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Zhang H, Andreou A, Bhatt R, Whitworth J, Yngvadottir B, Maher ER. Characteristics, aetiology and implications for management of multiple primary renal tumours: a systematic review. Eur J Hum Genet 2024; 32:887-894. [PMID: 38802529 PMCID: PMC11291654 DOI: 10.1038/s41431-024-01628-5] [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: 02/07/2024] [Revised: 04/16/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024] Open
Abstract
In a subset of patients with renal tumours, multiple primary lesions may occur. Predisposition to multiple primary renal tumours (MPRT) is a well-recognised feature of some inherited renal cancer syndromes. The diagnosis of MPRT should therefore provoke a thorough assessment for clinical and genetic evidence of disorders associated with predisposition to renal tumourigenesis. To better define the clinical and genetic characteristics of MPRT, a systematic literature review was performed for publications up to 3 April 2024. A total of 7689 patients from 467 articles were identified with MPRT. Compared to all patients with renal cell carcinoma (RCC), patients with MPRT were more likely to be male (71.8% versus 63%) and have an earlier age at diagnosis (<46 years, 32.4% versus 19%). In 61.1% of cases MPRT were synchronous. The proportion of cases with similar histology and the proportion of cases with multiple papillary renal cell carcinoma (RCC) (16.1%) were higher than expected. In total, 14.9% of patients with MPRT had a family history of cancer or were diagnosed with a hereditary RCC associated syndrome with von Hippel-Lindau (VHL) disease being the most common one (69.7%), followed by Birt-Hogg-Dubé (BHD) syndrome (14.2%). Individuals with a known or likely genetic cause were, on average, younger (43.9 years versus 57.1 years). In rare cases intrarenal metastatic RCC can phenocopy MPRT. We review potential genetic causes of MPRT and their implications for management, suggest an approach to genetic testing for individuals presenting with MPRT and considerations in cases in which routine germline genetic testing does not provide a diagnosis.
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Affiliation(s)
- Huairen Zhang
- Department of Medical Genetics, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Avgi Andreou
- Department of Medical Genetics, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Rupesh Bhatt
- Department of Urology, Queen Elizabeth Hospital, Birmingham, B15, UK
| | - James Whitworth
- Department of Medical Genetics, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Bryndis Yngvadottir
- Department of Medical Genetics, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Eamonn R Maher
- Department of Medical Genetics, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK.
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, UK.
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Counil É, Henry E. When Scientific Knowledge and Ignorance Make It Difficult to Improve Occupational Health: A French and European Perspective. New Solut 2021; 31:141-151. [PMID: 34038192 DOI: 10.1177/10482911211019135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This article analyzes the consequences of the increasing reference to scientific expertise in the decision and implementation process of occupational health policy. Based on examples (exposure limits and attributable fractions) taken from an interdisciplinary seminar conducted in 2014 to 2015 in France, it shows how the measurement or regulation of a problem through biomedicine-based tools produces blind spots. It also uses a case study to show the contradictions between scientific and academic aims and public health intervention. Other indirect implications are also examined, such as the limitation of trade unions' scope for action. Finally, the article suggests launching a broad political debate accessible to nonspecialists about collective occupational health issues-a dialogue made difficult by the rise of the afore-mentioned techno-scientific perspective.
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Affiliation(s)
- Émilie Counil
- French Institute for Demographic Studies (INED), "Mortality, health and epidemiology" research unit, Campus Condorcet, Aubervilliers, France
| | - Emmanuel Henry
- IRISSO, Université Paris-Dauphine, PSL University, CNRS, Paris, France
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Narayanan S, Patel PH, Fan A, Srinivas S. Epidemiology of Renal Cell Carcinoma. KIDNEY CANCER 2015. [DOI: 10.1007/978-3-319-17903-2_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Iwatsubo Y, Bénézet L, Boutou-Kempf O, Févotte J, Garras L, Goldberg M, Luce D, Pilorget C, Imbernon E. An extensive epidemiological investigation of a kidney cancer cluster in a chemical plant: what have we learned? Occup Environ Med 2013; 71:4-11. [DOI: 10.1136/oemed-2013-101477] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Navai N, Wood CG. Environmental and modifiable risk factors in renal cell carcinoma. Urol Oncol 2012; 30:220-4. [PMID: 22385993 DOI: 10.1016/j.urolonc.2011.10.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 10/03/2011] [Accepted: 10/04/2011] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Prevention of disease requires a firm understanding of the relevant environmental and modifiable risk factors. We present a comprehensive review of these factors in renal cell carcinoma. MATERIALS AND METHODS A literature search of the PubMed database was performed to identify clinical studies examining the relationship between environmental and modifiable factors in the development of renal cell carcinoma (terms utilized: kidney cancer; renal cell carcinoma; risk factors; environment; obesity; hypertension; trichloroethylene). An emphasis was placed on more recent studies. RESULTS Case control and large cohort studies have examined the relationship of numerous environmental and modifiable factors and the risk of renal cell carcinoma. Of particular note are dose-dependent increases in smokers, the obese, and hypertensive patients. CONCLUSIONS Environmental and modifiable risk factors contribute significantly to the risk of sporadic renal cell carcinoma. Emphasis should be placed on smoking cessation and hypertension control. Emerging evidence would suggest that dietary intake and quality impact renal cell carcinoma risk.
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Affiliation(s)
- Neema Navai
- Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, TX 77054, USA.
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Patel PH, Srinivas S. Epidemiology of Renal Cell Carcinoma. KIDNEY CANCER 2012. [DOI: 10.1007/978-3-642-21858-3_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Saillant J, Biat I, Boudet G, Maublant C, Chamoux A. À propos de trois cas groupés d’oncocytomes rénaux sur un même site industriel chimique. ARCH MAL PROF ENVIRO 2010. [DOI: 10.1016/j.admp.2010.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Report of Three Cases of Renal Oncocytoma in the Same French Chemical Industrial Factory. J Occup Environ Med 2009; 51:1113-5. [DOI: 10.1097/jom.0b013e3181ad49eb] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
We analyzed renal cell cancer incidence patterns in the United States and reviewed recent epidemiologic evidence with regard to environmental and host genetic determinants of renal cell cancer risk. Renal cell cancer incidence rates continued to rise among all racial/ethnic groups in the United States, across all age groups, and for all tumor sizes, with the most rapid increases for localized stage disease and small tumors. Recent cohort studies confirmed the association of smoking, excess body weight, and hypertension with an elevated risk of renal cell cancer, and suggested that these factors can be modified to reduce the risk. There is increasing evidence for an inverse association between renal cell cancer risk and physical activity and moderate intake of alcohol. Occupational exposure to trichloroethylene has been positively associated with renal cell cancer risk in several recent studies, but its link with somatic mutations of the von Hippel-Lindau gene has not been confirmed. Studies of genetic polymorphisms in relation to renal cell cancer risk have produced mixed results, but genome-wide association studies with larger sample size and a more comprehensive approach are underway. Few epidemiologic studies have evaluated risk factors by subtypes of renal cell cancer defined by somatic mutations and other tumor markers.
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Charbotel B, Gad S, Caïola D, Béroud C, Fevotte J, Bergeret A, Ferlicot S, Richard S. Trichloroethylene exposure and somatic mutations of the VHL gene in patients with Renal Cell Carcinoma. J Occup Med Toxicol 2007; 2:13. [PMID: 17997830 PMCID: PMC2211482 DOI: 10.1186/1745-6673-2-13] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Accepted: 11/12/2007] [Indexed: 12/03/2022] Open
Abstract
Background We investigated the association between exposure to trichloroethylene (TCE) and mutations in the von Hippel-Lindau (VHL) gene and the subsequent risk for renal cell carcinoma (RCC). Methods Cases were recruited from a case-control study previously carried out in France that suggested an association between exposures to high levels of TCE and increased risk of RCC. From 87 cases of RCC recruited for the epidemiological study, 69 were included in the present study. All samples were evaluated by a pathologist in order to identify the histological subtype and then be able to focus on clear cell RCC. The majority of the tumour samples were fixed either in formalin or Bouin's solutions. The majority of the tumours were of the clear cell RCC subtype (48 including 2 cystic RCC). Mutation screening of the 3 VHL coding exons was carried out. A descriptive analysis was performed to compare exposed and non exposed cases of clear cell RCC in terms of prevalence of mutations in both groups. Results In the 48 cases of RCC, four VHL mutations were detected: within exon 1 (c.332G>A, p.Ser111Asn), at the exon 2 splice site (c.463+1G>C and c.463+2T>C) and within exon 3 (c.506T>C, p.Leu169Pro). No difference was observed regarding the frequency of mutations in exposed versus unexposed groups: among the clear cell RCC, 25 had been exposed to TCE and 23 had no history of occupational exposure to TCE. Two patients with a mutation were identified in each group. Conclusion This study does not confirm the association between the number and type of VHL gene mutations and exposure to TCE previously described.
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Affiliation(s)
- Barbara Charbotel
- UMRESTTE, Université Lyon 1, Université de Lyon, Domaine Rockefeller, Lyon, F-69373, France.,Hospices Civils de Lyon, Service des maladies professionnelles, Centre Hospitalier Lyon Sud, F-69495 Pierre Bénite, France
| | - Sophie Gad
- Laboratoire de Génétique Oncologique EPHE, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre 94275 Le Kremlin-Bicêtre Cedex, France.,CNRS FRE-2939, Institut de Cancérologie Gustave Roussy (IGR), 94805 Villejuif, France
| | - Delphine Caïola
- Laboratoire de Génétique Oncologique EPHE, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre 94275 Le Kremlin-Bicêtre Cedex, France.,CNRS FRE-2939, Institut de Cancérologie Gustave Roussy (IGR), 94805 Villejuif, France
| | - Christophe Béroud
- Laboratoire de Génétique Moléculaire, CHU de Montpellier, Institut Universitaire de Recherche Clinique (IURC), INSERM, U 827, Montpellier, F-34000 France
| | - Joelle Fevotte
- UMRESTTE, Université Lyon 1, Université de Lyon, Domaine Rockefeller, Lyon, F-69373, France
| | - Alain Bergeret
- UMRESTTE, Université Lyon 1, Université de Lyon, Domaine Rockefeller, Lyon, F-69373, France.,Hospices Civils de Lyon, Service des maladies professionnelles, Centre Hospitalier Lyon Sud, F-69495 Pierre Bénite, France
| | - Sophie Ferlicot
- Laboratoire d'Anatomie Pathologique, CHU de Bicêtre, 94275 Le Kremlin-Bicêtre Cedex, France
| | - Stéphane Richard
- Laboratoire de Génétique Oncologique EPHE, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre 94275 Le Kremlin-Bicêtre Cedex, France.,CNRS FRE-2939, Institut de Cancérologie Gustave Roussy (IGR), 94805 Villejuif, France
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Abstract
Our understanding of the role of vitamin E in human nutrition, health, and disease has broadened and changed over the past two decades. Viewed initially as nature's most potent lipid-soluble antioxidant (and discovered for its crucial role in mammalian reproduction) we have now come to realize that vitamin E action has many more facets, depending on the physiological context. Although mainly acting as an antioxidant, vitamin E can also be a pro-oxidant; it can even have nonantioxidant functions: as a signaling molecule, as a regulator of gene expression, and, possibly, in the prevention of cancer and atherosclerosis. Since the term vitamin E encompasses a group of eight structurally related tocopherols and tocotrienols, individual isomers have different propensities with respect to these novel, nontraditional roles. The particular beneficial effects of the individual isomers have to be considered when dissecting the physiological impact of dietary vitamin E or supplements (mainly containing only the alpha-tocopherol isomer) in clinical trials. These considerations are also relevant for the design of transgenic crop plants with the goal of enhancing vitamin E content because an engineered biosynthetic pathway may be biased toward formation of one isomer. In contrast to the tremendous recent advances in knowledge of vitamin E chemistry and biology, there is little hard evidence from clinical and epidemiologic studies on the beneficial effects of supplementation with vitamin E beyond the essential requirement.
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Affiliation(s)
- Claus Schneider
- Division of Clinical Pharmacology, Department of Pharmacology, Vanderbilt University Medical School, Nashville, TN 37232-6602, USA.
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Abstract
PURPOSE OF REVIEW The incidence of renal cell carcinoma has been increasing worldwide. Although the etiology of renal cell carcinoma is largely unknown, recent epidemiological investigations have shed some light on the issue. This article reviews the literature related to etiology, incidence and epidemiology of renal cell carcinoma published between May 1, 2003 and April 30, 2004. RECENT FINDINGS Accumulating evidence has confirmed the increasing incidence of renal cell carcinoma. A racial disparity has been reported for the first time. Being overweight and obesity were confirmed to be risk factors for renal cell carcinoma. Recreational exercise was shown to reduce the risk, whereas a Western-style diet and smoking increased the risk. Occupational exposure may relate to the development of renal cell carcinoma; however, no definite carcinogens have so far been identified. A susceptibility to develop renal cell carcinoma may also exist in relation to the gene polymorphisms of detoxifying enzymes including glutathione S-transferase and cytochrome P450. SUMMARY Although high-risk groups for renal cell carcinoma have been identified, a large portion of renal cell carcinoma still has an unknown etiology. Life-style modifications might reduce renal cell carcinoma risks. Further studies are thus needed to explore the etiology of renal cell carcinoma in terms of gene-environment interactions.
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Affiliation(s)
- Masaru Murai
- Department of Urology, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
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