies. Six patients were newly diagnosed, while the indication of 12 patients was restaging. All patients underwent [68 Ga]Ga-FAPI-04 and [18F]F-FDG PET/CT. SUVmax and tumor-to-background ratio (TBR) of primary (n = 7) and local recurrent lesions (n = 6) and lymph node (n = 26), lung (n = 32), bone (n = 5), and other metastases (n = 14) were compared between the two tracers. RESULTS We detected 90 lesions in 18 patients with varying FAPI and FDG uptake values on both PET/CT. The median TBR of FAPI-PET/CT of all lesions was higher than TBR of FDG-PET/CT with statistically significance (5.6 vs. 2.1, p < 0.001). In primary and recurrent lesions, the median SUVmax, TBR, and tumor volume on FAPI-PET/CT were higher than FDG-PET/CT. The median SUVmax of lung lesions on FAPI-PET/CT was statistical significantly higher than FDG-SUVmax (3.8 vs. 1.8, p = 0.02). The median of FAPI-SUVmax on primary lesions was lower in the early stage based on TNM compared to the advanced stage. FAPI-SUVmax in 49% of all lesions were SUVmax ≥ 6, and 13% were SUVmax ≥ 10. In patient-based analyses, seven patients (39%) had at least one lesion with FAPI-SUVmax ≥ 10; 12 patients (67%) had at least one lesion with FAPI-SUVmax ≥ 6. CONCLUSION This study showed the potential utility of [68 Ga]Ga-FAPI-04 PET/CT showing promising results in RCC. We have presumed that FAPI-PET/CT may be performed for complementary imaging modality providing prognosis and possibility of theranostic application in selected patients.
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Affiliation(s)
- Caner Civan
- Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, 34093, Fatih, Istanbul, Turkey.
| | - Serkan Kuyumcu
- Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, 34093, Fatih, Istanbul, Turkey
| | - Duygu Has Simsek
- Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, 34093, Fatih, Istanbul, Turkey
| | - Oner Sanli
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, 34093, Fatih, Istanbul, Turkey
| | - Emine Goknur Isik
- Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, 34093, Fatih, Istanbul, Turkey
| | - Zeynep Gozde Ozkan
- Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, 34093, Fatih, Istanbul, Turkey
| | - Ozge Hurdogan
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, 34093, Fatih, Istanbul, Turkey
| | - Yasemin Sanli
- Department of Nuclear Medicine, Istanbul Faculty of Medicine, Istanbul University, 34093, Fatih, Istanbul, Turkey
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Pacheco RR, Pacheco R, Cooley C, Kaufman R, Akgul M. Diffuse Carbonic Anhydrase 9 and GATA3 Expression in Fumarate Hydratase Deficient Renal Cell Carcinoma - A Case Report and Immunoprofile Review. Int J Surg Pathol 2024; 32:145-149. [PMID: 37050851 DOI: 10.1177/10668969231167486] [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] [Indexed: 04/14/2023]
Abstract
Fumarate hydratase deficient renal cell carcinoma (FHRCC) can exhibit a heterogenous immunoprofile. In the present case, a solitary 10.5 cm mixed cystic and solid left kidney tumor showed various growth patterns, involving renal sinus adipose tissue and the renal pelvis. Tumor cells showed prominent nucleoli and perinucleolar halos. Aberrant diffuse (>90%), strong, and membranous carbonic anhydrase 9 and variable GATA3 expression were present. Diagnostic loss of fumarate hydratase expression and 2-succinyl cysteine overexpression (cytoplasmic and nuclear) were identified. Carbonic anhydrase 9 and GATA3 expression in FHRCC is rarely reported in the literature, and may cause misdiagnosis of clear cell RCC and/or urothelial carcinoma.
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Affiliation(s)
- Richard R Pacheco
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | - Robert Pacheco
- Department of Radiology, Albany Medical Center, Albany, NY, USA
| | | | - Ronald Kaufman
- Department of Urology, Albany Medical Center, Albany, NY, USA
| | - Mahmut Akgul
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
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Ouchene L, Wilde B, Chan-Pak-Choon F, Camacho Valenzuela J, Brimo F, Witkowski L, Christofk H, Domecq C, Fu L, Weber E, Lemieux Anglin B, Netchiporouk E, Foulkes WD. Segregation, immunohistochemical, molecular and functional analyses classify a novel missense variant in fumarate hydratase (FH) as pathogenic. Genes Chromosomes Cancer 2024; 63:e23221. [PMID: 38682608 DOI: 10.1002/gcc.23221] [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: 10/25/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 05/01/2024] Open
Abstract
Hereditary leiomyomatosis and renal cell cancer (HLRCC) is an autosomal dominant cancer predisposition syndrome characterized by cutaneous leiomyomas, uterine leiomyomas, and aggressive renal cancer. Germline variants in the fumarate hydratase (FH) gene predispose to HLRCC. Identifying germline pathogenic FH variants enables lifetime renal cancer screening and genetic testing for family members. In this report, we present a FH missense variant (c.1039T>C (p.S347P)), initially classified as a variant of uncertain significance. Clinical assessment, histopathological findings, molecular genetic studies, and enzymatic activity studies support the re-classification of the FH c.1039T>C variant to "pathogenic" based on ACMG/AMP criteria. Further insights into pathological recognition of FH-deficient renal cancer are discussed and should be recognized. This study has shown how (a) detailed multi-disciplinary analyses of a single variant can reclassify rare missense variants in FH and (b) careful pathological review of renal cancers is obligatory when HLRCC is suspected.
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Affiliation(s)
- Lydia Ouchene
- Division of Experimental Medicine, Department of Medicine, McGill University, Montréal, Quebec, Canada
- Division of Dermatology, Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Blake Wilde
- Department of Biological Chemistry, University of California Los Angeles, Los Angeles, California, USA
- Jonnson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California, USA
| | | | - Jose Camacho Valenzuela
- Department of Human Genetics, McGill University, Montréal, Québec, Canada
- Cancer Research Program, Centre for Translational Biology, The Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - Fadi Brimo
- Department of Pathology, McGill University, Montreal, Québec, Canada
| | - Leora Witkowski
- Department of Human Genetics, McGill University, Montréal, Québec, Canada
- Core Molecular Diagnostic Laboratory, McGill University Health Centre, Montreal, Quebec, Canada
| | - Heather Christofk
- Department of Biological Chemistry, University of California Los Angeles, Los Angeles, California, USA
- Jonnson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California, USA
- Broad Stem Cell Research Center, University of California Los Angeles, Los Angeles, California, USA
| | - Celine Domecq
- Division of Medical Genetics, Department of Specialized Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Lili Fu
- Department of Pathology, McGill University, Montreal, Québec, Canada
| | - Evan Weber
- Department of Human Genetics, McGill University, Montréal, Québec, Canada
- Division of Medical Genetics, Department of Specialized Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Brianna Lemieux Anglin
- Division of Medical Genetics, Department of Specialized Medicine, McGill University Health Centre, Montreal, Quebec, Canada
- Division of Medical Genetics, Department of Specialized Medicine, and Cancer Axis, Lady Davis Institute for Medical Research Jewish General Hospital, Montreal, Quebec, Canada
| | - Elena Netchiporouk
- Division of Experimental Medicine, Department of Medicine, McGill University, Montréal, Quebec, Canada
- Division of Dermatology, Department of Medicine, McGill University, Montréal, Québec, Canada
| | - William D Foulkes
- Division of Experimental Medicine, Department of Medicine, McGill University, Montréal, Quebec, Canada
- Department of Human Genetics, McGill University, Montréal, Québec, Canada
- Cancer Research Program, Centre for Translational Biology, The Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
- Division of Medical Genetics, Department of Specialized Medicine, McGill University Health Centre, Montreal, Quebec, Canada
- Division of Medical Genetics, Department of Specialized Medicine, and Cancer Axis, Lady Davis Institute for Medical Research Jewish General Hospital, Montreal, Quebec, Canada
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112
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Wu Z, Chen H, Chen Q, Ge S, Yu N, Campi R, Gómez Rivas J, Autorino R, Rouprêt M, Psutka SP, Mehrazin R, Porpiglia F, Bensalah K, Black PC, Mir MC, Minervini A, Djaladat H, Margulis V, Bertolo R, Caliò A, Carbonara U, Amparore D, Borregales LD, Ciccarese C, Diana P, Erdem S, Marandino L, Marchioni M, Muselaers CHJ, Palumbo C, Pavan N, Pecoraro A, Roussel E, Warren H, Pandolfo SD, Chen R, Zhou W, Zhai W, He M, Li Y, Han B, Wan J, Zeng X, Yan J, Fu Y, Ji C, Fan X, Zhang G, Zhao C, Jing T, Wang A, Feng C, Zhao H, Sun D, Wang L, Tai S, Zhang C, Chen S, Liu Y, Xu Z, Wang H, Gao J, Wang F, Cheng J, Miao H, Rao Q, Wang J, Xu N, Wang G, Liang C, Liu Z, Xia D, Jiang J, Zu X, Chen M, Guo H, Qin W, Wang Z, Xue W, Shi B, Zhou X, Wang S, Zheng J, Ge J, Feng X, Li M, Chen C, Qu L, Wang L. Prognostic Significance of Grade Discrepancy Between Primary Tumor and Venous Thrombus in Nonmetastatic Clear-cell Renal Cell Carcinoma: Analysis of the REMEMBER Registry and Implications for Adjuvant Therapy. Eur Urol Oncol 2024; 7:112-121. [PMID: 37468393 DOI: 10.1016/j.euo.2023.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/14/2023] [Accepted: 06/26/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Further stratification of the risk of recurrence of clear-cell renal cell carcinoma (ccRCC) with venous tumor thrombus (VTT) will facilitate selection of candidates for adjuvant therapy. OBJECTIVE To assess the impact of tumor grade discrepancy (GD) between the primary tumor (PT) and VTT in nonmetastatic ccRCC on disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS). DESIGN, SETTING, AND PARTICIPANTS This was a retrospective analysis of a multi-institutional nationwide data set for patients with pT3N0M0 ccRCC who underwent radical nephrectomy and thrombectomy. OUTCOMES MEASUREMENTS AND STATISTICAL ANALYSIS Pathology slides were centrally reviewed. GD, a bidirectional variable (upgrading or downgrading), was numerically defined as the VTT grade minus the PT grade. Multivariable models were built to predict DFS, OS, and CSS. RESULTS AND LIMITATIONS We analyzed data for 604 patients with median follow-up of 42 mo (excluding events). Tumor GD between VTT and PT was observed for 47% (285/604) of the patients and was an independent risk factor with incremental value in predicting the outcomes of interest (all p < 0.05). Incorporation of tumor GD significantly improved the performance of the ECOG-ACRIN 2805 (ASSURE) model. A GD-based model (PT grade, GD, pT stage, PT sarcomatoid features, fat invasion, and VTT consistency) had a c index of 0.72 for DFS. The hazard ratios were 8.0 for GD = +2 (p < 0.001), 1.9 for GD = +1 (p < 0.001), 0.57 for GD = -1 (p = 0.001), and 0.22 for GD = -2 (p = 0.003) versus GD = 0 as the reference. According to model-converted risk scores, DFS, OS, and CSS significantly differed between subgroups with low, intermediate, and high risk (all p < 0.001). CONCLUSIONS Routine reporting of VTT upgrading or downgrading in relation to the PT and use of our GD-based nomograms can facilitate more informed treatment decisions by tailoring strategies to an individual patient's risk of progression. PATIENT SUMMARY We developed a tool to improve patient counseling and guide decision-making on other therapies in addition to surgery for patients with the clear-cell type of kidney cancer and tumor invasion of a vein.
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Affiliation(s)
- Zhenjie Wu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China; European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands.
| | - Hui Chen
- Department of Pathology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Qi Chen
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Silun Ge
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Nengwang Yu
- Department of Urology, Qilu Hospital, Shandong University, Jinan, China
| | - Riccardo Campi
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Juan Gómez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Riccardo Autorino
- Department of Urology, Rush University Medical Center, Chicago, IL, USA
| | - Morgan Rouprêt
- Department of Urology, GRC No. 5, Predictive ONCO-URO, Hospital Pitié-Salpêtrière, AP-HP, Sorbonne University, Paris, France
| | - Sarah P Psutka
- Department of Urology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Reza Mehrazin
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Karim Bensalah
- Department of Urology, University of Rennes, Rennes, France
| | - Peter C Black
- Department of Urologic Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Maria C Mir
- Department of Urology; Hospital Universitario La Ribera; Valencia, Spain
| | - Andrea Minervini
- Departments of Urology and Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Hooman Djaladat
- Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Riccardo Bertolo
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Urology Unit, San Carlo di Nancy Hospital, Rome, Italy
| | - Anna Caliò
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Umberto Carbonara
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Daniele Amparore
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Leonardo D Borregales
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Weill Cornell Medicine/New York-Presbyterian, New York, NY, USA
| | - Chiara Ciccarese
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Pietro Diana
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Selcuk Erdem
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Urologic Oncology, Department of Urology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Laura Marandino
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Michele Marchioni
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Medical, Oral and Biotechnological Sciences, Urology Unit, University G. d'Annunzio, Chieti, Italy
| | - Constantijn H J Muselaers
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carlotta Palumbo
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Nicola Pavan
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Urology Clinic, Department of Surgical, Oncological, and Oral Sciences, University of Palermo, Palermo, Italy
| | - Angela Pecoraro
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Eduard Roussel
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Hannah Warren
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Surgery and Interventional Science, University College London, London, UK
| | - Savio Domenico Pandolfo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Rui Chen
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Wenquan Zhou
- Department of Urology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Wei Zhai
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Miaoxia He
- Department of Pathology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yaoming Li
- Department of Urology, Daping Hospital, Army Medical University, Chongqing, China
| | - Bo Han
- Department of Pathology, Qilu Hospital, Shandong University, Jinan, China
| | - Jie Wan
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing Zeng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junan Yan
- Department of Urology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Yao Fu
- Department of Pathology, Drum Tower Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Changwei Ji
- Department of Urology, Drum Tower Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Xiang Fan
- Department of Pathology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Guangyuan Zhang
- Department of Urology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Cheng Zhao
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Taile Jing
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Anbang Wang
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Chenchen Feng
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongwei Zhao
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Di Sun
- Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Liang Wang
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Sheng Tai
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Cheng Zhang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shaohao Chen
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yixun Liu
- Department of Urology, Anhui Provincial Hospital/The First Hospital of the University of Science and Technology of China, Hefei, China
| | - Zhipeng Xu
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Haifeng Wang
- Department of Urology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Jinli Gao
- Department of Pathology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Fubo Wang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
| | - Jiwen Cheng
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - He Miao
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Qiu Rao
- Department of Pathology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Jianning Wang
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Ning Xu
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Gongxian Wang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhiyu Liu
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Dan Xia
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Jiang
- Department of Urology, Daping Hospital, Army Medical University, Chongqing, China
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Ming Chen
- Department of Urology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Hongqian Guo
- Department of Urology, Drum Tower Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Weijun Qin
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhe Wang
- Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Wei Xue
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Benkang Shi
- Department of Urology, Qilu Hospital, Shandong University, Jinan, China
| | - Xiaojun Zhou
- Department of Pathology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junhua Zheng
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jingping Ge
- Department of Urology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Xiang Feng
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
| | - Minming Li
- Department of Radiology, Changhai Hospital, Naval Medical University, Shanghai, China.
| | - Cheng Chen
- Department of Medical Oncology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China.
| | - Le Qu
- Department of Urology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China.
| | - Linhui Wang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
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Garolla A, Graziani A, Grande G, Ortolani C, Ferlin A. HPV-related diseases in male patients: an underestimated conundrum. J Endocrinol Invest 2024; 47:261-274. [PMID: 37770654 PMCID: PMC10859347 DOI: 10.1007/s40618-023-02192-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE Human papillomavirus (HPV) infection is the most common sexually transmitted disease, in males and females worldwide. While the role of HPV in female diseases is well known and largely studied, males have negligibly been included in these programs, also because the proportion of women suffering and dying from HPV-related diseases is much larger than men. The aim of this review is to focus on HPV-related diseases in male patients. METHODS We performed a literature analysis on the electronic database PubMed. We considered randomized trials, observational and retrospective studies, original articles having as topic the relationship between HPV male infection and the following items: oral, anal penile cancers, warts, condylomas, male infertility, altered sperm parameters, anti-sperm antibodies (ASA). We also included experimental in vitro studies focused on the effects of HPV infection on oocyte fertilization, blastocyst development, and trophoblastic cell invasiveness. In addition, studies describing the adjuvant administration of the HPV vaccination as a possible strategy to promote HPV clearance from semen in infected males were included. RESULTS Regarding head and neck HPV-related diseases, the most important non-neoplastic disease is recurrent respiratory papillomatosis (RRP). Regarding neoplastic diseases, the proportion of head and neck cancers attributable to HPV has increased dramatically worldwide. In addition, nowadays, it is thought that half of head and neck squamous cell carcinomas (HNSCCs) cases in the United States are caused by infection with high-risk HPV. HPV is noteworthy in andrological practice too. It was described as having a high HPV prevalence, ranging between 50 and 70%, in male penile shaft, glans penis/coronal sulcus, semen as well as in scrotal, perianal, and anal regions. Moreover, in male patients, HPV infection has been associated, among other diseases, with penile cancers. HPV semen infection has been reported in about 10% in men from the general population and about 16% in men with unexplained infertility, although these data seem widely underestimated according to clinical experience. In particular, HPV semen infection seems to be most related to asthenozoospermia and to anti-sperm antibodies (ASAs). CONCLUSIONS HPV infection represents a health problem with a detrimental social and public impact. Despite this evidence, little has been done to date to widely promote vaccination among young males.
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Affiliation(s)
- A Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy.
| | - A Graziani
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - G Grande
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - C Ortolani
- Section of Otolaryngology, Department of Neurosciences, University of Padova, Padua, Italy
| | - A Ferlin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
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Rosellini M, Mollica V, Marchetti A, Coluccelli S, Giunchi F, Tassinari E, Ricci C, Fiorentino M, Tallini G, De Biase D, Massari F. Chromosome 3p gene alterations as biomarkers for immunocombinations in metastatic renal cell carcinoma: A hypothesis-generating analysis. Pathol Res Pract 2024; 254:155142. [PMID: 38277752 DOI: 10.1016/j.prp.2024.155142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/31/2023] [Accepted: 01/13/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Identifying biomarkers for metastatic renal cell carcinoma (mRCC) is an unmet need in actual immunotherapy era. Available data regarding chromosome 3p genes (i.e., VHL, PBRM1, SETD2) mutations as potential predictors for therapy response is conflicting. We describe the impact of these mutations on clinical outcomes in mRCC patients treated with immune checkpoint inhibitor (ICI)-doublet or ICI/tyrosine kinase inhibitor (TKI) combinations. METHODS We performed a single-center retrospective analysis on mRCC patients treated with first line ICI/ICI or ICI/TKI. A multi-gene panel was used, allowing the amplification of 841 amplicons (54.93 kb, human reference sequence hg19/GRCh37) in the coding sequences of the following genes: ATM, BAP1, KDM5C, MET, MTOR, NF2, PBRM1, PIK3CA, PTEN, SETD2, SMARCB1, TP53, TSC1, TSC2, VHL. RESULTS 18 patients undergoing ICI/ICI and ICI/TKI who had tumor tissue adequate for molecular analysis were included. Histology was 100% clear cell. IMDC risk was 50% intermediate, 33.4% good, 16.6% poor. First line therapy was 89% ICI/TKI, 11% ICI/ICI. 83.3% pts (n = 15) carried genomic alterations (GA). Most common GA included VHL in 44% (n = 8; 7 pathogenic - PAT and 1 variant of unknown significance - VUS), PBRM1 in 44% (n = 8; 5 PAT and 3 VUS) and SETD2 in 33% (n = 6; 4 PAT and 2 VUS). With the limit of a small sample that did not allow proper statistical analyses, SETD2-mutated patients had lower median progression free (mPFS) and overall survival (mOS) than non-SETD2 mutated patients. Higher mPFS and mOS were shown with VHL or PBRM1 GA, especially in PBRM1 +VHL mutated pts. CONCLUSIONS Our data shows a possible negative predictive role of SETD2 GA for ICI-based therapy in RCC. Concomitant VHL and PBRM1 GA could act as a predictor for ICI/TKI efficacy. Our hypothesis-generating analysis highlights the need of an integrated evaluation of these genes as promising biomarkers in RCC. Further larger studies are required.
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Affiliation(s)
- Matteo Rosellini
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Veronica Mollica
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Andrea Marchetti
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Sara Coluccelli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy; Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Francesca Giunchi
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Elisa Tassinari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Costantino Ricci
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy; Pathology Unit, Maggiore Hospital-AUSL Bologna, Bologna, Italy
| | - Michelangelo Fiorentino
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy; Pathology Unit, Maggiore Hospital-AUSL Bologna, Bologna, Italy
| | - Giovanni Tallini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy; Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Dario De Biase
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; Department of Pharmacy and Biotechnology (FaBit), University of Bologna, 40126 Bologna, Italy
| | - Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
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Klontzas ME, Kalarakis G, Koltsakis E, Papathomas T, Karantanas AH, Tzortzakakis A. Convolutional neural networks for the differentiation between benign and malignant renal tumors with a multicenter international computed tomography dataset. Insights Imaging 2024; 15:26. [PMID: 38270726 PMCID: PMC10811309 DOI: 10.1186/s13244-023-01601-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 12/17/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVES To use convolutional neural networks (CNNs) for the differentiation between benign and malignant renal tumors using contrast-enhanced CT images of a multi-institutional, multi-vendor, and multicenter CT dataset. METHODS A total of 264 histologically confirmed renal tumors were included, from US and Swedish centers. Images were augmented and divided randomly 70%:30% for algorithm training and testing. Three CNNs (InceptionV3, Inception-ResNetV2, VGG-16) were pretrained with transfer learning and fine-tuned with our dataset to distinguish between malignant and benign tumors. The ensemble consensus decision of the three networks was also recorded. Performance of each network was assessed with receiver operating characteristics (ROC) curves and their area under the curve (AUC-ROC). Saliency maps were created to demonstrate the attention of the highest performing CNN. RESULTS Inception-ResNetV2 achieved the highest AUC of 0.918 (95% CI 0.873-0.963), whereas VGG-16 achieved an AUC of 0.813 (95% CI 0.752-0.874). InceptionV3 and ensemble achieved the same performance with an AUC of 0.894 (95% CI 0.844-0.943). Saliency maps indicated that Inception-ResNetV2 decisions are based on the characteristics of the tumor while in most tumors considering the characteristics of the interface between the tumor and the surrounding renal parenchyma. CONCLUSION Deep learning based on a diverse multicenter international dataset can enable accurate differentiation between benign and malignant renal tumors. CRITICAL RELEVANCE STATEMENT Convolutional neural networks trained on a diverse CT dataset can accurately differentiate between benign and malignant renal tumors. KEY POINTS • Differentiation between benign and malignant tumors based on CT is extremely challenging. • Inception-ResNetV2 trained on a diverse dataset achieved excellent differentiation between tumor types. • Deep learning can be used to distinguish between benign and malignant renal tumors.
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Affiliation(s)
- Michail E Klontzas
- Department of Medical Imaging, University Hospital of Heraklion, Heraklion, Crete, Greece
- Computational BioMedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology (FORTH), Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, Voutes Campus, Heraklion, Greece
| | - Georgios Kalarakis
- Department of Diagnostic Radiology, Karolinska University Hospital, Stockholm, Sweden
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Emmanouil Koltsakis
- Department of Diagnostic Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Papathomas
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Department of Clinical Pathology, Vestre Viken Hospital Trust, Drammen, Norway
| | - Apostolos H Karantanas
- Department of Medical Imaging, University Hospital of Heraklion, Heraklion, Crete, Greece
- Computational BioMedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology (FORTH), Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, Voutes Campus, Heraklion, Greece
| | - Antonios Tzortzakakis
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
- Medical Radiation Physics and Nuclear Medicine, Section for Nuclear Medicine, Karolinska University Hospital, 14 186, Huddinge, Stockholm, Sweden.
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Arı E, Köseoğlu H, Eroğlu T. Predictive value of SIRI and SII for metastases in RCC: a prospective clinical study. BMC Urol 2024; 24:14. [PMID: 38218876 PMCID: PMC10788028 DOI: 10.1186/s12894-024-01401-2] [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: 07/06/2023] [Accepted: 01/01/2024] [Indexed: 01/15/2024] Open
Abstract
OBJECTIVES In this prospective cross-sectional clinical study, we aimed to determine the efficiency of preoperative hematological markers namely SIRI (systemic inflammatory response index) and SII (systemic inflammatory index) for renal cell cancer to predict the possibility of postoperative metastases. METHODS Istanbul Education and Research Hospital, Clinic of Urology and Medical Oncology in the clinic between the dates of June 2022 to 2023 February, a diagnosis of renal cell cancer by surgical or medical oncology units imported into the treatment planning of 72 patients were included in the study. All cases with diagnoses of renal cell carcinoma were searched from hospital records. Patients with secondary malignancy, hematological or rheumatological disorders or ones with recent blood product transfusion or diagnoses of infection within the 1-month-time of diagnoses were excluded for data analyses. The data within complete blood counts (CBC) analyzed just before the time of renal biopsy or surgery were studied for SIRI and SII calculations. Twenty-two metastatic and 50 non-metastatic RCC patients were included. SIRI and SII values were compared among groups to seek change of values in case of metastasis and in non-metastatic patients a cut-off value were sought to indicate malignancy before pathological diagnosis. RESULTS Mean age of non-metastatic RCC patients were 60.12+/-11.55 years and metastatic RCC patients were 60.25+/-11.72. Histological sub-types of the RCC specimens were clear cell (72%), chromophobe cell (17%), papillary cell (7%) and others (4%). Median SIRI values for non-metastatic and metastatic groups were 1.26 and 2.1 (mean+/-S.D. 1.76 +/-1.9 and 3.12+/-4.22 respectively (p < 0.05). Median SII values for non-metastatic and metastatic groups were 566 and 1434 (mean+/-S.D. 870 +/-1019 and 1537+/-917) respectively (p < 0.001). AUC for detection of metastasis were 0.809 for SII and 0.737 for SIRI. CONCLUSIONS SIRI and SII indexes seem to show a moderate efficiency to show metastases in RCC.
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Affiliation(s)
- Emre Arı
- Hamidiye Faculty of Medicine, Istanbul Health Practice and Research Center, Department of Urology, Health Sciences University, Istanbul, Turkey
| | - Hikmet Köseoğlu
- Hamidiye Faculty of Medicine, Istanbul Health Practice and Research Center, Department of Urology, Health Sciences University, Istanbul, Turkey.
| | - Tolga Eroğlu
- Hamidiye Faculty of Medicine, Istanbul Health Practice and Research Center, Department of Urology, Health Sciences University, Istanbul, Turkey
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Naik P, Dudipala H, Chen YW, Rose B, Bagrodia A, McKay RR. The incidence, pathogenesis, and management of non-clear cell renal cell carcinoma. Ther Adv Urol 2024; 16:17562872241232578. [PMID: 38434237 PMCID: PMC10906063 DOI: 10.1177/17562872241232578] [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: 10/29/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024] Open
Abstract
Renal cell carcinoma (RCC) is the most common type of kidney cancer and is divided into two distinct subtypes, clear cell renal cell carcinoma (ccRCC) and non-clear cell renal cell carcinoma (nccRCC). Although many treatments exist for RCC, these are largely based on clinical trials performed in ccRCC and there are limited studies on the management of nccRCC. Non-clear cell RCC consists of multiple histological subtypes: papillary, chromophobe, translocation, medullary, collecting duct, unclassified, and other rare histologies. Due to variations in pathogenesis and therapeutic response, therapy should be tailored to specific variant histologies. For patients with localized nccRCC, surgical resection remains the gold standard. In the metastatic setting, the standard of care has yet to be clearly defined, and most guidelines recommend clinical trial participation. General therapeutic options include immunotherapy, either as monotherapy or in combination, targeted therapies such as vascular endothelial growth factor tyrosine kinase inhibitors and MET inhibitors, and chemotherapy in certain subtypes. Here we present a review of the incidence and pathogenesis of the various subtypes, as well as available clinical data to support therapeutic recommendations for these subtypes. We also highlight currently available clinical trials in nccRCC and future directions in investigating novel treatment modalities tailored to patients with variant histology.
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Affiliation(s)
- Priyanka Naik
- Undergraduate Studies, University of California, San Diego, La Jolla, CA, USA
| | - Harshitha Dudipala
- Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - Yu-Wei Chen
- Department of Hematology and Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Brent Rose
- Department of Radiation Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Aditya Bagrodia
- Department of Urology, University of California, San Diego, La Jolla, CA, USA
| | - Rana R. McKay
- Department of Hematology and Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
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Gupta S, Alruwaili KHA, Escobedo RLO, Pangarkar M, Chawla JPS, Sunitha S, Qureshi K, Yadav AB. Renal cell carcinoma metastasizing to salivary glands: Systematic review. Natl J Maxillofac Surg 2024; 15:3-17. [PMID: 38690239 PMCID: PMC11057583 DOI: 10.4103/njms.njms_79_23] [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: 05/07/2023] [Revised: 06/23/2023] [Accepted: 08/11/2023] [Indexed: 05/02/2024] Open
Abstract
Distant metastasis to salivary glands is a very rare event. Renal cell carcinoma (RCC) has been known for its high propensity of metastasis to unusual locations and salivary glands are one among those sites. Approximately 0.1% of all salivary gland metastatic neoplasms originate from renal malignancies Literature has reported several studies analysing the metastatic tumors to the oral region. However, very little research work has been published to date to analyse solely the RCC metastasizing to the salivary glands. Thus, this review was conducted to examine the published cases of RCC metastasizing to salivary glands in the literature to date and to learn about their characteristics. An electronic search of the published literature was performed without publication year limitation in PubMed/ Medline, Scopus, Google Scholar, Web of Science, Science Direct, Embase, and Research Gate databases, using mesh keywords like ('Renal cancer', OR 'Renal carcinoma' OR 'Renal cell cancer' OR 'Renal cell carcinoma'), AND ('Metastasis' OR 'Metastases'), And ('Salivary glands' OR 'Parotid gland' OR 'Submandibular gland' OR 'Sublingual gland'). We also searched all related journals manually. The reference list of all articles was also checked. Our research revealed a total of 83 relevant papers (1965-2022) with 100 patients. Parotid was the most predominant gland affected. 8% of patients died with a mean survival time of 1.3 yr. From this research, it can be concluded that RCC metastasizing to salivary glands is a rare occurrence. Careful evaluation of these cases is needed in order to raise awareness of these lesions and gain a better understanding of their characteristics for clinical as well as global implications.
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Affiliation(s)
- Sonia Gupta
- Department of Oral Pathology and Microbiology and Forensic Odontology, Rayat and Bahra Dental College and Hospital, Kharar, Mohali, Punjab, India
| | | | | | - Manasi Pangarkar
- Private Practitioner, The Tooth Place Dental Clinic, Mumbai, Maharashtra, India
| | | | - S. Sunitha
- Department of Public Health Dentistry, JSS Dental College and Hospital, Mysore, Karnataka, India
| | - Kinza Qureshi
- Department of Prosthodontics, Rehmat Memorial Hospital, Abbottabad, Pakistan
| | - Achla Bharti Yadav
- Department of Oral Pathology and Microbiology and Forensic Odontology, D J College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
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Lei N, Lei LL, Wang CH, Mei CR. Pure testicular choriocarcinoma, a rare and highly malignant subtype with challenging treatment: A case report and review of the literature. Mol Clin Oncol 2024; 20:1. [PMID: 38223403 PMCID: PMC10784770 DOI: 10.3892/mco.2023.2699] [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: 06/11/2023] [Accepted: 10/26/2023] [Indexed: 01/16/2024] Open
Abstract
Testicular choriocarcinoma (CC) is the rarest subtype of germ cell tumours (GCTs) of the testis, with a high malignant potential and early haematogenous metastasis. Radical surgical resection should be performed primarily for histological diagnosis, while chemotherapy remains the mainstay of therapy for advanced disease. In the present study, the case of a 65-year-old male patient diagnosed with metastatic testicular CC, who did not fully respond to chemotherapy is reported. This patient underwent surgical removal of the testicular tumour, chemotherapy with etoposide and cisplatin, and radiotherapy of the intracranial lesions. Although the serum human chorionic gonadotropin (HCG) levels of the patient and most of the metastases continued decreasing during chemotherapy, complete response was not achieved after six cycles of chemotherapy. The patient refused high-dose chemotherapy and autologous stem cell transplantation due to severe side effects, and eventually developed respiratory failure on maintenance therapy with oral etoposide. A literature review was then performed, aiming to summarize the characteristics and therapeutic principles of testicular CC. In addition, the emerging therapeutic agents that could be used in maintenance therapy for GCTs, particularly for testicular CC, were also discussed. The limited clinical trials of targeted treatments showed potential benefit for long survival of patients with selected GCTs with fewer side effects. In particular, immunotherapy showed unique potential for testicular CC in preclinical studies, offering new approaches of maintenance therapy for advanced disease. Further studies should shed light on the identification of prognostic factors that predict the response to immune-based therapy in GCTs.
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Affiliation(s)
- Na Lei
- Department of Medical Oncology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C. T.), Chengdu, Sichuan 610041, P.R. China
| | - Li-Li Lei
- Department of Medical Oncology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C. T.), Chengdu, Sichuan 610041, P.R. China
| | - Chao-Hong Wang
- Department of Medical Oncology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C. T.), Chengdu, Sichuan 610041, P.R. China
| | - Chao-Rong Mei
- Department of Medical Oncology, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C. T.), Chengdu, Sichuan 610041, P.R. China
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Elfakharany HK, Ghoraba HM, Gaweesh KA, Eldeen AAS, Eid AM. Immunohistochemical expression of cytochrome P4A11 (CYP4A11), carbonic anhydrase 9 (CAIX) and Ki67 in renal cell carcinoma; diagnostic relevance and relations to clinicopathological parameters. Pathol Res Pract 2024; 253:155070. [PMID: 38183818 DOI: 10.1016/j.prp.2023.155070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Cytochrome P4A11 (CYP4A11) is a member of cytochrome p450 family, which is involved in arachidonic acid metabolism that participates in promoting malignant cell proliferation, progression, and angiogenetic capacity. Carbonic Anhydrase 9 (CAIX) is a transmembrane protein that plays an integral part in regulating hypoxia which affects cancer cell metabolism, proliferation and promotes metastasis. The aim of this study was to evaluate the immunohistochemical expression of CYP4A11, CAIX and ki67 in RCC subtypes in relation to clinicopathological parameters and to evaluate the diagnostic significance of CYP4A11 and CAIX in differentiating renal cell carcinoma (RCC) subtypes. MATERIALS AND METHODS one hundred primary RCC cases, collected from Pathology Department, Faculty of Medicine, Tanta University and from private laboratories, were evaluated for immunohistochemical expression of CYP4A11, CAIX and ki67. RESULTS CYP4A11 was expressed in 59% of RCC; with 91.7% sensitivity and 90% specificity in differentiating clear cell and non-clear cell subtypes. CAIX was expressed in 50% of RCC; with 95% sensitivity, 80% specificity. High expression of CYP4A11 was statistically positively associated with higher tumor grade, high expression of CAIX was statistically positively associated with lower tumor grade and absence of necrosis and high ki67 labeling index was significantly associated with clear cell subtype, larger tumor sizes, higher tumor grade, advanced tumor stage, fat invasion and vascular invasion. CONCLUSIONS CYP4A11 and CAIX can be used as diagnostic markers to differentiate clear cell RCC from other subtypes. CYP4A11 is more diagnostically accurate and specific than CAIX. High expression of CYP4A11, low CAIX expression and high ki67 labeling index were related to features of aggressive tumor behavior.
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Lin R, Wang C, Chen S, Lin T, Cai H, Chen S, Yang Y, Zhang J, Xu F, Zhang J, Chen X, Zang J, Miao W. [ 68Ga]Ga‑LNC1007 PET/CT in the evaluation of renal cell carcinoma: comparison with 2-[ 18F]FDG/[ 68Ga]Ga-PSMA PET/CT. Eur J Nucl Med Mol Imaging 2024; 51:535-547. [PMID: 37728667 DOI: 10.1007/s00259-023-06436-5] [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: 07/05/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE To compare the potential efficiency of [68Ga]Ga-LNC1007 with 2-[18F]FDG/[68Ga]Ga-PSMA PET/CT for detecting renal cell carcinoma (RCC) and to explore parameters derived from [68Ga]Ga-LNC1007 PET/CT for discriminating pathological characteristics in RCC. METHODS Twenty-five RCC patients confirmed by pathology were enrolled in this prospective study. The maximum standardized uptake value (SUVmax), mean SUV (SUVmean), gross tumor volume (GTV) and total lesion-tracer (TL-tracer) of lesions were calculated from the corresponding PET/CT images. Pathological characteristics included World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade and adverse pathological features (tumor necrosis or sarcomatoid or rhabdoid feature). RESULTS [68Ga]Ga-LNC1007 PET/CT showed a higher detection rate for primary lesions than 2-[18F]FDG and [68Ga]Ga-PSMA (LNC1007 vs. FDG: 13/17 vs. 4/17, P = 0.005; LNC1007 vs. PSMA: 9/11 vs. 6/11, P = 0.361). [68Ga]Ga-LNC1007 PET/CT showed higher SUVmax (6.6 vs. 3.7, P = 0.005), SUVmean (4.1 vs. 2.3, P = 0.001) and TBR (2.6 vs. 1.7, P = 0.011) compared with 2-[18F]FDG PET/CT, and it also showed higher TBR (2.9 vs. 0.5, P = 0.003), TBR-delay (2.8 vs. 0.3, P = 0.003), GTV (84.1 vs. 42.9, P = 0.003) and TL-tracer (442.7 vs. 235.8, P = 0.008) compared with [68Ga]Ga-PSMA PET/CT. SUVmax and TBR derived from [68Ga]Ga-LNC1007 PET/CT could effectively differentiate WHO/ISUP grade (3-4 vs. 1-2) and adverse pathological features (positive vs. negative) (SUVmax: AUC 0.81, P = 0.04; AUC 0.80, P = 0.033; TBR: AUC 0.84, P = 0.026; AUC 0.85, P = 0.014). The SUVmax was positively correlated with the FAP expression, integrin αvβ3 expression and the total expression of FAP and integrin αvβ3 (r = 0.577, P = 0.006, r = 0.701, P < 0.001, and r = 0.702, P < 0.001, respectively). CONCLUSION [68Ga]Ga-LNC1007 is a promising tracer for RCC imaging and can effectively identify aggressive pathological characteristics of RCC.
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Affiliation(s)
- Rong Lin
- Department of Nuclear Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian Province, China
- Department of Nuclear Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Changle District, No. 999 Huashan Road, Fuzhou, 350212, China
| | - Chao Wang
- Department of Nuclear Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian Province, China
- Department of Nuclear Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Changle District, No. 999 Huashan Road, Fuzhou, 350212, China
| | - Shaohao Chen
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Tingting Lin
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Hai Cai
- Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Shaoming Chen
- Department of Nuclear Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian Province, China
- Department of Nuclear Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Changle District, No. 999 Huashan Road, Fuzhou, 350212, China
| | - Yun Yang
- Department of Nuclear Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian Province, China
- Department of Nuclear Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Changle District, No. 999 Huashan Road, Fuzhou, 350212, China
| | - Jiaying Zhang
- Department of Nuclear Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian Province, China
- Department of Nuclear Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Changle District, No. 999 Huashan Road, Fuzhou, 350212, China
| | - Fuqi Xu
- Department of Nuclear Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian Province, China
- Department of Nuclear Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Changle District, No. 999 Huashan Road, Fuzhou, 350212, China
| | - Jingjing Zhang
- Departments of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119074, Singapore.
- Clinical Imaging Research Centre, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117599, Singapore.
- Nanomedicine Translational Research Program, NUS Center for Nanomedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore.
| | - Xiaoyuan Chen
- Departments of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119074, Singapore.
- Clinical Imaging Research Centre, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117599, Singapore.
- Nanomedicine Translational Research Program, NUS Center for Nanomedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore.
- Departments of Chemical and Biomolecular Engineering, and Biomedical Engineering, Faculty of Engineering, National University of Singapore, Singapore, 117597, Singapore.
| | - Jie Zang
- Department of Nuclear Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
- Department of Nuclear Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Changle District, No. 999 Huashan Road, Fuzhou, 350212, China.
| | - Weibing Miao
- Department of Nuclear Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
- Department of Nuclear Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Changle District, No. 999 Huashan Road, Fuzhou, 350212, China.
- Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
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Alchoueiry M, Cornejo K, Henske EP. Kidney cancer: Links between hereditary syndromes and sporadic tumorigenesis. Semin Diagn Pathol 2024; 41:1-7. [PMID: 38008653 DOI: 10.1053/j.semdp.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/06/2023] [Indexed: 11/28/2023]
Abstract
Multiple hereditary syndromes predispose to kidney cancer, including Von Hippel-Lindau syndrome, BAP1-Tumor Predisposition Syndrome, Hereditary Papillary Renal Cell Carcinoma, Tuberous Sclerosis Complex, Birt-Hogg-Dubé syndrome, Hereditary Paraganglioma-Pheochromocytoma Syndrome, Fumarate Hydratase Tumor Predisposition Syndrome, and Cowden syndrome. In some cases, mutations in the genes that cause hereditary kidney cancer are tightly linked to similar histologic features in sporadic RCC. For example, clear cell RCC occurs in the hereditary syndrome VHL, and sporadic ccRCC usually has inactivation of the VHL gene. In contrast, mutations in FLCN, the causative gene for Birt-Hogg-Dube syndrome, are rarely found in sporadic RCC. Here, we focus on the genes and pathways that link hereditary and sporadic RCC.
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Affiliation(s)
- Michel Alchoueiry
- Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kristine Cornejo
- Pathology Department, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Elizabeth P Henske
- Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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123
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Sweeney PL, Suri Y, Basu A, Koshkin VS, Desai A. Mechanisms of tyrosine kinase inhibitor resistance in renal cell carcinoma. CANCER DRUG RESISTANCE (ALHAMBRA, CALIF.) 2023; 6:858-873. [PMID: 38239394 PMCID: PMC10792482 DOI: 10.20517/cdr.2023.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/20/2023] [Accepted: 12/21/2023] [Indexed: 01/22/2024]
Abstract
Renal cell carcinoma (RCC), the most prevalent type of kidney cancer, is a significant cause of cancer morbidity and mortality worldwide. Antiangiogenic tyrosine kinase inhibitors (TKIs), in combination with immune checkpoint inhibitors (ICIs), are among the first-line treatment options for patients with advanced RCC. These therapies target the vascular endothelial growth factor receptor (VEGFR) tyrosine kinase pathway and other kinases crucial to cancer proliferation, survival, and metastasis. TKIs have yielded substantial improvements in progression-free survival (PFS) and overall survival (OS) for patients with advanced RCC. However, nearly all patients eventually progress on these drugs as resistance develops. This review provides an overview of TKI resistance in RCC and explores different mechanisms of resistance, including upregulation of alternative proangiogenic pathways, epithelial-mesenchymal transition (EMT), decreased intracellular drug concentrations due to efflux pumps and lysosomal sequestration, alterations in the tumor microenvironment including bone marrow-derived cells (BMDCs) and tumor-associated fibroblasts (TAFs), and genetic factors such as single nucleotide polymorphisms (SNPs). A comprehensive understanding of these mechanisms opens the door to the development of innovative therapeutic approaches that can effectively overcome TKI resistance, thereby improving outcomes for patients with advanced RCC.
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Affiliation(s)
- Patrick L. Sweeney
- Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Yash Suri
- University of Arizona College of Medicine, Tucson, AZ 85724, USA
| | - Arnab Basu
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Vadim S. Koshkin
- Division of Hematology and Oncology, Department of Medicine, University of California at San Francisco School of Medicine, San Francisco, CA 94143, USA
| | - Arpita Desai
- Division of Hematology and Oncology, Department of Medicine, University of California at San Francisco School of Medicine, San Francisco, CA 94143, USA
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Lu X, Luo Y, Nie X, Zhang B, Wang X, Li R, Liu G, Zhou Q, Liu Z, Fan L, Hotaling JM, Zhang Z, Bo H, Guo J. Single-cell multi-omics analysis of human testicular germ cell tumor reveals its molecular features and microenvironment. Nat Commun 2023; 14:8462. [PMID: 38123589 PMCID: PMC10733385 DOI: 10.1038/s41467-023-44305-9] [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: 04/06/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
Seminoma is the most common malignant solid tumor in 14 to 44 year-old men. However, its molecular features and tumor microenvironment (TME) is largely unexplored. Here, we perform a series of studies via genomics profiling (single cell multi-omics and spatial transcriptomics) and functional examination using seminoma samples and a seminoma cell line. We identify key gene expression programs share between seminoma and primordial germ cells, and further characterize the functions of TFAP2C in promoting tumor invasion and migration. We also identify 15 immune cell subtypes in TME, and find that subtypes with exhaustion features were located closer to the tumor region through combined spatial transcriptome analysis. Furthermore, we identify key pathways and genes that may facilitate seminoma disseminating beyond the seminiferous tubules. These findings advance our knowledge of seminoma tumorigenesis and produce a multi-omics atlas of in situ human seminoma microenvironment, which could help discover potential therapy targets for seminoma.
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Affiliation(s)
- Xiaojian Lu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yanwei Luo
- Department of Blood Transfusion, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Xichen Nie
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Bailing Zhang
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xiaoyan Wang
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, China
| | - Ran Li
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, China
| | - Guangmin Liu
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Qianyin Zhou
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Zhizhong Liu
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Liqing Fan
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Zhe Zhang
- Department of Urology, Peking University Third Hospital, Beijing, China.
- Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China.
| | - Hao Bo
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China.
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China.
| | - Jingtao Guo
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China.
- Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, China.
- University of Chinese Academy of Sciences, Beijing, China.
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125
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de Moraes FCA, Vilbert M, Alves VFC, de Oliveira Almeida G, Priantti JN, Madeira T, Stecca C, Fernandes MR, dos Santos NPC. Mesenchymal-Epithelial Transition Kinase Inhibitor Therapy in Patients with Advanced Papillary Renal-Cell Carcinoma: A Systematic Review and Meta-Analysis. Int J Mol Sci 2023; 24:17582. [PMID: 38139411 PMCID: PMC10744118 DOI: 10.3390/ijms242417582] [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: 10/07/2023] [Revised: 11/25/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
Papillary subtypes of renal-cell carcinoma (pRCC) represent 10-15% of the cases and commonly have MET alterations. This systematic review and single-arm meta-analysis evaluated MET inhibitor therapy (METi) efficacy and safety in adults with confirmed advanced pRCC. The search strategy included PubMed, Web-of-science, Cochrane, and Scopus. We used the DerSimonian/Laird random effect model for all analyses; p-value < 5% was considered significant, and heterogeneity was assessed with I2. Three clinical trials and six cohort studies were included with 504 patients; 31% were MET-driven. Our pooled analysis demonstrated an objective response rate (ORR) in MET-driven, MET-independent, and overall patients of: 36% (95%CI: 10-62), 0% (95%CI: 0-3), and 21% (95%CI: 1-41), respectively. One-year disease control and progression-free survival rates were, respectively, 70% (95%CI: 52-88) and 15% (95%CI: 10-20). Twelve- and twenty-four-month survival rates were, respectively, 43% (95%CI: 23-64) and 10% (95%CI: 0-30). The prevalence of adverse events of any grade and grades 3-5 were 96% (95%CI: 91-100) and 44% (95%CI: 37-50), respectively. We suggest METi has anti-tumor activity and is tolerable in patients with advanced pRCC.
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Affiliation(s)
| | - Maysa Vilbert
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5T 2S8, Canada
| | | | | | - Jonathan N. Priantti
- School of Medicine, Federal University of Amazonas—UFAM, Manaus 69020-160, Brazil
| | - Thiago Madeira
- School of Medicine, Federal University of Minas Gerais—UFMG, Belo Horizonte 31270-901, Brazil
| | - Carlos Stecca
- Mackenzie Evangelical University Hospital, Curitiba 80710-390, Brazil
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Fukagawa A, Hama N, Totoki Y, Nakamura H, Arai Y, Saito-Adachi M, Maeshima A, Matsui Y, Yachida S, Ushiku T, Shibata T. Genomic and epigenomic integrative subtypes of renal cell carcinoma in a Japanese cohort. Nat Commun 2023; 14:8383. [PMID: 38104198 PMCID: PMC10725467 DOI: 10.1038/s41467-023-44159-1] [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: 06/06/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023] Open
Abstract
Renal cell carcinoma (RCC) comprises several histological types characterised by different genomic and epigenomic aberrations; however, the molecular pathogenesis of each type still requires further exploration. We perform whole-genome sequencing of 128 Japanese RCC cases of different histology to elucidate the significant somatic alterations and mutagenesis processes. We also perform transcriptomic and epigenomic sequencing to identify distinguishing features, including assay for transposase-accessible chromatin sequencing (ATAC-seq) and methyl sequencing. Genomic analysis reveals that the mutational signature differs among the histological types, suggesting that different carcinogenic factors drive each histology. From the ATAC-seq results, master transcription factors are identified for each histology. Furthermore, clear cell RCC is classified into three epi-subtypes, one of which expresses highly immune checkpoint molecules with frequent loss of chromosome 14q. These genomic and epigenomic features may lead to the development of effective therapeutic strategies for RCC.
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Affiliation(s)
- Akihiko Fukagawa
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Natsuko Hama
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Yasushi Totoki
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
- Department of Cancer Genome Informatics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hiromi Nakamura
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Yasuhito Arai
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Mihoko Saito-Adachi
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Akiko Maeshima
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiyuki Matsui
- Department of Urology, National Cancer Center Hospital, Tokyo, Japan
| | - Shinichi Yachida
- Department of Cancer Genome Informatics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuhiro Shibata
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan.
- Laboratory of Molecular Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
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Chrabańska M, Szweda-Gandor N, Drozdzowska B. Does the VHL polymorphisms rs779805 and rs1642742 affect renal cell carcinoma susceptibility, prognosis and survival in Central European population? Medicine (Baltimore) 2023; 102:e36540. [PMID: 38115281 PMCID: PMC10727644 DOI: 10.1097/md.0000000000036540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/30/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023] Open
Abstract
Renal cell carcinoma (RCC) is a common malignant tumor of the urinary system. The von Hippel-Lindau (VHL) tumor suppressor gene play an essential role in the tumorigenic pathway of clear cell RCC (ccRCC). This study was aimed to clarify the influence of VHL polymorphisms on ccRCC susceptibility and survival in Central European population. We genotyped 2 single-nucleotide polymorphisms (SNPs) rs779805 and rs1642742 in VHL gene and assessed their associations with ccRCC risk, clinicopathologic parameters, and prognosis in 171 cases. The selected SNPs were genotyped by ROCHE LifeCycler 96 using tumor tissue-derived DNA. Both SNPs do not directly influence ccRCC susceptibility and overall survival. A significant associations were found between allele G and genotypes AG and GG of rs779805 in the VHL tumor suppressor gene and increased tumor size, as well as high nuclear grade. Furthermore, a statistically significant association was observed between rs1642742 of VHL gene and low pathological tumor stage and between rs779805 of VHL gene and high pathological tumor stage. Both investigated SNPs can be important prognostic indicators of RCC in the Central European population, because statistically significant associations were observed between evaluated VHL polymorphisms and the best known factors with proven prognostic significance in kidney cancer.
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Affiliation(s)
- Magdalena Chrabańska
- Department and Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Nikola Szweda-Gandor
- Department and Clinic of Internal Medicine, Diabetology and Nephrology, Medical University of Silesia, Zabrze, Poland
| | - Bogna Drozdzowska
- Department and Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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128
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Młynarczyk G, Domian N, Kasacka I. Changes in adhesion molecules: β-catenin, E-cadherin and Galectin-3 in cells of testicular seminoma. Front Oncol 2023; 13:1269637. [PMID: 38144531 PMCID: PMC10739379 DOI: 10.3389/fonc.2023.1269637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction The most common testicular tumors are seminomas. They are characterized by rapid growth and a very high potential for metastasis to other organs. Mutual interactions of tumor cells play an important role in the invasiveness and metastatic capacity, in which complexes of adhesion proteins play a special role. There is a lack of studies on changes in these molecules and their behaviour in testicular cancer. The aim of the study was immunohistochemical identification and evalutaion of adhesive molecules β-catenin, E-cadherin, galectin-3 in testicular cancer - seminoma. Methods Tests were performed on sections of testicular cancer - seminoma in comparison with unchanged tissue samples as a control. Material was taken from 30 patients who underwent orchiectomy. Immunohistochemistry and PCR were used to identify β-catenin, E-cadherin and galectin-3 and gene expression. Results Immunoreactivity and expression of β-catenin and E-cadherin in seminomas were markedly decreased compared to non-cancerous testicular tissue. Galectin-3 immunoreactivity was found in both control and cancerous tissue, but in different location. In non-cancerous tissue, it was localized in the cytoplasm of the cells of the seminiferous tubules, in seminomas it was localized mainly in the endothelium. The expression of the Lgals3 gene encoding galectin-3 in seminomas was slightl higher in relation to the tissue unchanged by the carcinogenetic process. Conclusions The results of the study suggest a significant role of β-catenin, E-cadherin and galectin-3 in the carcinogenesis of seminomas and may indicate new aspects of the patomechanism of seminomas formation, and thus time lead to better understand the biology of these tumors.
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Affiliation(s)
| | - Natalia Domian
- Department of Histology and Cytophysiology, Medical University of Białystok, Bialystok, Poland
| | - Irena Kasacka
- Department of Histology and Cytophysiology, Medical University of Białystok, Bialystok, Poland
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129
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Krege S, Oing C, Bokemeyer C. Testicular Tumors. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:843-854. [PMID: 37378600 PMCID: PMC10824497 DOI: 10.3238/arztebl.m2023.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Germ-cell tumors of the testes are the most common type of malignant tumor in men aged 20 to 40. Their incidence in Germany is 10 per 100 000 men per year, with an estimated 4200 new cases annually. METHODS This selective review is based on the recommendations of the German clinical practice guideline on the diagnosis, treatment and follow-up care of testicular germ-cell tumors, as well as on pertinent original articles and reviews. RESULTS The treatment of germ-cell tumors requires an interdisciplinary approach comprising resection of the affected testis followed by further steps that depend on the histological type and stage of the tumor, which may include active surveillance, chemotherapy, radiotherapy, further surgery, or some combination of these measures. Two-thirds of germ-cell tumors are diagnosed in clinical stage I, when they are still confined to the testis; one-third are already metastatic when diagnosed, with organ metastases in 10-15%. Stage-based multimodal treatment approaches are associated with cure rates of more than 99% for stage I tumors and 67-95% for advanced metastatic disease, depending on the degree of progression. CONCLUSION For patients with early-stage tumors, overtreatment should be avoided in order to minimize long-term sequelae. For those whose tumors are in advanced stages, it must be decided which patients should receive intensified treatment to optimize the outcome. Multimodal treatment approaches are associated with high cure rates even for patients with metastatic disease.
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Affiliation(s)
- Susanne Krege
- Department of Urology, Pediatric Urology, and Urological Oncology, Essen-Mitte Hospital, Essen
- * Joint first authors
| | - Christoph Oing
- Translational and Clinical Research Institute, Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
- Department of Oncology, Hematology, and Stem Cell Transplantation, Pulmonology Section, University Hospital Hamburg Eppendorf, Hamburg
- * Joint first authors
| | - Carsten Bokemeyer
- Department of Oncology, Hematology, and Stem Cell Transplantation, Pulmonology Section, University Hospital Hamburg Eppendorf, Hamburg
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Caliò A, Amparore D, Roussel E, Bertolo R, Erdem S, Marchioni M, Pavan N, Campi R. The World Health Organization 2022 Classification of renal tumors: key updates for urologists. Minerva Urol Nephrol 2023; 75:766-769. [PMID: 38126288 DOI: 10.23736/s2724-6051.23.05434-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- Anna Caliò
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona, Verona, Italy -
| | - Daniele Amparore
- School of Medicine, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Eduard Roussel
- Department of Urology, University Hospitals of Leuven, Leuven, Belgium
| | | | - Selçuk Erdem
- Division of Urologic Oncology, Department of Urology, Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, G. D'Annunzio Chieti-Pescara University, Chieti, Italy
- Department of Urology, SS Annunziata Hospital, G. D'Annunzio Chieti-Pescara University, Chieti, Italy
| | - Nicola Pavan
- Unit of Urology, Department of Surgical, Oncological and Oral Sciences, P. Giaccone University Hospital, Palermo, Italy
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Raj RK, Upadhyay R, Wang SJ, Singer EA, Dason S. Incorporating Stereotactic Ablative Radiotherapy into the Multidisciplinary Management of Renal Cell Carcinoma. Curr Oncol 2023; 30:10283-10298. [PMID: 38132383 PMCID: PMC10742565 DOI: 10.3390/curroncol30120749] [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: 10/26/2023] [Revised: 11/25/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Stereotactic ablative radiotherapy (SABR) has challenged the conventional wisdom surrounding the radioresistance of renal cell carcinoma (RCC). In the past decade, there has been a significant accumulation of clinical data to support the safety and efficacy of SABR in RCC. Herein, we review the use of SABR across the spectrum of RCC. We performed an online search of the Pubmed database from January 1990 through April 2023. Studies of SABR/stereotactic radiosurgery targeting primary, extracranial, and intracranial metastatic RCC were included. For SABR in non-metastatic RCC, this includes its use in small renal masses, larger renal masses, and inferior vena cava tumor thrombi. In the metastatic setting, SABR can be used at diagnosis, for oligometastatic and oligoprogressive disease, and for symptomatic reasons. Notably, SABR can be used for both the primary renal tumor and metastasis-directed therapy. Management of RCC is evolving rapidly, and the role that SABR will have in this landscape is being assessed in a number of ongoing prospective clinical trials. The objective of this narrative review is to summarize the evidence corroborating the use of SABR in RCC.
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Affiliation(s)
- Rohit K. Raj
- Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA; (R.K.R.); (R.U.); (S.-J.W.)
| | - Rituraj Upadhyay
- Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA; (R.K.R.); (R.U.); (S.-J.W.)
| | - Shang-Jui Wang
- Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA; (R.K.R.); (R.U.); (S.-J.W.)
| | - Eric A. Singer
- Division of Urologic Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA;
| | - Shawn Dason
- Division of Urologic Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA;
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Liu Y, Li Y, Xu H, Zhou L, Yang X, Wang C. Exploration of Morphological Features of Clear Cell Renal Cell Carcinoma With PBRM1, SETD2, BAP1, or KDM5C Mutations. Int J Surg Pathol 2023; 31:1485-1494. [PMID: 36911986 DOI: 10.1177/10668969231157317] [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] [Indexed: 03/14/2023]
Abstract
The last decade has seen great advances in genomic profiling and prognosis-associated factors of clear cell renal cell carcinoma (RCC), the most common entity in kidney cancer. Following VHL, PBRM1, SETD2, BAP1, and KDM5C have been validated as the most common co-occurring gene mutations in clear cell RCC by multicenter studies. However, the morphological features of clear cell RCC with co-occurring gene mutations remain unclear. In this study, we presented 20 clear cell RCCs that underwent next-generation sequencing, of which 1 tumor was reclassified as ELOC-mutated RCC. PBRM1, SETD2, BAP1, and KDM5C were the most common mutations, following VHL. Morphologically, clear cell RCC with PBRM1 or KDM5C mutation usually displayed a low-grade pattern. Cystic changes and hyalinized stroma were often observed. The Ki67 index was <10%. These observations indicated good prognosis. However, mutated SETD2 may increase the malignancy of clear cell RCC with PBRM1 mutation. Two clear cell RCCs with mutated PBRM1 and SETD2 developed local or distant metastases. Clear cell RCC with BAP1 mutations always had high-grade patterns, and rhabdoid differentiation was also observed, indicating that BAP1 mutation was associated with poor outcomes. Papillary architecture was often a feature of BAP1 mutation, which is uncommon in clear cell RCC. PDL1 was positive in only one tumor with BAP1 mutation, and the positivity rate was limited to 5%. B7H3 was negative in all tumors. Morphologic findings in this small cohort may suggest why PBRM1 mutation does not correlate with decreased survival, whereas BAP1 mutation usually predicts poor outcomes.
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Affiliation(s)
- Yang Liu
- Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunhao Li
- The First Clinical College, China Medical University, Shenyang, China
| | - Haimin Xu
- Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luting Zhou
- Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoqun Yang
- Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chaofu Wang
- Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wenzel M, Hoeh B, Cano Garcia C, Bernatz S, Köllermann J, Kluth LA, Chun FKH, Becker A, Mandel P. Patient and tumor characteristics of histological subtypes of renal cell carcinoma and its risk of upstaging to ≥pT3. Urol Oncol 2023; 41:487.e7-487.e13. [PMID: 37758628 DOI: 10.1016/j.urolonc.2023.09.004] [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: 06/01/2023] [Revised: 08/03/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVE To explore how histological subtypes impact upstaging to nonorgan confined renal cell carcinoma (≥pT3 RCC) in patients treated with partial/radical nephrectomy for cT1-2 RCC. MATERIALS AND METHODS We relied on an institutional tertiary-care database to identify RCC patients treated with partial/radical nephrectomy between January 2002 and December 2021. Patients were stratified according to histological subtype of RCC. Upstaging was defined as any cT1-2 tumor classified as ≥pT3 at final pathology. Uni- and multivariable logistic regression models were fitted to predict upstaging. RESULTS Of overall 1,020 surgically treated RCC patients, 743 harbored clear-cell (72.8%) vs. 193 (18.9%) papillary vs. 49 (4.8%) chromophobe vs. each 4 (0.4%) collecting duct and sarcomatoid vs. 27 (2.6%) other/mixed pathology of RCC. Median tumor size ranged from 3.0 cm (mixed RCC) to 7.7 cm (sarcomatoid RCC). In total, upstaging rate to ≥pT3 was 22% and ranged from 6.1% (chromophobe RCC) to 75% (collecting duct RCC). In univariable logistic regression models, chromophobe and papillary histological subtypes were significantly associated with lower upstaging of all cT1-2 RCC tumors. After controlling for patient and tumor characteristics in multivariable logistic regression models, papillary RCC independently lowers the risk of upstaging, even in sensitivity analyses for cT1 RCC only. CONCLUSION Important differences between histological subtypes of RCC exist regarding characteristics such as stage and tumor size at presentation, as well as upstaging to ≥pT3 at final pathology. Specifically, papillary RCC is significantly associated with lower chance of upstaging even after controlling for confounding parameters. The study is limited by missing central pathological/radiographic review and lack of survival analyses.
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Affiliation(s)
- Mike Wenzel
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
| | - Benedikt Hoeh
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Cristina Cano Garcia
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Simon Bernatz
- Department of Radiology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Jens Köllermann
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Luis A Kluth
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Felix K H Chun
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Andreas Becker
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Philipp Mandel
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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134
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Lopez-Beltran A. Testicular cancer: new developments, molecular pathology, and current research keynote. PATHOLOGIE (HEIDELBERG, GERMANY) 2023; 44:204-207. [PMID: 37975918 DOI: 10.1007/s00292-023-01264-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 11/19/2023]
Abstract
Germ cell tumors (GCTs) are now considered a curable cancer, with a > 95% cure rate in all patients and about 90% cure rate in patients with metastatic disease. The success of physicians in curing the disease is underpinned by multidisciplinary advances. Of relevance in this regard are the nowadays-applied homogeneous terminology based on pathologically better characterized testicular neoplasms and the development of a widely used risk stratification model for metastatic disease introduced by the International Germ Cell Cancer Collaborative Group in 1997 and updated in 2021. Non-pulmonary visceral metastases, high levels of the serum tumor markers alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG), and primary mediastinal non-seminoma are currently identified as determinants of poor prognosis. In addition, the presence of distinct microRNA profiles between seminomas and non-seminoma GCTs has opened up important perspectives in terms of noninvasive biomarkers that can be used in diagnosis and treatment monitoring.
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Affiliation(s)
- Antonio Lopez-Beltran
- Department of Morphological Sciences, Cordoba University Medical School, Avda. Menendez-Pidal S/N, 14004, Cordoba, Spain.
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135
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Hao YW, Zhang Y, Guo HP, Xu W, Bai X, Zhao J, Ding XH, Gao S, Cui MQ, Liu BC, Ye HY, Wang HY. Differentiation between renal epithelioid angiomyolipoma and clear cell renal cell carcinoma using clear cell likelihood score. Abdom Radiol (NY) 2023; 48:3714-3727. [PMID: 37747536 DOI: 10.1007/s00261-023-04034-5] [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: 05/18/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE Clear cell likelihood score (ccLS) may be a reliable diagnostic method for distinguishing renal epithelioid angiomyolipoma (EAML) and clear cell renal cell carcinoma (ccRCC). In this study, we aim to explore the value of ccLS in differentiating EAML from ccRCC. METHODS We performed a retrospective analysis in which 27 EAML patients and 60 ccRCC patients underwent preoperative magnetic resonance imaging (MRI) at our institution. Two radiologists trained in the ccLS algorithm scored independently and the consistency of their interpretation was evaluated. The difference of the ccLS score was compared between EAML and ccRCC in the whole study cohort and two subgroups [small renal masses (SRM; ≤ 4 cm) and large renal masses (LRM; > 4 cm)]. RESULTS In total, 87 patients (59 men, 28 women; mean age, 55±11 years) with 90 renal masses (EAML: ccRCC = 1: 2) were identified. The interobserver agreement of two radiologists for the ccLS system to differentiate EAML from ccRCC was good (k = 0.71). The ccLS score in the EAML group and the ccRCC group ranged from 1 to 5 (73.3% in scores 1-2) and 2 to 5 (76.7% in scores 4-5), respectively, with statistically significant differences (P < 0.001). With the threshold value of 2, ccLS can distinguish EAML from ccRCC with the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 87.8%, 95.0%, 73.3%, 87.7%, and 88.0%, respectively. The AUC (area under the curve) was 0.913. And the distribution of the ccLS score between the two diseases was not affected by tumor size (P = 0.780). CONCLUSION The ccLS can distinguish EAML from ccRCC with high accuracy and efficiency.
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Affiliation(s)
- Yu-Wei Hao
- Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Yun Zhang
- Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
- Department of Radiology, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hui-Ping Guo
- Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Wei Xu
- Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Xu Bai
- Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Jian Zhao
- Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Xiao-Hui Ding
- Department of Pathology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Sheng Gao
- Department of Radiology, Linyi Central Hospital, Shandong, China
| | - Meng-Qiu Cui
- Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Bai-Chuan Liu
- Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Hui-Yi Ye
- Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Hai-Yi Wang
- Department of Radiology, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China.
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136
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Yan W, Hou N, Zheng J, Zhai W. Predictive genomic biomarkers of therapeutic effects in renal cell carcinoma. Cell Oncol (Dordr) 2023; 46:1559-1575. [PMID: 37223875 DOI: 10.1007/s13402-023-00827-4] [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] [Accepted: 05/04/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND In recent years, there have been great improvements in the therapy of renal cell carcinoma. Nevertheless, the therapeutic effect varies significantly from person to person. To discern the effective treatment for different populations, predictive molecular biomarkers in response to target, immunological, and combined therapies are widely studied. CONCLUSION This review summarized those studies from three perspectives (SNPs, mutation, and expression level) and listed the relationship between biomarkers and therapeutic effect, highlighting the great potential of predictive molecular biomarkers in metastatic RCC therapy. However, due to a series of reasons, most of these findings require further validation.
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Affiliation(s)
- Weijie Yan
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Naiqiao Hou
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Junhua Zheng
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Zhai
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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137
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Liu Y, Wu G. The utilization of single-cell sequencing technology in investigating the immune microenvironment of ccRCC. Front Immunol 2023; 14:1276658. [PMID: 38090562 PMCID: PMC10715415 DOI: 10.3389/fimmu.2023.1276658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
The growth and advancement of ccRCC are strongly associated with the presence of immune infiltration and the tumor microenvironment, comprising tumor cells, immune cells, stromal cells, vascular cells, myeloid-derived cells, and extracellular matrix (ECM). Nevertheless, as a result of the diverse and constantly evolving characteristics of the tumor microenvironment, prior advanced sequencing methods have frequently disregarded specific less prevalent cellular traits at varying intervals, thereby concealing their significance. The advancement and widespread use of single-cell sequencing technology enable us to comprehend the source of individual tumor cells and the characteristics of a greater number of individual cells. This, in turn, minimizes the impact of intercellular heterogeneity and temporal heterogeneity of the same cell on experimental outcomes. This review examines the attributes of the tumor microenvironment in ccRCC and provides an overview of the progress made in single-cell sequencing technology and its particular uses in the current focus of immune infiltration in ccRCC.
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Affiliation(s)
| | - Guangzhen Wu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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138
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Elkady N, Aldesoky AI, Dawoud MM. Evaluation of ARK5 and SIRT3 expression in renal cell carcinoma and their clinical significance. Diagn Pathol 2023; 18:125. [PMID: 37996927 PMCID: PMC10666306 DOI: 10.1186/s13000-023-01409-6] [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: 03/30/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Globally Renal Cell Carcinoma (RCC) represents 3% of malignant tumours in adults and 1.78% in Egypt. AMPK-related protein kinase 5 (ARK5) is mainly associated with a hypoxic microenvironment which is a feature of the major RCC subtypes. Additionally, it displays decreased mitochondrial respiration. SIRT3 is a mitochondrial deacetylase that modifies multiple mitochondrial proteins. MATERIAL AND METHODS Fifty eight cases of RCC, and 30 non-neoplastic cases (of End-Stage Kidney Disease (ESKD) were subjected to immunohistochemistry by ARK5 and SIRT3. The results of IHC were correlated together and correlated with the available clinicopathologic and survival data. RESULTS Although no significant difference was detected between RCC and ESKD groups regarding ARK5 expression, there was a significant association with RCC regarding H-score and nucleocytoplasmic expression (both P = 0.001). Also, SIRT3 was highly expressed in RCC in comparison to the ESKD group (H-score: P = 0.001). There were significant associations between nucleocytoplasmic ARK5 expression and higher tumour grade, low apoptotic and high mitotic indices, tumour extent, advanced tumour stage, and impaired response of tumours to chemotherapeutic drugs (P = 0.039, P = 0.001, P = 0.027, P = 0.011, P = 0.009, and P = 0.014 respectively). Moreover, the H score of ARK5 expression showed significant associations with tumour grade, apoptotic and mitotic indices, tumour extension, tumour stage, and response to therapy (P = 0.01, 0.035, 0.001, 0.004. 0.003 and 0.013). Regarding SIRT3 expression, it showed significant associations with apoptotic and mitotic indices, tumour extent, tumour stage and response to therapy (P = 0.022, 0.02, 0.042, 0.039 and 0.027). Interestingly, there was a highly significant correlation between the expression of ARK5 and SIRT3 (P = 0.009). Univariate survival analysis revealed a significant association between short survival duration and both nucleocytoplasmic expression of ARK5 and positive SIRT3 expression (P = 0.014 and 0.035). CONCLUSION ARK5 and SIRT3 are overexpressed in RCC and associated with parameters of poor prognosis as well as short survival. Both seem to influence response to therapy in RCC. So, they could be new targets for therapy that may improve tumour response and patients' survival. There is a postulated relationship that needs more extensive investigation.
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Affiliation(s)
- Noha Elkady
- Pathology Department, Faculty of Medicine, Menoufia University, Shibin El Kom, Menoufia, 32511, Egypt
| | - Amira I Aldesoky
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Menoufia University, Shibin El Kom, Menoufia, Egypt
| | - Marwa Mohammed Dawoud
- Pathology Department, Faculty of Medicine, Menoufia University, Shibin El Kom, Menoufia, 32511, Egypt.
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139
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Strikic A, Kokeza J, Ogorevc M, Kelam N, Vukoja M, Dolonga P, Tomas SZ. Differential expression of HIF1A and its downstream target VEGFA in the main subtypes of renal cell carcinoma and their impact on patient survival. Front Oncol 2023; 13:1287239. [PMID: 38053655 PMCID: PMC10694430 DOI: 10.3389/fonc.2023.1287239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/03/2023] [Indexed: 12/07/2023] Open
Abstract
Renal cell carcinoma (RCC) represents around 3% of all cancers, with the most frequent histological types being clear-cell RCC (ccRCC), followed by papillary (pRCC) and chromophobe (chRCC). Hypoxia-inducible factors (HIFs), which promote the expression of various target genes, including vascular endothelial growth factor (VEGF) and the high- affinity glucose transporter 1, have an important role in the pathogenesis of RCC. This study investigated the immunohistochemical expression of HIF-1α and VEGF-A, showing significantly higher HIF-1α nuclear expression in pRCC compared to ccRCC, while there was no significant difference in VEGF-A protein expression between the analyzed histological RCC subtypes. The quantitative reverse transcription polymerase chain reaction for HIF1A showed no statistical difference between histological types. Data from publicly available RNA sequencing databases were analyzed and showed that, compared to healthy kidney tissue, VEGFA was significantly up-regulated in ccRCC and significantly down-regulated in pRCC. The comparison between histological subtypes of RCC revealed that VEGFA was significantly up-regulated in ccRCC compared to both pRCC and chRCC. There was no statistically significant difference in survival time between HIF1A high- and low-expression groups of patients. As for VEGFA expression, pRCC patients with low expression had a significantly higher survival rate compared to patients with high VEGFA expression.
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Affiliation(s)
- Ante Strikic
- Department of Oncology and Radiotherapy, University Hospital of Split, Split, Croatia
| | - Josipa Kokeza
- Department of Pulmonology, University Hospital of Split, Split, Croatia
| | - Marin Ogorevc
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Split, Croatia
| | - Nela Kelam
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Split, Croatia
| | - Martina Vukoja
- Laboratory of Morphology, Department of Histology and Embryology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Petar Dolonga
- University of Split School of Medicine, Split, Croatia
| | - Sandra Zekic Tomas
- Department of Pathology, Forensic Medicine and Cytology, University Hospital of Split, Split, Croatia
- Department of Pathology, University of Split School of Medicine, Split, Croatia
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Courcier J, Leguerney I, Benatsou B, Pochon S, Tardy I, Albiges L, Cournède PH, De La Taille A, Lassau N, Ingels A. BR55 Ultrasound Molecular Imaging of Clear Cell Renal Cell Carcinoma Reflects Tumor Vascular Expression of VEGFR-2 in a Patient-Derived Xenograft Model. Int J Mol Sci 2023; 24:16211. [PMID: 38003400 PMCID: PMC10671137 DOI: 10.3390/ijms242216211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Standard imaging cannot reliably predict the nature of renal tumors. Among malignant renal tumors, clear cell renal cell carcinoma (ccRCC) is the most common histological subtype, in which the vascular endothelial growth factor 2 (VEGFR-2) is highly expressed in the vascular endothelium. BR55, a contrast agent for ultrasound imaging, consists of gas-core lipid microbubbles that specifically target and bind to the extracellular portion of the VEGFR-2. The specific information provided by ultrasound molecular imaging (USMI) using BR55 was compared with the vascular tumor expression of the VEGFR-2 by immunohistochemical (IHC) staining in a preclinical model of ccRCC. Patients' ccRCCs were orthotopically grafted onto Nod-Scid-Gamma (NSG) mice to generate patient-derived xenografts (PdX). Mice were divided into four groups to receive either vehicle or axitinib an amount of 2, 7.5 or 15 mg/kg twice daily. Perfusion parameters and the BR55 ultrasound contrast signal on PdX renal tumors were analyzed at D0, D1, D3, D7 and D11, and compared with IHC staining for the VEGFR-2 and CD34. Significant Pearson correlation coefficients were observed between the area under the curve (AUC) and the CD34 (0.84, p < 10-4), and between the VEGFR-2-specific signal obtained by USMI and IHC (0.72, p < 10-4). USMI with BR55 could provide instant, quantitative information on tumor VEGFR-2 expression to characterize renal masses non-invasively.
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Affiliation(s)
- Jean Courcier
- Department of Urology, Henri Mondor Hospital, University of Paris Est Créteil (UPEC), 94000 Créteil, France
- Biomaps, UMR1281, INSERM, Centre National de la Recherche Scientifique (CNRS), Commissariat à l’Energie Atomique (CEA), Université Paris Saclay, 94800 Villejuif, France
| | - Ingrid Leguerney
- Biomaps, UMR1281, INSERM, Centre National de la Recherche Scientifique (CNRS), Commissariat à l’Energie Atomique (CEA), Université Paris Saclay, 94800 Villejuif, France
- Department of Imaging, Gustave Roussy Cancer Campus, 94800 Villejuif, France
| | - Baya Benatsou
- Biomaps, UMR1281, INSERM, Centre National de la Recherche Scientifique (CNRS), Commissariat à l’Energie Atomique (CEA), Université Paris Saclay, 94800 Villejuif, France
- Department of Imaging, Gustave Roussy Cancer Campus, 94800 Villejuif, France
| | | | | | - Laurence Albiges
- Department of Urological Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Paul-Henry Cournède
- Laboratory of Mathematics and Computer Science (MICS), CentraleSupélec, Université Paris-Saclay, 91190 Gif-Sur-Yvette, France
| | - Alexandre De La Taille
- Department of Urology, Henri Mondor Hospital, University of Paris Est Créteil (UPEC), 94000 Créteil, France
| | - Nathalie Lassau
- Biomaps, UMR1281, INSERM, Centre National de la Recherche Scientifique (CNRS), Commissariat à l’Energie Atomique (CEA), Université Paris Saclay, 94800 Villejuif, France
- Department of Imaging, Gustave Roussy Cancer Campus, 94800 Villejuif, France
| | - Alexandre Ingels
- Department of Urology, Henri Mondor Hospital, University of Paris Est Créteil (UPEC), 94000 Créteil, France
- Biomaps, UMR1281, INSERM, Centre National de la Recherche Scientifique (CNRS), Commissariat à l’Energie Atomique (CEA), Université Paris Saclay, 94800 Villejuif, France
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Pozza C, Tenuta M, Sesti F, Bertolotto M, Huang DY, Sidhu PS, Maggi M, Isidori AM, Lotti F. Multiparametric Ultrasound for Diagnosing Testicular Lesions: Everything You Need to Know in Daily Clinical Practice. Cancers (Basel) 2023; 15:5332. [PMID: 38001591 PMCID: PMC10670367 DOI: 10.3390/cancers15225332] [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: 08/29/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Ultrasonography (US) represents the gold standard imaging method for the assessment of testicular lesions (TL). The gray-scale (GSUS) and color-Doppler (CDUS) ultrasound examination allow sonographers to investigate the size, margins, echotexture, and vascular features of TLs with the aim to differentiate benign from malignant lesions. Recently, the use of contrast-enhanced US (CEUS) and sonoelastography (SE) has led to further improvements in the differential diagnosis of TL. Although GSUS and CDUS are often sufficient to suggest the benign or malignant nature of the TL, CEUS can be decisive in the differential diagnosis of unclear findings, while SE can help to strengthen the diagnosis. The contemporary combination of GSUS, CDUS, CEUS, and SE has led to a new diagnostic paradigm named multiparametric US (mp-US), which is able to provide a more detailed characterization of TLs than single techniques alone. This narrative and pictorial review aimed to describe the mp-US appearance of several TLs. METHODS An extensive Medline search was performed to identify studies in the English language focusing on the mp-US evaluation of TLs. RESULTS A practical mp-US "identity card" and iconographic characterization of several benign and malignant TLs is provided herein. CONCLUSIONS The mp-US characterization of TL reported herein can be useful in daily clinical practice.
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Affiliation(s)
- Carlotta Pozza
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.T.); (F.S.); (A.M.I.)
| | - Marta Tenuta
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.T.); (F.S.); (A.M.I.)
| | - Franz Sesti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.T.); (F.S.); (A.M.I.)
| | - Michele Bertolotto
- Department of Radiology, Ospedale Di Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Dean Y. Huang
- Department of Imaging Sciences, Faculty of Life Sciences and Medicine, School of Biomedical Engineering and Imaging Sciences, King’s College London, London WC2R 2LS, UK; (D.Y.H.); (P.S.S.)
| | - Paul S. Sidhu
- Department of Imaging Sciences, Faculty of Life Sciences and Medicine, School of Biomedical Engineering and Imaging Sciences, King’s College London, London WC2R 2LS, UK; (D.Y.H.); (P.S.S.)
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50139 Florence, Italy;
| | - Andrea M. Isidori
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.T.); (F.S.); (A.M.I.)
| | - Francesco Lotti
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
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Lu X, Tawanaie Pour Sedehi N, Su X, Yan F, Alhalabi O, Tannir NM, Malouf GG. Racial Disparities in MiT Family Translocation Renal Cell Carcinoma. Oncologist 2023; 28:1009-1013. [PMID: 37315151 PMCID: PMC10628562 DOI: 10.1093/oncolo/oyad173] [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: 05/05/2023] [Accepted: 05/23/2023] [Indexed: 06/16/2023] Open
Abstract
Racial disparities have been documented in the biology and outcome of certain renal cell carcinomas (RCCs) among Black patients. However, little is known about racial differences in MiT family translocation RCC (TRCC). To investigate this issue, we performed a case-control study using data from The Cancer Genome Atlas (TCGA) and the Chinese OrigiMed2020 cohort. A total of 676 patients with RCC (14 Asian, 113 Black, and 525 White) were identified in TCGA, and TRCC was defined as RCC with TFE3/TFEB translocation or TFEB amplification, leading to 21 patients with TRCC (2 Asian, 8 Black, 10 White, and 1 unknown). Asian (2 of 14 [14.3%] vs 10 of 525 [1.9%]; P = .036) and Black (8 of 113 [7.1%] vs 1.9%; P = .007) patients with RCC showed significantly higher prevalence of TRCC compared with White patients with RCC. The overall mortality rate of TRCC was slightly higher in Asian and Black patients compared with White patients (HR: 6.05, P = .069). OrigiMed2020 Chinese patients with RCC had a significantly higher proportion of TRCC with TFE3 fusions than TCGA White patients with RCC (13 of 250 [5.2%] vs 7 of 525 [1.3%]; P = .003). Black patients with TRCC were more likely to exhibit the proliferative subtype than White patients (6 of 8 [75%] vs 2 of 9 [22.2%]; P = .057) for those who had RNA-seq profiles. We present evidence of higher prevalence of TRCC in Asian and Black patients with RCC compared with White patients and show that these tumors in Asian and Black patients have distinct transcriptional signatures and are associated with poor outcomes.
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Affiliation(s)
- Xiaofan Lu
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, Illkirch, France
| | - Nassim Tawanaie Pour Sedehi
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, Illkirch, France
| | - Xiaoping Su
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fangrong Yan
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Omar Alhalabi
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nizar M Tannir
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gabriel G Malouf
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, Illkirch, France
- Department of Medical Oncology, Institut de Cancérologie de Strasbourg, Strasbourg University, Strasbourg, France
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Campbell P, Gebrael G, Agarwal N. Racial Disparities and Molecular Insights in Translocation Renal Cell Carcinoma: Advancing Understanding and Treatment Approaches. Oncologist 2023; 28:925-927. [PMID: 37597001 PMCID: PMC10628571 DOI: 10.1093/oncolo/oyad236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/26/2023] [Indexed: 08/21/2023] Open
Abstract
This commentary remarks on the study conducted by Lu et al, which contributes to the existing knowledge on translocation renal cell carcinoma (tRCC) by examining how race may influence susceptibility to tRCC and how distinct transcriptomic profiles among different races may explain variations in tRCC prognosis.
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Affiliation(s)
- Patrick Campbell
- Division of Medical Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Georges Gebrael
- Division of Medical Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Neeraj Agarwal
- Division of Medical Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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Bremmer F, Pongratanakul P, Skowron M, Che Y, Richter A, Küffer S, Reuter-Jessen K, Bohnenberger H, Pauls S, Kresbach C, Schüller U, Stühler K, Ströbel P, Albers P, Nettersheim D. Characterizing the mutational burden, DNA methylation landscape, and proteome of germ cell tumor-related somatic-type malignancies to identify the tissue-of-origin, mechanisms of therapy resistance, and druggable targets. Br J Cancer 2023; 129:1580-1589. [PMID: 37726478 PMCID: PMC10645790 DOI: 10.1038/s41416-023-02425-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 08/22/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Germ cell tumors (GCT) might undergo transformation into a somatic-type malignancy (STM), resulting in a cell fate switch to tumors usually found in somatic tissues, such as rhabdomyosarcomas or adenocarcinomas. STM is associated with a poor prognosis, but the molecular and epigenetic mechanisms triggering STM are still enigmatic, the tissue-of-origin is under debate and biomarkers are lacking. METHODS To address these questions, we characterized a unique cohort of STM tissues on mutational, epigenetic and protein level using modern and high-throughput methods like TSO assays, 850k DNA methylation arrays and mass spectrometry. RESULTS AND CONCLUSIONS For the first time, we show that based on DNA methylation and proteome data carcinoma-related STM more closely resemble yolk-sac tumors, while sarcoma-related STM resemble teratoma. STM harbor mutations in FGF signaling factors (FGF6/23, FGFR1/4) highlighting the corresponding pathway as a therapeutic target. Furthermore, STM utilize signaling pathways, like AKT, FGF, MAPK, and WNT to mediate molecular functions coping with oxidative stress, toxin transport, DNA helicase activity, apoptosis and the cell cycle. Collectively, these data might explain the high therapy resistance of STM. Finally, we identified putative novel biomarkers secreted by STM, like EFEMP1, MIF, and DNA methylation at specific CpG dinucleotides.
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Affiliation(s)
- Felix Bremmer
- Institute of Pathology, University Medical Center Goettingen, Goettingen, Germany
| | - Pailin Pongratanakul
- Department of Urology, Urological Research Laboratory, Translational UroOncology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Margaretha Skowron
- Department of Urology, Urological Research Laboratory, Translational UroOncology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Yue Che
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Annika Richter
- Institute of Pathology, University Medical Center Goettingen, Goettingen, Germany
| | - Stefan Küffer
- Institute of Pathology, University Medical Center Goettingen, Goettingen, Germany
| | | | - Hanibal Bohnenberger
- Institute of Pathology, University Medical Center Goettingen, Goettingen, Germany
| | - Stella Pauls
- Molecular Proteomics Laboratory (MPL), Biological and Medical Research Centre (BMFZ), Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Catena Kresbach
- Institute of Neuropathology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrich Schüller
- Institute of Neuropathology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Kai Stühler
- Molecular Proteomics Laboratory (MPL), Biological and Medical Research Centre (BMFZ), Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Philipp Ströbel
- Institute of Pathology, University Medical Center Goettingen, Goettingen, Germany
| | - Peter Albers
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Daniel Nettersheim
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
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145
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Fakhralddin SS, Ali RM, Abdullah AM, Faraj FM, Hussein DM, Mohammed SH, Abdalla BA, Kakamad FH, Rahim HM. Pleomorphic giant cell carcinoma of the prostate: A case report and mini‑review of the literature. MEDICINE INTERNATIONAL 2023; 3:60. [PMID: 38222251 PMCID: PMC10784873 DOI: 10.3892/mi.2023.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/03/2023] [Indexed: 01/16/2024]
Abstract
Pleomorphic giant cell carcinoma (PGCC) is an exceptionally uncommon form of prostate adenocarcinoma. It consists of unusually large and irregular cells with varied nuclei. The present study describes a rare case of prostatic PGCC. A 65-year-old male patient presented to the urology clinic with severe dysuria, nocturia, and frequent, urgent, and difficult urination for a period of 3 months. Pelvic magnetic resonance imaging revealed a large pelvic mass. A prostate biopsy was performed, and immunohistochemical analysis revealed positivity for the pan-epithelial markers, AE1/AE3, alpha-methyl acyl-CoA racemase, and focally for sphingolipid activator protein-2. While waiting for his pathology report, the patient's condition deteriorated, and he was diagnosed with intestinal obstruction. The patient underwent laparotomy and end colostomy. Later, he developed severe sepsis and wound dehiscence. After 2 weeks, the patient succumbed due to multiorgan failure. Prostatic PGCC cases are frequently associated with previous chemo-, hormone, or radiation therapy. Prior to the diagnosis of PGCC, it is critical to rule out urothelial carcinoma. Early recognition of this rare condition can lead to more effective therapy. Prostatic PGCC is extremely rare. Immunohistochemistry for prostatic markers, such as prostate-specific membrane antigen, prostate-specific antigen, NK3 homeobox 1 and androgen receptor, can be used to confirm its origin.
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Affiliation(s)
- Saman Salih Fakhralddin
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
- Department of Scientific Affairs, Smart Health Tower, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
- Sulaimaniyah Surgical Teaching Hospital, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
| | - Rawa M. Ali
- Department of Scientific Affairs, Smart Health Tower, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
| | - Ari M. Abdullah
- Department of Scientific Affairs, Smart Health Tower, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
- Sulaimaniyah Surgical Teaching Hospital, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
| | - Farman Mohammed Faraj
- Sulaimaniyah Surgical Teaching Hospital, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
| | - Dlsoz M. Hussein
- Department of Scientific Affairs, Smart Health Tower, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
| | - Shvan H. Mohammed
- Kscien Organization, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
| | - Berun A. Abdalla
- Department of Scientific Affairs, Smart Health Tower, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
| | - Fahmi H. Kakamad
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
- Department of Scientific Affairs, Smart Health Tower, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
| | - Hawbash M. Rahim
- Department of Scientific Affairs, Smart Health Tower, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
- Department of Medical Laboratory Science, College of Health Sciences, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
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146
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Deng Z, Hajihosseini M, Moore JX, Khan S, Graff RE, Bondy ML, Chung BI, Langston ME. Lifetime Body Weight Trajectories and Risk of Renal Cell Cancer: A Large U.S. Prospective Cohort Study. Cancer Epidemiol Biomarkers Prev 2023; 32:1651-1659. [PMID: 37624040 DOI: 10.1158/1055-9965.epi-23-0668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/25/2023] [Accepted: 08/23/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Body mass index (BMI) is a known risk factor for renal cell cancer (RCC), but data are limited as to the effect of lifetime exposure to excess body weight. METHODS Using the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (N = 138,614, 527 incident RCCs), we identified several anthropometric measures to capture the lifetime BMI patterns: (i) BMI at specific ages; (ii) adulthood BMI trajectories; (iii) cumulative exposure to overweight/obesity denoted as weighted years of living overweight/obese (WYO); and (iv) weight change during each age span. We conducted multivariable Cox model to quantify the association between each anthropometric metric and incident RCC. RESULTS A higher BMI at ages 20 and 50 and at baseline was associated with a greater hazard of RCC. Compared with individuals who retained normal BMI throughout adulthood, we observed an increased hazard of RCC for BMI trajectory of progressing from normal BMI to overweight [HR, 1.49; 95% confidence interval (CI), 1.19-1.87], from normal BMI to obesity (HR, 2.22; 95% CI, 1.70-2.90), and from overweight to obesity (HR, 2.78; 95% CI, 1.81-4.27). Compared with individuals who were never overweight (WYO = 0), elevated HRs were observed among individuals who experienced low (HR, 1.31; 95% CI, 0.99-1.74), medium (HR, 1.57; 95% CI, 1.20-2.05), and high (HR, 2.10; 95% CI, 1.62-2.72) WYO tertile. Weight gain of ≥10 kg was associated with increased RCC incidence for each age span. CONCLUSIONS Across the lifespan, being overweight/obese, weight gain, and higher cumulative exposure to excess weight were all associated with increased RCC risk. IMPACT It is important to avoid weight gain and assess BMI from a life-course perspective to reduce RCC risk.
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Affiliation(s)
- Zhengyi Deng
- Department of Urology, Stanford University School of Medicine, Palo Alto, California
| | - Morteza Hajihosseini
- Department of Urology, Stanford University School of Medicine, Palo Alto, California
| | - Justin X Moore
- Center for Health Equity Transformation, Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Saira Khan
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Rebecca E Graff
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
| | - Melissa L Bondy
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California
| | - Benjamin I Chung
- Department of Urology, Stanford University School of Medicine, Palo Alto, California
| | - Marvin E Langston
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California
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147
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Ma J, He S, Li M, Peng Y, Yang X, Chen L, Jia Q, Liu Y. RUNX1 predicts poor prognosis and correlates with tumor progression in clear cell renal carcinoma. Pathol Res Pract 2023; 251:154886. [PMID: 37844486 DOI: 10.1016/j.prp.2023.154886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Runt-related transcription factor 1 (RUNX1), also called acute myeloid leukaemia 1, is a member of RUNX family of transcription factors. This family is composed of evolutionarily conserved transcription factors that function as critical lineage determinants in various tissues, however its function in cancer development and clinical significance in RCC are still unknown. METHODS We used paraffin-embedded tumor tissues from 100 patients and fresh-harvested and paired adjacent normal renal tissues from 15 RCC patients who underwent primary surgical resection in Xijing Hospital between 2018 and 2022. The expression level of RUNX1 was evaluated by immunohistochemistry and Western Blot. RUNX1 promoted tumor cells proliferation, migration and invasion were verified by CCK-8, wound-healing and transwell assays. Finally, we constructed a xenografts model of the 786-O cell lines to observe the effect of RUNX1 on tumorigenesis in vivo. RESULTS TCGA database showed higher RUNX1 expression levels in KIRC (kidney renal clear cell carcinoma). In overall survival analysis, RCC patients with higher RUNX1 expression level would have a shorter survival period than those with lower expression. Similarly, immunohistochemical results of our cohort also showed that RUNX1 was over-expression in cancer tissues than in corresponding non-cancer tissues. We also proved this result at protein level by western-blot. Meanwhile, prognostic and OS analyses of our cohort showed that the RUNX1 expression level was an individual prognostic factor in RCC patients. CCK-8, wound-healing and transwell assays proved that the overexpression of RUNX1 in Caki-1 cells promoted the proliferation, migration and invasion of the cells. Knocking down RUNX1 in 786-O cells inhibited the proliferation, migration and invasion of cells. The experimental results of xenografts model in nude mice showed that the knockdown of RUNX1 in 786-O cells slowed down the growth of tumor. CONCLUSION RUNX1 is a poor prognostic factor of clear cell renal carcinoma, which may provide a novel therapeutic target for ccRCC.
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Affiliation(s)
- Jing Ma
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Shaofei He
- Shaanxi University of Chinese Medicine, Xi'an-Xianyang New Ecomic Zone, Shaanxi Province, China
| | - Mingyang Li
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Yang Peng
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Xinyu Yang
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China
| | - Ligang Chen
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, China.
| | - Qingge Jia
- Department of Reproductive Medicine, Xi'an International Medical Center Hospital, Northwest University, Xi'an, China.
| | - Yixiong Liu
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
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148
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Li XF, Wang ZJ, Zhang HM, Yang MQ. Warthin-like papillary renal cell carcinoma: A case report. World J Clin Cases 2023; 11:7450-7456. [PMID: 37969440 PMCID: PMC10643085 DOI: 10.12998/wjcc.v11.i30.7450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/26/2023] [Accepted: 10/08/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Warthin-like papillary renal cell carcinoma (WPRCC) has been described as a rare pathological subtype of papillary renal cell carcinoma in the 2022 World Health Organization Classification of the Urinary and Male Reproductive System. Herein we report a case of WPRCC in the left kidney. CASE SUMMARY Physical examination of a previously healthy 47-year-old woman revealed a lump in her left kidney, 4.5 cm × 3.5 cm × 3.5 cm in size. Based on the clinical information, imaging data, histmorphological features, and immunohistochemistry results, the pathological diagnosis was WPRCC in left kidney. CONCLUSION Resection of the mass in the left kidney was performed and her postoperative course was uneventful.
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Affiliation(s)
- Xiu-Feng Li
- Department of Pathology, Weifang People's Hospital (First Affiliated Hospital of Weifang Medical University), Weifang 261041, Shandong Province, China
| | - Zheng-Jiang Wang
- Department of Pathology, Weifang People's Hospital (First Affiliated Hospital of Weifang Medical University), Weifang 261041, Shandong Province, China
| | - Heng-Ming Zhang
- Department of Pathology, Weifang People's Hospital (First Affiliated Hospital of Weifang Medical University), Weifang 261041, Shandong Province, China
| | - Mai-Qing Yang
- Department of Pathology, Weifang People's Hospital (First Affiliated Hospital of Weifang Medical University), Weifang 261041, Shandong Province, China
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149
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Wood GE, Bunting CP, Veli M, Arora R, Berney DM, Alifrangis C, MacDonald ND, Miller RE, Shamash J, Stoneham S, Lockley M. Seminoma and dysgerminoma: evidence for alignment of clinical trials and de-escalation of systemic chemotherapy. Front Oncol 2023; 13:1271647. [PMID: 37954076 PMCID: PMC10634240 DOI: 10.3389/fonc.2023.1271647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/18/2023] [Indexed: 11/14/2023] Open
Abstract
Malignant germ cell tumours are a group of rare cancers whose incidence peaks in late adolescence and early adulthood. Dysgerminomas of the ovary and seminomas of the testis are analogous diseases, but seminomas have a 10-fold higher incidence. The two tumours are morphologically identical and are only differentiated by surrounding organ-specific tissue or testicular germ cell neoplasia in situ. They share genetic features including KIT and RAS mutations, amplification of chromosome 12p, and expression of pluripotency markers (NANOG (Nanog homeobox), OCT3/4 (Octamer-binding transcription factor 3/4), and SAL4 (Spalt-like trascription factor 4)). Both histologies are exquisitely sensitive to platinum chemotherapy, and the combination of bleomycin, etoposide, and cisplatin (BEP) yields survival rates greater than 90%. However, BEP causes significant, lifelong toxicity (cardiovascular, renal, respiratory, and neurological) in these young patients with an expectation of cure. Here, we comprehensively review the biological features of dysgerminoma and seminoma to demonstrate that they are biologically analogous diseases. We present available clinical trial data supporting de-escalation of chemotherapy treatment. Finally, we propose that future trials should enrol men, women, and children to benefit all patients regardless of age or sex.
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Affiliation(s)
- Georgina E. Wood
- Medical Oncology, University College London Hospital, London, United Kingdom
| | - Christopher P. Bunting
- Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Mesel Veli
- Medical Oncology, University College London Hospital, London, United Kingdom
| | - Rupali Arora
- Histopathology, University College London Hospital, London, United Kingdom
| | | | | | - Nicola D. MacDonald
- Department of Gynaecology, University College London Hospital, London, United Kingdom
| | - Rowan E. Miller
- Medical Oncology, University College London Hospital, London, United Kingdom
- Medical Oncology, Barts Health NHS Trust, London, United Kingdom
| | - Jonathan Shamash
- Medical Oncology, Barts Health NHS Trust, London, United Kingdom
| | - Sara Stoneham
- Paediatric Oncology, University College London Hospital, London, United Kingdom
| | - Michelle Lockley
- Medical Oncology, University College London Hospital, London, United Kingdom
- Centre for Cancer Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
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150
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Yang H, Dong X, Pan X, Ma W, Pan J, Guo H, Gan W. A safe and effective treatment combination of neoadjuvant therapy and surgical resection for metastatic TFE3-rearranged renal cell carcinoma:a case report. Front Oncol 2023; 13:1252282. [PMID: 37936602 PMCID: PMC10627181 DOI: 10.3389/fonc.2023.1252282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/03/2023] [Indexed: 11/09/2023] Open
Abstract
TFE3-rearranged renal cell carcinoma (RCC) is a rare subtype of renal tumor that primarily affects young women and is characterized by early metastasis and a poor prognosis. This case study presents a 29-year-old woman diagnosed with TFE3-rearranged RCC, who initially presented with painless gross hematuria. Computed Tomography (CT) imaging revealed the presence of a solid mass in the left kidney along with retroperitoneal metastasis. The patient received axitinib, a vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFR-TKI), as first-line neoadjuvant therapy. Subsequent testing confirmed positive expression of programmed death-1 protein L1 (PDL1), leading to the addition of tislelizumab, a PD1 inhibitor, to the treatment regimen. After 8 months, the patient's tumor size and metastases exhibited significant reduction, providing a favorable opportunity for subsequent surgical intervention. The tumor was classified as IV (pT3aN0M1) based on the pathologic stage of the American Joint Committee on Cancer (AJCC, 8th edition, 2017). The patient achieved long-term survival through combined systemic therapy involving surgery and neoadjuvant treatment. At the 30-month follow-up, there was no evidence of tumor recurrence or metastasis.
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Affiliation(s)
- Haiyang Yang
- Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, China
| | - Xiang Dong
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xinghe Pan
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenliang Ma
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jun Pan
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Hongqian Guo
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Weidong Gan
- Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, China
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
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