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Toyoda S, Fukuokaya W, Mori K, Kawada T, Katayama S, Nishimura S, Maenosono R, Tsujino T, Adachi T, Hirasawa Y, Saruta M, Komura K, Nukaya T, Yanagisawa T, Takahara K, Hashimoto T, Azuma H, Ohno Y, Shiroki R, Araki M, Kimura T, Fujita K. Clinical outcomes and prognostic factors in metastatic nonclear cell renal cell carcinoma treated with immuno-oncology combination therapy. Jpn J Clin Oncol 2024; 54:1336-1342. [PMID: 39178171 DOI: 10.1093/jjco/hyae108] [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: 06/06/2024] [Accepted: 08/02/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND Metastatic nonclear cell renal cell carcinoma (nccRCC) is a heterogeneous disease with poor prognosis. The clinical characteristics and prognostic factors of immuno-oncology (IO) combination therapy for nccRCC are not well known. This study analyzed patients with metastatic nccRCC treated with IO combination therapy. METHODS We retrospectively collected data from 447 patients with metastatic RCC treated with IO-based combination therapy as first-line treatment between September 2018 and July 2023 in a Japanese multicenter study. The primary endpoints were objective response rate, progression-free survival (PFS), and overall survival (OS), comparing groups treated with IO-IO and IO-tyrosine kinase inhibitor (TKI) therapies. RESULTS Seventy-five patients with metastatic nccRCC were eligible for analysis: 39 were classified into the IO-IO group and 36 into the IO-TKI group. Median PFS was 5.4 months (95% CI: 1.6-9.1) for the IO-IO group and 5.6 (95% CI: 3.4-12.0) for the IO + TKI group. Median OS was 24.2 months (95% CI: 7.5-NA) for the IO-IO group and 23.4 (95% CI: 18.8-NA) for the IO + TKI group, with no significant difference. In univariate analysis, International Metastatic Renal Cell Carcinoma Database Consortium scores, Karnofsky performance status, neutrophil-to-lymphocyte ratio, and the presence of liver metastases were significantly associated with OS, whereas in multivariate analysis, only the presence of liver metastases was significantly associated with OS (P = .035). CONCLUSIONS There was no significant difference in OS or PFS between IO-IO and IO-TKI combination therapy as first-line treatment for patients with nccRCC. Liver metastasis is a poor prognostic factor for such patients.
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Affiliation(s)
- Shingo Toyoda
- Department of Urology, Kindai University Faculty of Medicine, 377-2, Ohnohigashi, Osaka-Sayama City, Osaka Prefecture, Japan
| | - Wataru Fukuokaya
- Department of Urology, The Jikei University School of Medicine, 3-19-18 Nishi-Shinbashi, Minato-ku, Tokyo, Japan
| | - Keiichiro Mori
- Department of Urology, The Jikei University School of Medicine, 3-19-18 Nishi-Shinbashi, Minato-ku, Tokyo, Japan
| | - Tatsushi Kawada
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, Okayama City, Okayama Prefecture, Japan
| | - Satoshi Katayama
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, Okayama City, Okayama Prefecture, Japan
| | - Shingo Nishimura
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, Okayama City, Okayama Prefecture, Japan
| | - Ryoichi Maenosono
- Department of Urology, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-cho, Takatsukishi, Osaka, Japan
| | - Takuya Tsujino
- Department of Urology, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-cho, Takatsukishi, Osaka, Japan
| | - Takahiro Adachi
- Department of Urology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, Japan
| | - Yosuke Hirasawa
- Department of Urology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, Japan
| | - Masanobu Saruta
- Department of Urology, Fujita-Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-shi, Aichi, Japan
| | - Kazumasa Komura
- Department of Urology, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-cho, Takatsukishi, Osaka, Japan
| | - Takuhisa Nukaya
- Department of Urology, Fujita-Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-shi, Aichi, Japan
| | - Takafumi Yanagisawa
- Department of Urology, The Jikei University School of Medicine, 3-19-18 Nishi-Shinbashi, Minato-ku, Tokyo, Japan
| | - Kiyoshi Takahara
- Department of Urology, Fujita-Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-shi, Aichi, Japan
| | - Takeshi Hashimoto
- Department of Urology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, Japan
| | - Haruhito Azuma
- Department of Urology, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-cho, Takatsukishi, Osaka, Japan
| | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, Japan
| | - Ryoichi Shiroki
- Department of Urology, Fujita-Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-shi, Aichi, Japan
| | - Motoo Araki
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kita-ku, Okayama City, Okayama Prefecture, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, 3-19-18 Nishi-Shinbashi, Minato-ku, Tokyo, Japan
| | - Kazutoshi Fujita
- Department of Urology, Kindai University Faculty of Medicine, 377-2, Ohnohigashi, Osaka-Sayama City, Osaka Prefecture, Japan
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Britton CJ, Sharma V, Zganjar A, Lohse CM, Cheville JC, Houston Thompson R, Leibovich BC, Boorjian SA, Potretzke AM. Evaluation of American Urological Association Renal Cell Carcinoma Risk Groups for Chromophobe Renal Cell Carcinoma. Urology 2024; 194:138-143. [PMID: 39128633 DOI: 10.1016/j.urology.2024.07.050] [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: 01/14/2024] [Revised: 06/19/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVE To develop and compare various models for risk stratification in chromophobe renal cell carcinoma (chrRCC). Models have been developed to predict progression-free (PFS) and cancer-specific survival (CSS) following surgery for localized renal cell carcinoma (RCC). Notably, chromophobe RCC (chrRCC) is not included in American Urological Association (AUA) risk stratification, as nuclear grading is not recommended. METHODS We queried our institutional registry to identify patients managed surgically for unilateral, sporadic, M0, chrRCC from 1970-2012. AUA risk groups were defined using reported criteria, excluding grade, and were compared to the Mayo system incorporating nodal involvement, perinephric/renal sinus fat invasion, and sarcomatoid differentiation. PFS and CSS were estimated using the Kaplan-Meier method. Predictive ability was summarized using c-indexes from Cox proportional hazard regression models. RESULTS A total of 257 patients were identified. Thirty-nine patients experienced disease progression at a median 30 months (IQR 5.0-84) and 25 died from chrRCC at a median 34 months (IQR 15-79) following surgery. PFS and CSS rates at 10 years after surgery were 84% and 90%, respectively. C-indexes for modified AUA and Mayo risk groups were similar at 0.76 and 0.75, respectively, for PFS, and 0.77 and 0.76, respectively for CSS. CONCLUSION The modified AUA and Mayo risk stratification systems have similarly robust c-indexes for PFS and CSS in chrRCC. These models can be used to counsel patients based on pathologic features, inform clinicians on appropriate follow-up pathways, and identify patients at risk of disease progression for enrollment in adjuvant systemic therapy trials.
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Affiliation(s)
| | - Vidit Sharma
- Department of Urology, Mayo Clinic, Rochester, MN
| | | | - Christine M Lohse
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - John C Cheville
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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Tian X, Liu J, Yi C, You X, Yuan C. Hsa_circ_0072732 enhances sunitinib resistance of renal cell carcinoma by inhibiting ferroptosis. Discov Oncol 2024; 15:700. [PMID: 39580569 PMCID: PMC11585529 DOI: 10.1007/s12672-024-01580-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 11/12/2024] [Indexed: 11/25/2024] Open
Abstract
BACKGROUND Renal cell carcinoma (RCC) is one of the most diagnosed urological malignancies with high mortality and increasing incidence. What's more, the sunitinib resistance undoubtedly increased the difficulties in RCC therapy. Circular RNAs (circRNAs) are a newly found type of non-coding RNAs with a special circular structure, and are found to participate in the occurrence development, chemoresistance, and prognosis of cancers. Ferroptosis regulates disease progression mainly via polyunsaturated fatty acid metabolism and glutamine catabolic pathways. The mechanism of circRNAs contributed to sunitinib resistance through ferroptosis has not been elucidated clearly. MATERIALS AND METHODS In our research, we identified a novel circRNA Hsa_circ_0072732 from circRNA datasets (GSE108735 and GSE100186). RNase R and Actinomycin D assays were used to detect the loop structure and stability of circRNAs. qRT-PCR and western blot were used for the detection of RNA and protein levels. CCK8 assays were used to detect proliferation and cell viability. Lipid peroxidation (MDA), and reactive oxygen species (ROS) were detected by indicted kits. Dual-luciferase reporter and RNA pull-down assays were used to detect the RNA interactions. RESULTS Our results showed that Hsa_circ_0072732 was highly expressed in RCC cells. Further investigations showed that the silence of Hsa_circ_0072732 could increase RCC sensitivity to sunitinib. Hsa_circ_0072732 contributed to sunitinib chemoresistance by impairing ferroptosis. Hsa_circ_0072732 exerts its function mainly by acting as sponges for miR-548b-3p and regulating the expression SLC7A11. Our research suggests that ferroptosis is involved in sunitinib resistance, and targeting ferroptosis is a promising way for RCC treatment. CONCLUSION Our research suggests Hsa_circ_0072732 enhanced renal cell carcinoma sunitinib resistance by inhibiting ferroptosis through miR-548b-3p/SLC7A11.
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Affiliation(s)
- Xiaorui Tian
- Department of Urology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443002, China
- Department of Urology, Yichang Central People's Hospital, Yichang, 443002, China
| | - Jun Liu
- Nursing Department, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China
| | - Cheng Yi
- Department of Urology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443002, China
| | - Xiangyun You
- Department of Urology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443002, China
| | - Chunli Yuan
- Department of Urology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443002, China.
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4
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Zhao T, Denize T, Wang H, Fisch AS, Wu S, Wu CL, Cornejo KM. Multinucleated tumor cells and micropapillary morphology appear to be predictors of poor prognosis in renal cell carcinoma with papillary and oncocytic features. Hum Pathol 2024; 153:105677. [PMID: 39489385 DOI: 10.1016/j.humpath.2024.105677] [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: 08/22/2024] [Revised: 10/28/2024] [Accepted: 10/30/2024] [Indexed: 11/05/2024]
Abstract
Renal cell carcinoma with papillary and oncocytic features (RCC-PO) are poorly understood, partially due to conflicting results in multiple studies. The histological features that predict behavior of RCC-PO have not been elucidated. The aim is to review clinicopathologic features and to correlate clinical outcomes of patients with RCC-PO to further expand our knowledge on these heterogeneous tumors. An archival search was done for "RCC" and "papillary," and tumors with >50% papillary and oncocytic features were included. Clinicopathologic data including tumor size, grade, stage, molecular and immunohistochemical testing when performed, and follow-up data were collected. Using multivariate analyses, correlation between histological features, tumor stage and prognosis were analyzed. Sixty-one patients with RCC-PO were identified of which 49 (80%) were male with a median age of 65 (range: 36-93) years, and a mean tumor size of 5.2 (range: 1-21.5) cm. Micropapillary features were seen in 4, bizarre nuclei (at least 3 times larger or with irregular shape) in 6, multinucleated tumor cells (MTC) in 15, single or small clusters (SSC) (made of 2-3 tumor cells) located away from areas of necrosis in 16, and striking eosinophilic cytoplasmic inclusions in 3 tumors, respectively. Thirty-six (59%) tumors were high-grade (WHO/ISUP grade 3-4), and 23 (38%) had a high stage (≥pT3 or pN1). Tumors were positive for AMACR (15/16) and CK7 (13/17), with preserved FH (7/7) staining and were all negative for CD117 (0/7), ALK, TFE3, cathepsin K, Melan A, and HMB45 (0/4, each). Three tumors underwent chromosomal microarray (CMA) plus gene fusion assay, and FISH and germline testing for FLCN and MET gene alterations by PCR were done on 1 each. Ten (16%) patients had a local recurrence (LR) or metastasis after nephrectomy; 4 died of disease (2 had tumors with micropapillary features), with a median follow-up of 7 (range: 0.01-19) years. Tumors with micropapillary features showed significantly higher RCC-PO-related mortality (50% vs. 3.5%, p < 0.001). In multivariable analysis, SSC correlated with a higher stage (HR: 11.95; p = 0.005); micropapillary features (HR: 18.42; p = 0.017) and MTC (HR: 180.22; p = 0.036) with presence of metastasis/LR; and micropapillary features with a higher RCC-PO-related mortality (HR: 60.35; p = 0.036). RCC-PO are cytogenetically heterogeneous with overlapping features of various renal neoplasms. Micropapillary features and MTC appear to be independent predictors of poor outcomes in these tumors.
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Affiliation(s)
- Ting Zhao
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Thomas Denize
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Hanzhang Wang
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Adam S Fisch
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Shulin Wu
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Chin-Lee Wu
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Kristine M Cornejo
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
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5
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Shuch B, Pantuck AJ, Bernhard JC, Morris MA, Master V, Scott AM, van Praet C, Bailly C, Önal B, Aksoy T, Merkx R, Schuster DM, Lee ST, Pandit-Taskar N, Fan AC, Allman P, Schmidt K, Tauchmanova L, Wheatcroft M, Behrenbruch C, Hayward CRW, Mulders P. [ 89Zr]Zr-girentuximab for PET-CT imaging of clear-cell renal cell carcinoma: a prospective, open-label, multicentre, phase 3 trial. Lancet Oncol 2024; 25:1277-1287. [PMID: 39270701 DOI: 10.1016/s1470-2045(24)00402-9] [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: 05/24/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND With limitations of conventional imaging and biopsy, accurate, non-invasive techniques to detect clear-cell renal cell carcinoma in patients with renal masses remain an unmet need. 89Zr-labelled monoclonal antibody ([89Zr]Zr-girentuximab) has high affinity for carbonic anhydrase 9, a tumour antigen highly expressed in clear-cell renal cell carcinoma. We aimed to evaluate [89Zr]Zr-girentuximab PET-CT imaging for detection and characterisation of clear-cell renal cell carcinoma. METHODS ZIRCON was a prospective, open-label, multicentre, phase 3 trial conducted at 36 research hospitals and practices across nine countries (the USA, Australia, Canada, the UK, Türkiye, Belgium, the Netherlands, Spain, and France). Patients aged 18 years or older with an indeterminate renal mass 7 cm or smaller (cT1) suspicious for clear-cell renal cell carcinoma and scheduled for nephrectomy received a single dose of [89Zr]Zr-girentuximab (37 MBq ±10%; 10 mg girentuximab) intravenously followed by abdominal PET-CT imaging 5 days (±2 days) later. Surgery was performed no later than 90 days after administration of [89Zr]Zr-girentuximab. Blinded central review, conducted by three independent readers, determined the histology from surgical samples. The coprimary endpoints, determined for each individual reader, were the sensitivity and specificity of [89Zr]Zr-girentuximab PET-CT imaging to detect clear-cell renal cell carcinoma, with histopathological confirmation as standard of truth. Analyses were on the full analysis set of patients, defined as patients who had evaluable PET-CT imaging and a confirmed histopathological diagnosis. The trial is registered with ClinicalTrials.gov, NCT03849118, and EUDRA Clinical Trials Register, 2018-002773-21, and is closed to enrolment. FINDINGS Between Aug 14, 2019, and July 8, 2022, 371 patients were screened for eligibility, 332 of whom were enrolled. 300 patients received [89Zr]Zr-girentuximab (214 [71%] male and 86 [29%] female). 284 (95%) evaluable patients were included in the primary analysis. The mean sensitivity was 85·5% (95% CI 81·5-89·6) and mean specificity was 87·0% (81·0-93·1). No safety signals were observed. Most adverse events were not or were unlikely to be related to [89Zr]Zr-girentuximab, with most (193 [74%] of 261 events) occurring during or after surgery. The most common grade 3 or worse adverse events were post-procedural haemorrhage (in six [2%] of 261 patients), urinary retention (three [1%]), and hypertension (three [1%]). In 25 (8%) of 300 patients, 52 serious adverse events were reported, of which 51 (98%) occurred after surgery. There were no treatment-related deaths. INTERPRETATION Our results suggest that [89Zr]Zr-girentuximab PET-CT has a favourable safety profile and is a highly accurate, non-invasive imaging modality for the detection and characterisation of clear-cell renal cell carcinoma, which has the potential to be practice changing. FUNDING Telix Pharmaceuticals.
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Affiliation(s)
- Brian Shuch
- Institute of Urologic Oncology, University of California Los Angeles, Los Angeles, CA, USA.
| | - Allan J Pantuck
- Institute of Urologic Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Jean-Christophe Bernhard
- Department of Urology, Centre Hospitalier Universitaire de Bordeaux-Groupe Hospitalier Pellegrin, Bordeaux, France
| | | | - Viraj Master
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Andrew M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, VIC, Australia; Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia; School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia
| | | | - Clement Bailly
- Department of Nuclear Medicine, Nantes University Hospital, Nantes, France
| | - Bülent Önal
- Department of Urology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tamer Aksoy
- Department of Nuclear Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Robin Merkx
- Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - David M Schuster
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Sze Ting Lee
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, VIC, Australia; Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, VIC, Australia; School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia
| | - Neeta Pandit-Taskar
- Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
| | - Alice C Fan
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Karl Schmidt
- ABX-CRO Advanced Pharmaceutical Services Forschungsgesellschaft, Dresden, Germany
| | | | | | | | | | - Peter Mulders
- Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands
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6
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Yildirim HC, Bayram E, Chalabiyev E, Majidova N, Avci T, Güzel HG, Kapar C, Uzun M, Perkin P, Akgül F, Yildirim SS, Sali S, Yildiz A, Kazaz SN, Hendem E, Arcagok M, Tufan G, Yildirim U, Akgul OF, Arslan Ç, Taban H, Sahin E, Caglayan M, Esen R, Öksüzoğlu B, Guven DC, Kaplan MA, Araz M, Basaran M, Cubukcu E, Gokmen E, Cicin I, Algin E, Semiz HS, Tural D, Ozturk B, Erdogan AP, Sari M, Kara O, Erman M. Comparison of the efficacy of sunitinib and pazopanib in patients with advanced non-clear renal cell carcinoma. J Chemother 2024:1-12. [PMID: 39257075 DOI: 10.1080/1120009x.2024.2403051] [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: 07/29/2024] [Revised: 09/03/2024] [Accepted: 09/06/2024] [Indexed: 09/12/2024]
Abstract
Non-clear cell renal cell carcinoma (non-ccRCC) is a highly heterogeneous disease group, accounting for approximately 25% of all RCC cases. Due to its rarity and especially heterogeneity, phase III trial data is limited and treatment options generally follow those of clear cell RCC. In the literature, there exists a number of studies with sunitinib, cabozantinib, and everolimus, but data on the efficacy of pazopanib are limited. Our aim in this study was to compare the efficacy of pazopanib and sunitinib, in a multicenter retrospective cohort of non-ccRCC patients. Our study included patients diagnosed with non-ccRCC who received pazopanib or sunitinib treatment as first-line therapy from 22 tertiary hospitals. We compared the progression-free survival (PFS), overall survival (OS), and response rates of pazopanib and sunitinib treatments. Additionally, we investigated prognostic factors in non-ccRCC. PFS and response rates of sunitinib and pazopanib were found to be similar, while a numerical difference was observed in OS. Being 65 years and older, being in the intermediate or poor risk group according to the International Metastatic Renal Cell Carcinoma Database Consortium, having liver metastases, presence of a sarcomatoid component, and having de novo metastatic disease were found to be significantly associated with shorter PFS. Pazopanib treatment appears to have similar efficacy in the treatment of non-ccRCC compared to sunitinib. Though randomized controlled trials are lacking and will probably be never be available, we suggest that pazopanib could be a preferred agent like sunitinib and cabozantinib.
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Affiliation(s)
- Hasan Cagri Yildirim
- Department of Medical Oncology, Niğde Education and Research Hospital, Niğde, Turkey
| | - Ertuğrul Bayram
- Department of Medical Oncology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Elvin Chalabiyev
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Nargız Majidova
- Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Tugay Avci
- Department of Medical Oncology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Halil Göksel Güzel
- Department of Medical Oncology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Caner Kapar
- Department of Medical Oncology, Bakırkoy Dr. Sadi Konuk Education and Research Hospital, İstanbul, Turkey
| | - Mehmet Uzun
- Department of Medical Oncology, 9 Eylül University Faculty of Medicine, Izmir, Turkey
| | - Perihan Perkin
- Department of Medical Oncology, Yildirim Beyazit University, Bilkent State Hospital, Ankara, Turkey
| | - Fahri Akgül
- Department of Medical Oncology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Saadet Sim Yildirim
- Department of Medical Oncology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Seda Sali
- Department of Medical Oncology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Anil Yildiz
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Seher Nazli Kazaz
- Department of Medical Oncology, Medical Park Hospital, Trabzon, Turkey
| | - Engin Hendem
- Department of Medical Oncology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Murat Arcagok
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Gulnihal Tufan
- Department of Medical Oncology, Dr. A. Y. Ankara Oncology Research and Education Hospital, University of Health Sciences, Ankara, Turkey
| | - Umit Yildirim
- Department of Medical Oncology, Yuzuncu Yil University Faculty of Medicine, Van, Turkey
| | - Omer Faruk Akgul
- Department of Medical Oncology, Adnan Menderes University Faculty of Medicine, Aydin, Turkey
| | - Çagatay Arslan
- Department of Medical Oncology, Medicalpoint Hospital, Izmir, Turkey
| | - Hakan Taban
- Department of Medical Oncology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Eren Sahin
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Melek Caglayan
- Department of Medical Oncology, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Ramazan Esen
- Department of Medical Oncology, Yuzuncu Yil University Faculty of Medicine, Van, Turkey
| | - Berna Öksüzoğlu
- Department of Medical Oncology, Dr. A. Y. Ankara Oncology Research and Education Hospital, University of Health Sciences, Ankara, Turkey
| | - Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Muhammet Ali Kaplan
- Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Murat Araz
- Department of Medical Oncology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Mert Basaran
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Erdem Cubukcu
- Department of Medical Oncology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Erhan Gokmen
- Department of Medical Oncology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Irfan Cicin
- Department of Medical Oncology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Efnan Algin
- Department of Medical Oncology, Yildirim Beyazit University, Bilkent State Hospital, Ankara, Turkey
| | - Huseyin Salih Semiz
- Department of Medical Oncology, 9 Eylül University Faculty of Medicine, Izmir, Turkey
| | - Deniz Tural
- Department of Medical Oncology, Bakırkoy Dr. Sadi Konuk Education and Research Hospital, İstanbul, Turkey
| | - Banu Ozturk
- Department of Medical Oncology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Atike Pinar Erdogan
- Department of Medical Oncology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Murat Sari
- Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Oguz Kara
- Department of Medical Oncology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Mustafa Erman
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Nakaigawa N, Hasumi H, Utsunomiya D, Yoshida K, Ishiwata Y, Oka T, Hayward C, Makiyama K. Evaluation of PET/CT imaging with [89Zr]Zr-DFO-girentuximab: a phase 1 clinical study in Japanese patients with renal cell carcinoma (Zirdac-JP). Jpn J Clin Oncol 2024; 54:873-879. [PMID: 38864246 PMCID: PMC11322881 DOI: 10.1093/jjco/hyae075] [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: 01/25/2024] [Accepted: 05/29/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND PET/CT imaging with Zirconium-89 labeled [89Zr]Zr-DFO-girentuximab, which targets tumor antigen CAIX, may aid in the differentiation and characterization of clear cell renal cell carcinomas (RCC) and other renal and extrarenal lesions, and has been studied in European and American cohorts. We report results from a phase I study that evaluated the safety profile, biodistribution, and dosimetry of [89Zr]Zr-DFO-girentuximab in Japanese patients with suspected RCC. METHODS Eligible adult patients received 37 MBq (± 10%; 10 mg mass dose) of intravenous [89Zr]Zr-DFO-girentuximab. Safety and tolerability profile was assessed based on adverse events, concomitant medications, physical examination, vital signs, hematology, serum chemistry, urinalysis, human anti-chimeric antibody measurement, and 12-lead electrocardiograms at predefined intervals. Biodistribution and normal organ and tumor dosimetry were evaluated with PET/CT images acquired at 0.5, 4, 24, 72 h and Day 5 ± 2 d after administration. RESULTS [89Zr]Zr-DFO-girentuximab was administered in six patients as per protocol. No treatment-emergent adverse events were reported. Dosimetry analysis showed that radioactivity was widely distributed in the body, and that the absorbed dose in healthy organs was highest in the liver (mean ± standard deviation) (1.365 ± 0.245 mGy/MBq), kidney (1.126 ± 0.190 mGy/MBq), heart wall (1.096 ± 0.232 mGy/MBq), and spleen (1.072 ± 0.466 mGy/MBq). The mean effective dose, adjusted by the radioactive dose administered, was 0.470 mSv/MBq. The radiation dose was highly accumulated in the targeted tumor, while any abnormal accumulation in other organs was not reported. CONCLUSIONS This study demonstrates that [89Zr]Zr-DFO-girentuximab administered to Japanese patients with suspected RCC has a favorable safety profile and is well tolerated and has a similar dosimetry profile to previously studied populations.
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Affiliation(s)
- Noboru Nakaigawa
- Department of Urology, Yokohama City University, Yokohama City, Kanagawa 236-0004, Japan
- Department of Urology, Kanagawa Cancer Center, Yokohama City, Kanagawa 241-8515, Japan
| | - Hisashi Hasumi
- Department of Urology, Yokohama City University, Yokohama City, Kanagawa 236-0004, Japan
| | - Daisuke Utsunomiya
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Keisuke Yoshida
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
- Department of Radiology, Yuai Clinic Diagnostic Imaging, 1-6-2, Kita-shinyokohama, Kohoku-ku, Yokohama, Kanagawa 223-0059, Japan
| | - Yoshinobu Ishiwata
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Takashi Oka
- Telix Pharmaceuticals Japan K.K., KRP #4 Building, 93 Chudoji-Awata-machi, Shimogyu-ku, Kyoto-shi, Kyoto, Japan
| | - Colin Hayward
- Telix Pharmaceuticals, 55 Flemington Road, North Melbourne, VIC 3051, Australia
| | - Kazuhide Makiyama
- Department of Urology, Yokohama City University, Yokohama City, Kanagawa 236-0004, Japan
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Egen L, Quan A, Gottstein LIM, Haney CM, Walach MT, Mühlbauer J, Worst TS, Michel MS, Kowalewski KF. Relevance of Positive Surgical Margins in Localized Renal Cell Carcinoma After Surgical Resection: Predictive Factors and Survival Implications. Clin Genitourin Cancer 2024; 22:102110. [PMID: 38839503 DOI: 10.1016/j.clgc.2024.102110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/28/2024] [Accepted: 04/28/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION The implications of positive surgical margins (PSM) after surgery for renal cell carcinoma (RCC) remain subject of discussion. This study aimed to identify risk factors for PSM, assess its effect on overall survival (OS), and determine predictors of OS. PATIENTS AND METHODS Data from RCC surgeries at Mannheim University Medical Center between 2010 and 2023 was analyzed. Propensity score matching balanced PSM and control groups using age, surgical approach, tumor stage, histological subtype, and American Association of Anesthesiologists (ASA) score. Logistic and cox regression models predict PSM and OS, respectively. Kaplan-Meier analysis compared OS of PSM patients and controls. RESULTS A total of 1066 RCC patients were included. Propensity score matching yielded 32 PSM patients and 96 controls. Multivariable logistic regression identified tumor stage ≥ T3a (odds ratio [OR] = 2.74, 95% confidence interval [CI] = 1.0-6.8, P = .04) and chromophobe, compared to clear cell, RCC (OR = 3.19, 95% CI = 1.0-8.7, P = .03) as independent predictors of PSM. Multivariable cox regression found age > 65 years (hazard ratio [HR] = 2.65, 95% CI = 1.7-4.2, P < .01) and tumor stage ≥ T3a (HR = 2.25, 95% CI = 1.4-3.7, P < .01) to predict shorter OS. Partial vs. radical nephrectomy was associated with improved OS (HR = 0.49, 95% CI = 0.3-0.9, P = .02). Kaplan-Meier analysis revealed no OS difference between PSM patients and controls (P = .49) over a 45-month median follow-up. CONCLUSION PSM is not a primary determinant of inferior survival, while age and tumor stage play a more prominent role. A well-calibrated follow-up protocol for PSM patients, combining PSM with coinciding factors such as tumor stage, grade, size, or PSM extent, is crucial for adequate surveillance while preventing excessive interventions.
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Affiliation(s)
- Luisa Egen
- Department of Urology and Urosurgery, University Medical Center Mannheim, Mannheim, Germany; Division of Intelligent Systems and Robotics in Urology (ISRU), German Cancer Research Center (DKFZ), Heidelberg, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
| | - Allison Quan
- Department of Urology and Urosurgery, University Medical Center Mannheim, Mannheim, Germany; Division of Intelligent Systems and Robotics in Urology (ISRU), German Cancer Research Center (DKFZ), Heidelberg, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
| | | | - Caelan Max Haney
- Division of Intelligent Systems and Robotics in Urology (ISRU), German Cancer Research Center (DKFZ), Heidelberg, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany; Department of Urology, University of Leipzig, Leipzig, Germany
| | | | - Julia Mühlbauer
- Department of Urology and Urosurgery, University Medical Center Mannheim, Mannheim, Germany
| | - Thomas Stefan Worst
- Department of Urology and Urosurgery, University Medical Center Mannheim, Mannheim, Germany
| | - Maurice Stephan Michel
- Department of Urology and Urosurgery, University Medical Center Mannheim, Mannheim, Germany
| | - Karl-Friedrich Kowalewski
- Department of Urology and Urosurgery, University Medical Center Mannheim, Mannheim, Germany; Division of Intelligent Systems and Robotics in Urology (ISRU), German Cancer Research Center (DKFZ), Heidelberg, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany.
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9
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Nezami BG, MacLennan GT. Clear Cell Renal Cell Carcinoma: A Comprehensive Review of its Histopathology, Genetics, and Differential Diagnosis. Int J Surg Pathol 2024:10668969241256111. [PMID: 39051572 DOI: 10.1177/10668969241256111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Clear cell renal cell carcinoma (ccRCC) is the predominant subtype of renal epithelial tumor, accounting for roughly 2% of all malignancies. Clinically, it often presents in the sixth to seventh decade of life, predominantly in men. Pathologically, these tumors exhibit a distinctive golden yellow cut surface, usually arising from the renal cortex. Their microscopic features are characterized by solid and nested architectures of cells with clear or eosinophilic granular cytoplasm and a prominent vascular network. A hallmark genetic feature is the inactivation of the VHL gene situated on chromosome 3p25. The majority of ccRCCs are sporadic (over 95%), typically presenting as a single mass; and a small percentage have a hereditary basis, often associated with VHL disease, characterized by multiple bilateral tumors with an earlier onset. Immunohistochemically, ccRCC tumors express PAX8, CA9 box like pattern, and CD10 but are generally negative for AMACR (35% positive) and KRT7 (15% positive). The prognosis of ccRCC is largely determined by its TNM stage, ISUP/WHO nucleolar grade, and the presence of specific aggressive features. This review article delves into the detailed gross, microscopic, molecular, and clinical features of ccRCC, offering comprehensive insights into its diagnosis, management, and prognosis.
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Affiliation(s)
- Behtash G Nezami
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gregory T MacLennan
- Department of Pathology and Urology, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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10
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Huang KB, Gui CP, Xu YZ, Li XS, Zhao HW, Cao JZ, Chen YH, Pan YH, Liao B, Cao Y, Zhang XK, Han H, Zhou FJ, Liu RY, Chen WF, Jiang ZY, Feng ZH, Jiang FN, Yu YF, Xiong SW, Han GP, Tang Q, Ouyang K, Qu GM, Wu JT, Cao M, Dong BJ, Huang YR, Zhang J, Li CX, Li PX, Chen W, Zhong WD, Guo JP, Liu ZP, Hsieh JT, Xie D, Cai MY, Xue W, Wei JH, Luo JH. A multi-classifier system integrated by clinico-histology-genomic analysis for predicting recurrence of papillary renal cell carcinoma. Nat Commun 2024; 15:6215. [PMID: 39043664 PMCID: PMC11266571 DOI: 10.1038/s41467-024-50369-y] [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: 12/18/2023] [Accepted: 07/02/2024] [Indexed: 07/25/2024] Open
Abstract
Integrating genomics and histology for cancer prognosis demonstrates promise. Here, we develop a multi-classifier system integrating a lncRNA-based classifier, a deep learning whole-slide-image-based classifier, and a clinicopathological classifier to accurately predict post-surgery localized (stage I-III) papillary renal cell carcinoma (pRCC) recurrence. The multi-classifier system demonstrates significantly higher predictive accuracy for recurrence-free survival (RFS) compared to the three single classifiers alone in the training set and in both validation sets (C-index 0.831-0.858 vs. 0.642-0.777, p < 0.05). The RFS in our multi-classifier-defined high-risk stage I/II and grade 1/2 groups is significantly worse than in the low-risk stage III and grade 3/4 groups (p < 0.05). Our multi-classifier system is a practical and reliable predictor for recurrence of localized pRCC after surgery that can be used with the current staging system to more accurately predict disease course and inform strategies for individualized adjuvant therapy.
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Affiliation(s)
- Kang-Bo Huang
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Urology, Sun Yat-sen University Cancer center, Guangzhou, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer center, Guangzhou, China
| | - Cheng-Peng Gui
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yun-Ze Xu
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xue-Song Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Hong-Wei Zhao
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Jia-Zheng Cao
- Department of Urology, Jiangmen Hospital, Sun Yat-sen University, Jiangmen, China
| | - Yu-Hang Chen
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yi-Hui Pan
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Bing Liao
- Department of Pathology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yun Cao
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer center, Guangzhou, China
- Department of Pathology, Sun Yat-sen University Cancer center, Guangzhou, China
| | - Xin-Ke Zhang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer center, Guangzhou, China
- Department of Pathology, Sun Yat-sen University Cancer center, Guangzhou, China
| | - Hui Han
- Department of Urology, Sun Yat-sen University Cancer center, Guangzhou, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer center, Guangzhou, China
| | - Fang-Jian Zhou
- Department of Urology, Sun Yat-sen University Cancer center, Guangzhou, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer center, Guangzhou, China
| | - Ran-Yi Liu
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer center, Guangzhou, China
| | - Wen-Fang Chen
- Department of Pathology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ze-Ying Jiang
- Department of Pathology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zi-Hao Feng
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fu-Neng Jiang
- Department of Urology, Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yan-Fei Yu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Sheng-Wei Xiong
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Guan-Peng Han
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Qi Tang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Kui Ouyang
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Gui-Mei Qu
- Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Ji-Tao Wu
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Ming Cao
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bai-Jun Dong
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Ran Huang
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jin Zhang
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Cai-Xia Li
- School of Mathematics and Computational Science, Sun Yat-sen University, Guangzhou, China
| | - Pei-Xing Li
- School of Mathematics and Computational Science, Sun Yat-sen University, Guangzhou, China
| | - Wei Chen
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei-De Zhong
- Department of Urology, Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Jian-Ping Guo
- Institute of Precision Medicine, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhi-Ping Liu
- Department of Internal Medicine and Department of Molecular Biology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
| | - Jer-Tsong Hsieh
- Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
| | - Dan Xie
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer center, Guangzhou, China
- Department of Pathology, Sun Yat-sen University Cancer center, Guangzhou, China
| | - Mu-Yan Cai
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer center, Guangzhou, China
- Department of Pathology, Sun Yat-sen University Cancer center, Guangzhou, China
| | - Wei Xue
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Jin-Huan Wei
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Jun-Hang Luo
- Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
- Institute of Precision Medicine, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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11
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Liu W, Liu Y, Chen S, Hui J, He S. AURKB promotes immunogenicity and immune infiltration in clear cell renal cell carcinoma. Discov Oncol 2024; 15:286. [PMID: 39014265 PMCID: PMC11252114 DOI: 10.1007/s12672-024-01141-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/02/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Chromatin regulators (CRs) are capable of causing epigenetic alterations, which are significant features of cancer. However, the function of CRs in controlling Clear Cell Renal Cell Carcinoma (ccRCC) is not well understood. This research aims to discover a CRs prognostic signature in ccRCC and to elucidate the roles of CRs-related genes in tumor microenvironment (TME). METHODS Expression profiles and relevant clinical annotations were retrieved from the Cancer Genome Atlas (TCGA) and UCSC Xena platform for progression-free survival (PFS) data. The R package "limma" was used to identify differentially expressed CRs. A predictive model based on five CRs was developed using LASSO-Cox analysis. The model's predictive power and applicability were validated using K-M curves, ROC curves, nomograms, comparisons with other models, stratified survival analyses, and validation with the ICGC cohort. GO and GSEA analyses were performed to investigate mechanisms differentiating low and high riskScore groups. Immunogenicity was assessed using Tumor Mutational Burden (TMB), immune cell infiltrations were inferred, and immunotherapy was evaluated using immunophenogram analysis and the expression patterns of human leukocyte antigen (HLA) and checkpoint genes. Differentially expressed CRs (DECRs) between low and high riskScore groups were identified using log2|FC|> 1 and FDR < 0.05. AURKB, one of the high-risk DECRs and a component of our prognostic model, was selected for further analysis. RESULTS We constructed a 5 CRs signature, which demonstrated a strong capacity to predict survival and greater applicability in ccRCC. Elevated immunogenicity and immune infiltration in the high riskScore group were associated with poor prognosis. Immunotherapy was more effective in the high riskScore group, and certain chemotherapy medications, including cisplatin, docetaxel, bleomycin, and axitinib, had lower IC50 values. Our research shows that AURKB is critical for the immunogenicity and immune infiltration of the high riskScore group. CONCLUSION Our study produced a reliable prognostic prediction model using only 5 CRs. We found that AURKB promotes immunogenicity and immune infiltration. This research provides crucial support for the development of prognostic biomarkers and treatment strategies for ccRCC.
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Affiliation(s)
- Weihao Liu
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Ying Liu
- Department of Oncology, Huadu District People's Hospital of Guangzhou, Guangzhou, 510810, Guangdong, China
| | - Shisheng Chen
- Department of Urology, Dongguan Tungwah Hospital, Dongguan, 523110, Guangdong, China
| | - Jialiang Hui
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
| | - Shuhua He
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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12
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Uhlig A, Uhlig J, Shuch B, Kim HS. Stage IA papillary and chromophobe renal cell carcinoma: effectiveness of cryoablation and partial nephrectomy. Insights Imaging 2024; 15:171. [PMID: 38971873 PMCID: PMC11227485 DOI: 10.1186/s13244-024-01749-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/17/2024] [Indexed: 07/08/2024] Open
Abstract
OBJECTIVES To evaluate the effectiveness of cryoablation compared to partial nephrectomy in patients with stage IA papillary and chromophobe renal cell carcinoma (pRCC; chRCC). MATERIAL AND METHODS The 2004-2016 National Cancer Database was queried for adult patients with stage IA pRCC or chRCC treated with cryoablation or partial nephrectomy. Patients receiving systemic therapy or radiotherapy, as well as those with bilateral RCC or prior malignant disease were excluded. Overall survival (OS) was assessed using Kaplan-Meier plots and Cox proportional hazard regression models. Nearest neighbor propensity matching (1:1 cryoablation:partial nephrectomy, stratified for pRCC and chRCC) was used to account for potential confounders. RESULTS A total of 11122 stage IA renal cell carcinoma patients were included (pRCC 8030; chRCC 3092). Cryoablation was performed in 607 (5.5%) patients, and partial nephrectomy in 10515 (94.5%) patients. A higher likelihood of cryoablation treatment was observed in older patients with non-private healthcare insurance, as well as in those with smaller diameter low-grade pRCC treated at non-academic centers in specific US geographic regions. After propensity score matching to account for confounders, there was no statistically significant difference in OS comparing cryoablation vs partial nephrectomy in patients with pRCC (HR = 1.3, 95% CI: 0.96-1.75, p = 0.09) and those with chRCC (HR = 1.38, 95% CI: 0.67-2.82, p = 0.38). CONCLUSION After accounting for confounders, cryoablation, and partial nephrectomy demonstrated comparable OS in patients with stage IA papillary and chromophobe RCC. Cryoablation is a reasonable treatment alternative to partial nephrectomy for these histological RCC subtypes when radiologically suspected or diagnosed after biopsy. CRITICAL RELEVANCE STATEMENT Cryoablation might be considered as an upfront treatment alternative to partial nephrectomy in patients with papillary and chromophobe stage IA renal cell carcinoma, as both treatment approaches yield comparable oncological outcomes. KEY POINTS The utilization of cryoablation for stage IA papillary and chromophobe RCC increases. In the National Cancer Database, we found specific patterns of use of cryoablation. Cryoablation and partial nephrectomy demonstrate comparable outcomes after accounting for confounders.
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Affiliation(s)
- Annemarie Uhlig
- Department of Urology, University Medical Center Goettingen, Goettingen, Germany.
| | - Johannes Uhlig
- Department of Diagnostic and Interventional Radiology, University Medical Center Goettingen, Goettingen, Germany
- Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Brian Shuch
- Institute of Urologic Oncology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Hyun S Kim
- Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
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Xie W, Zhang Y, Zhang Z, Li Q, Tao L, Zhang R. ISG15 promotes tumor progression via IL6/JAK2/STAT3 signaling pathway in ccRCC. Clin Exp Med 2024; 24:140. [PMID: 38951255 PMCID: PMC11217101 DOI: 10.1007/s10238-024-01414-z] [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: 04/07/2024] [Accepted: 06/20/2024] [Indexed: 07/03/2024]
Abstract
Although renal cell carcinoma (RCC) is a prevalent type of cancer, the most common pathological subtype, clear cell renal cell carcinoma (ccRCC), still has poorly understood molecular mechanisms of progression. Moreover, interferon-stimulated gene 15 (ISG15) is associated with various types of cancer; however, its biological role in ccRCC remains unclear.This study aimed to explore the role of ISG15 in ccRCC progression.ISG15 expression was upregulated in ccRCC and associated with poor prognosis. RNA sequence analysis and subsequent experiments indicated that ISG15 modulated IL6/JAK2/STAT3 signaling to promote ccRCC proliferation, migration, and invasion. Additionally, our animal experiments confirmed that sustained ISG15 knockdown reduced tumor growth rate in nude mice and promoted cell apoptosis. ISG15 modulates the IL6/JAK2/STAT3 pathway, making it a potential therapeutic target and prognostic biomarker for ccRCC.
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Affiliation(s)
- Wei Xie
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road. 74, Jiangbei, Chongqing, China
| | - Yuanfeng Zhang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road. 74, Jiangbei, Chongqing, China
| | - Zhechuan Zhang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road. 74, Jiangbei, Chongqing, China
| | - Qinke Li
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road. 74, Yuzhong, Chongqing, China
| | - Lesha Tao
- Department of Urology, Chongqing People's Hospital, Xingguang Road.118, Chongqing, China
| | - Ronggui Zhang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road. 74, Jiangbei, Chongqing, China.
- Department of Urology, Chongqing People's Hospital, Xingguang Road.118, Chongqing, China.
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14
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Chen KY, Lange MJ, Qiu JX, Lambert D, Mithqal A, Krupski TL, Schenkman NS, Lobo JM. Cost-Effectiveness Analysis of the Clear Cell Likelihood Score Against Renal Mass Biopsy for Evaluating Small Renal Masses. Urology 2024; 188:111-117. [PMID: 38648945 PMCID: PMC11193637 DOI: 10.1016/j.urology.2024.04.007] [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: 12/11/2023] [Revised: 03/21/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To examine the cost-effectiveness of the clear cell likelihood score compared to renal mass biopsy (RMB) alone. METHODS The clear cell likelihood score, a new grading system based on multiparametric magnetic resonance imaging, has been proposed as a possible alternative to percutaneous RMB for identifying clear cell renal carcinoma in small renal masses and expediting treatment of high-risk patients. A decision analysis model was developed to compare a RMB strategy where all patients undergo biopsy and a clear cell likelihood score strategy where only patients that received an indeterminant score of 3 undergo biopsy. Effectiveness was assigned 1 for correct diagnoses and 0 for incorrect or indeterminant diagnoses. Costs were obtained from institutional fees and Medicare reimbursement rates. Probabilities were derived from literature estimates from radiologists trained in the clear cell likelihood score. RESULTS In the base case model, the clear cell likelihood score was both more effective (0.77 vs 0.70) and less expensive than RMB ($1629 vs $1966). Sensitivity analysis found that the nondiagnostic rate of RMB and the sensitivity of the clear cell likelihood score had the greatest impact on the model. In threshold analyses, the clear cell likelihood score was the preferred strategy when its sensitivity was greater than 62.7% and when an MRI cost less than $5332. CONCLUSION The clear cell likelihood score is a more cost-effective option than RMB alone for evaluating small renal masses for clear cell renal carcinoma.
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Affiliation(s)
- Katherina Y Chen
- Department of Urology, University of Virginia, Charlottesville, VA
| | - Moritz J Lange
- University of Virginia School of Medicine, Charlottesville, VA
| | - Jessica X Qiu
- University of Virginia School of Medicine, Charlottesville, VA
| | - Drew Lambert
- Department of Radiology and Medical Imaging, Charlottesville, VA
| | - Ayman Mithqal
- Department of Radiology and Medical Imaging, Charlottesville, VA
| | - Tracey L Krupski
- Department of Urology, University of Virginia, Charlottesville, VA
| | - Noah S Schenkman
- Department of Urology, University of Virginia, Charlottesville, VA
| | - Jennifer M Lobo
- Department of Urology, University of Virginia, Charlottesville, VA; Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA.
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15
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Karam JA, Bhattacharya R, Ogbomo A, Gautam S, Yu R, Sundaram M, Imai K, Chhabra J, Haas NB. Real-world study on the characteristics, post-nephrectomy journey, and outcomes of patients with early-stage renal cell carcinoma based on risk groups. Cancer Med 2024; 13:e7247. [PMID: 38826126 PMCID: PMC11145024 DOI: 10.1002/cam4.7247] [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: 11/20/2023] [Revised: 04/11/2024] [Accepted: 04/27/2024] [Indexed: 06/04/2024] Open
Abstract
OBJECTIVES To examine real-world characteristics, journey, and outcomes among patients with locoregional, nonmetastatic renal cell carcinoma (RCC). METHODS A retrospective analysis of medical records from the ConcertAI Oncology Dataset was performed on adults in the United States with newly diagnosed nonmetastatic RCC between January 2012-December 2017 who received surgical treatment, and were followed until August 2021. Patients were stratified based on the risk of recurrence after nephrectomy. Recurrence rate and survival outcomes were assessed. RESULTS The cohort (n = 439) had a median age of 64 years, 66.1% were male, and 76.5% had clear-cell histology. The median follow-up time from nephrectomy was 39.3 months overall, 41.0 months for intermediate-high-risk patients (n = 377; 85.9%) and 24.1 months for high-risk patients (n = 62; 14.1%). For intermediate-high- and high-risk patients, respectively, 68.4% and 56.5% had ≥1 medical oncologist visit after nephrectomy. Of 260 patients with documentation of postoperative imaging assessments, 72% were ordered by medical oncologists, and the median time from initial nephrectomy to the first scan was 110 days (intermediate-high-risk) and 51 days (high-risk). Provider-documented recurrence occurred in 223 (50.8%) patients, of whom 41.7% had ≥1 medical oncologist visit before the recurrence. Three-year disease-free survival (DFS), and overall survival rates were 49.4% and 80.8% (all patients): 27.7% and 64.7% (high-risk); and 52.9% and 83.3% (intermediate-high-risk). CONCLUSIONS Our study reports low DFS after nephrectomy for patients with intermediate-high- and high-risk RCC. Subsequent approval and use of new and newly approved adjuvant therapeutic options could potentially delay or prevent recurrence.
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Affiliation(s)
- Jose A. Karam
- Department of Urology and Translational Molecular PathologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | | | | | | | | | | | | | | | - Naomi B. Haas
- University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
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16
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Qiu Y, Liao Y, Zhang J, Ye Y, Zhang Z, Jiang Z, Zhang J, Xin J, Lv S, Peng H. Exploring the role of coagulation-related genes in renal cell carcinoma: Implications for tumor microenvironment and prognostic biomarkers. Comput Biol Chem 2024; 110:108082. [PMID: 38663187 DOI: 10.1016/j.compbiolchem.2024.108082] [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: 02/24/2024] [Revised: 04/10/2024] [Accepted: 04/20/2024] [Indexed: 05/27/2024]
Abstract
PURPOSE Clear cell renal cell carcinoma (ccRCC) frequently progresses to advanced stages due to tumor thrombus (TTs) formation. In this study, we aimed to investigate the role of coagulation-related pathway activation in the progression of ccRCC. METHODS Consensus clustering was used to identify coagulation-related molecular clusters of ccRCC patients from The Cancer Genome Atlas Program (TCGA) database. The function of coagulation and its correlation with the immune microenvironment were investigated. Protein-protein interactions and differential expression analysis were used to identify the key gene, which was verified by external experiments. The coagulation-associated risk score was constructed by cox proportional hazards regression. RESULTS Notable disparities were detected in immune characteristics, prognostic differentiation and drug sensitivity between two coagulation-related clusters. Through the integration of clinical stage significance and protein-protein interactions, the key gene MMP9 was screened and it was significantly correlated with CD4+T cells, CD8+T cells and Treg cells. A coagulation-related risk score prognostic model was developed in the Cancer Genome Atlas (TCGA) cohort for risk stratification and prognosis prediction. The prognostic predictive values of the coagulation-related risk score were further authenticated in both TCGA-KIRC and E-MTAB-1980 cohorts. CONCLUSION There is an obvious correlation between the coagulation and the tumor microenvironment in ccRCC. As a key coagulation-related gene, MMP9 may promote the progression of renal cell carcinoma by influencing immune infiltration of CD8+T cells and Treg cells. Additionally, the risk score could be used as a durable prognostic biomarker, which could assist in clinical decision making for ccRCC patients.
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Affiliation(s)
- Yang Qiu
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuanpeng Liao
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianqiang Zhang
- Department of Urology, The First People's Hospital of Nanning, No.89 Qixing Road, Qingxiu District, Nanning, China
| | - Yuedian Ye
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhongshu Zhang
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zheng Jiang
- Department of Physiology, Yibin Health School, Yibin, Sichuang, China
| | - Jiaai Zhang
- Southern Medical University, Guangzhou, Guangdong, China
| | - Jinghan Xin
- Southern Medical University, Guangzhou, Guangdong, China
| | - Shidong Lv
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Hongmei Peng
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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17
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Jiang Z, Wang J, Dao C, Zhu M, Li Y, Liu F, Zhao Y, Li J, Yang Y, Pan Z. Utilizing a novel model of PANoptosis-related genes for enhanced prognosis and immune status prediction in kidney renal clear cell carcinoma. Apoptosis 2024; 29:681-692. [PMID: 38281281 DOI: 10.1007/s10495-023-01932-3] [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] [Accepted: 12/19/2023] [Indexed: 01/30/2024]
Abstract
Kidney renal clear cell carcinoma (KIRC) is the most common histopathologic type of renal cell carcinoma. PANoptosis, a cell death pathway that involves an interplay between pyroptosis, apoptosis and necroptosis, is associated with cancer immunity and development. However, the prognostic significance of PANoptosis in KIRC remains unclear. RNA-sequencing expression and mutational profiles from 532 KIRC samples and 72 normal samples with sufficient clinical data were retrieved from the Cancer Genome Atlas (TCGA) database. A prognostic model was constructed using differentially expressed genes (DEGs) related to PANoptosis in the TCGA cohort and was validated in a Gene Expression Omnibus (GEO) cohorts. Incorporating various clinical features, the risk model remained an independent prognostic factor in multivariate analysis, and it demonstrated superior performance compared to unsupervised clustering of the 21 PANoptosis-related genes alone. Further mutational analysis showed fewer VHL and more BAP1 alterations in the high-risk group, with alterations in both genes also associated with patient prognosis. The high-risk group was characterized by an unfavorable immune microenvironment, marked by reduced levels of CD4 + T cells and natural killer cells, but increased M2 macrophages and regulatory T cells. Finally, the risk model was predictive of response to immune checkpoint blockade, as well as sensitivity to sunitinib and paclitaxel. The PANoptosis-related risk model developed in this study enables accurate prognostic prediction in KIRC patients. Its associations with the tumor immune microenvironment and drug efficacy may offer potential therapeutic targets and inform clinical decisions.
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Affiliation(s)
- Zhansheng Jiang
- Department of Integrative Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, 1 Huanhu West Road, Tianjin, 300060, China
| | - Jiahe Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chenghuan Dao
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Mingyu Zhu
- Department of Integrative Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, 1 Huanhu West Road, Tianjin, 300060, China
| | - Yuan Li
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Fangchao Liu
- Department of Integrative Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, 1 Huanhu West Road, Tianjin, 300060, China
| | - Yangyang Zhao
- Department of Integrative Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, 1 Huanhu West Road, Tianjin, 300060, China
| | - Jiayue Li
- Department of Integrative Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, 1 Huanhu West Road, Tianjin, 300060, China
| | - Yinli Yang
- Department of Integrative Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, 1 Huanhu West Road, Tianjin, 300060, China.
| | - Zhanyu Pan
- Department of Integrative Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, 1 Huanhu West Road, Tianjin, 300060, China.
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18
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Eule CJ, Hu J, Hedges D, Jani A, Pshak T, Manley BJ, Sanchez A, Dreicer R, Myint ZW, Zakharia Y, Lam ET. Clinical and Genomic Features of Patients with Renal Cell Carcinoma and Advanced Chronic Kidney Disease: Analysis of a Multi-Institutional Database. Cancers (Basel) 2024; 16:1920. [PMID: 38791999 PMCID: PMC11119962 DOI: 10.3390/cancers16101920] [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: 04/22/2024] [Revised: 04/30/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Patients with advanced chronic kidney disease (ACKD) are at an increased risk of developing renal cell carcinoma (RCC), but molecular alterations in RCC specimens arising from ACKD and overall survival (OS) in affected patients are not well defined. PATIENTS AND METHODS Using the Oncology Research Information Exchange Network (ORIEN) Total Cancer Care® protocol, 296 consented adult patients with RCC and somatic tumor whole exome sequencing were included. Patients with ACKD were defined as those with serum creatinine ≥1.5 mg/dL prior to RCC diagnosis. RESULTS Of 296 patients with RCC, 61 met the criteria for ACKD. The most common somatic mutations in the overall cohort were in VHL (126, 42.6%), PBRM1 (102, 34.5%), and SETD2 (54, 18.2%). BAP1 had a decreased mutational frequency in RCC specimens from patients without ACKD as compared to those with ACKD (10.6% versus 1.6%), but this was not statistically significant in univariable (OR 0.14, p = 0.056) or multivariable (OR 0.15, p = 0.067) analysis. Median OS was not reached in either cohort. CONCLUSIONS Using the clinicogenomic ORIEN database, our study found lower rates of BAP1 mutations in RCC specimens from patients with ACKD, which may reflect a BAP1-independent mutational driver of RCC in patients with ACKD.
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Affiliation(s)
- Corbin J. Eule
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Junxiao Hu
- Biostatistics Core, University of Colorado Cancer Center, Aurora, CO 80045, USA
| | | | - Alkesh Jani
- Division of Nephrology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Thomas Pshak
- Division of Urology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Brandon J. Manley
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA;
| | - Alejandro Sanchez
- Division of Urology, Department of Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Robert Dreicer
- Division of Medical Oncology, Department of Medicine, University of Virginia Comprehensive Cancer Center, Charlottesville, VA 22908, USA
| | - Zin W. Myint
- Division of Medical Oncology, Department of Internal Medicine, Markey Cancer Center, University of Kentucky, Lexington, KY 40506, USA
| | - Yousef Zakharia
- Division of Hematology, Oncology, and Blood and Bone Marrow Transplantation, Department of Internal Medicine, Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA 52242, USA
| | - Elaine T. Lam
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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Liu D, Wu G, Wang S, Zheng X, Che X. Evaluating the Role of Neddylation Modifications in Kidney Renal Clear Cell Carcinoma: An Integrated Approach Using Bioinformatics, MLN4924 Dosing Experiments, and RNA Sequencing. Pharmaceuticals (Basel) 2024; 17:635. [PMID: 38794205 PMCID: PMC11125012 DOI: 10.3390/ph17050635] [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: 04/09/2024] [Revised: 05/07/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Neddylation, a post-translational modification process, plays a crucial role in various human neoplasms. However, its connection with kidney renal clear cell carcinoma (KIRC) remains under-researched. METHODS We validated the Gene Set Cancer Analysis Lite (GSCALite) platform against The Cancer Genome Atlas (TCGA) database, analyzing 33 cancer types and their link with 17 neddylation-related genes. This included examining copy number variations (CNVs), single nucleotide variations (SNVs), mRNA expression, cellular pathway involvement, and methylation. Using Gene Set Variation Analysis (GSVA), we categorized these genes into three clusters and examined their impact on KIRC patient prognosis, drug responses, immune infiltration, and oncogenic pathways. Afterward, our objective is to identify genes that exhibit overexpression in KIRC and are associated with an adverse prognosis. After pinpointing the specific target gene, we used the specific inhibitor MLN4924 to inhibit the neddylation pathway to conduct RNA sequencing and related in vitro experiments to verify and study the specificity and potential mechanisms related to the target. This approach is geared towards enhancing our understanding of the prognostic importance of neddylation modification in KIRC. RESULTS We identified significant CNV, SNV, and methylation events in neddylation-related genes across various cancers, with notably higher expression levels observed in KIRC. Cluster analysis revealed a potential trade-off in the interactions among neddylation-related genes, where both high and low levels of gene expression are linked to adverse prognoses. This association is particularly pronounced concerning lymph node involvement, T stage classification, and Fustat score. Simultaneously, our research discovered that PSMB10 exhibits overexpression in KIRC when compared to normal tissues, negatively impacting patient prognosis. Through RNA sequencing and in vitro assays, we confirmed that the inhibition of neddylation modification could play a role in the regulation of various signaling pathways, thereby influencing the prognosis of KIRC. Moreover, our results underscore PSMB10 as a viable target for therapeutic intervention in KIRC, opening up novel pathways for the development of targeted treatment strategies. CONCLUSION This study underscores the regulatory function and potential mechanism of neddylation modification on the phenotype of KIRC, identifying PSMB10 as a key regulatory target with a significant role in influencing the prognosis of KIRC.
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Affiliation(s)
- Dequan Liu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (D.L.); (G.W.); (S.W.)
| | - Guangzhen Wu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (D.L.); (G.W.); (S.W.)
| | - Shijin Wang
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (D.L.); (G.W.); (S.W.)
| | - Xu Zheng
- Department of Cell Biology, College of Basic Medical Science, Dalian Medical University, Dalian 116011, China
| | - Xiangyu Che
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (D.L.); (G.W.); (S.W.)
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20
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Erdem S, Bertolo R, Campi R, Capitanio U, Amparore D, Anceschi U, Mir MC, Roussel E, Pavan N, Carbonara U, Kara O, Klatte T, Marchioni M, Pecoraro A, Muselaers S, Marandino L, Diana P, Borregales L, Palumbo C, Warren H, Wu Z, Calio A, Ciccarese C, Degirmenci E, Aydin R, Rebez G, Schips L, Simone G, Minervini A, Serni S, Ozcan F. The prognostic role of histomorphological subtyping in nonmetastatic papillary renal cell carcinoma after curative surgery: is subtype really irrelevant? A propensity score matching analysis of a multi-institutional real life data. Urol Oncol 2024; 42:163.e1-163.e13. [PMID: 38443238 DOI: 10.1016/j.urolonc.2024.01.028] [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: 09/02/2023] [Revised: 12/10/2023] [Accepted: 01/25/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND AND AIM The role of histomorphological subtyping is an issue of debate in papillary renal cell carcinoma (papRCC). This multi-institutional study investigated the prognostic role of histomorphological subtyping in patients undergoing curative surgery for nonmetastatic papRCC. PATIENTS AND METHODS A total of 1,086 patients undergoing curative surgery were included from a retrospectively collected multi-institutional nonmetastatic papRCC database. The patients were divided into 2 groups based on histomorphological subtyping (type 1, n = 669 and type 2, n = 417). Furthermore, a propensity score-matching (PSM) cohort in 1:1 ratio (n = 317 for each subtype) was created to reduce the effect of potential confounding variables. The primary outcome of the study, the predictive role of histomorphological subtyping on the prognosis (recurrence free survival [RFS], cancer specific survival [CSS] and overall survival [OS]) in nonmetastatic papRCC after curative surgery, was investigated in both overall and PSM cohorts. RESULTS In overall cohort, type 2 group were older (66 vs. 63 years, P = 0.015) and more frequently underwent radical nephrectomy (37.4% vs. 25.6%, P < 0.001) and lymphadenectomy (22.3% vs. 15.1%, P = 0.003). Tumor size (4.5 vs. 3.8 cm, P < 0.001) was greater, and nuclear grade (P < 0.001), pT stage (P < 0.001), pN stage (P < 0.001), VENUSS score (P < 0.001) and VENUSS high risk (P < 0.001) were significantly higher in type 2 group. 5-year RFS (89.6% vs. 74.2%, P < 0.001), CSS (93.9% vs. 84.2%, P < 0.001) and OS (88.5% vs. 78.5%, P < 0.001) were significantly lower in type 2 group. On multivariable analyses, type 2 was a significant predictor for RFS (HR:1.86 [95%CI:1.33-2.61], P < 0.001) and CSS (HR:1.91 [95%CI:1.20-3.04], P = 0.006), but not for OS (HR:1.27 [95%CI:0.92-1.76], P = 0.150). In PSM cohort balanced with age, gender, symptoms at diagnosis, pT and pN stages, tumor grade, surgical margin status, sarcomatoid features, rhabdoid features, and presence of necrosis, type 2 increased recurrence risk (HR:1.75 [95%CI: 1.16-2.65]; P = 0.008), but not cancer specific mortality (HR: 1.57 [95%CI: 0.91-2.68]; P = 0.102) and overall mortality (HR: 1.01 [95%CI: 0.68-1.48]; P = 0.981) CONCLUSIONS: This multiinstitutional study suggested that type 2 was associated with adverse histopathologic outcomes, and predictor of RFS and CSS after surgical treatment of nonmetastatic papRCC, in overall cohort. In propensity score-matching cohort, type 2 remained the predictor of RFS. Eventhough 5th WHO classification for renal tumors eliminated histomorphological subtyping, these findings suggest that subtyping is relevant from the point of prognostic view.
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Affiliation(s)
- Selcuk Erdem
- Division of Urologic Oncology, Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey; European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands.
| | - Riccardo Bertolo
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, San Carlo Di Nancy Hospital, Rome, Italy
| | - Riccardo Campi
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Unit of Urological Robotic Surgery and Renal Transplantation, Department of Experimental and Clinical Medicine University of Florence, Florence, Italy
| | - Umberto Capitanio
- Department of Urology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daniele Amparore
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; School of Medicine, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Umberto Anceschi
- Department of Urology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Eduard Roussel
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Nicola Pavan
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Umberto Carbonara
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Unit of Andrology and Kidney Transplantation, Department of Emergency and Organ Transplantation-Urology, University of Bari, Bari, Italy
| | - Onder Kara
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Tobias Klatte
- Department of Urology, Helios Klinikum Bad Saarow, Bad Saarow, Germany
| | - Michele Marchioni
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, SS. Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Angela Pecoraro
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Division of Urology, Pederzoli Hospital, Peschiera del Garda, Verona, Italy
| | - Stijn Muselaers
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Laura Marandino
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Pietro Diana
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, IRCCS Humanitas Clinic, Rozzano, Milan, Italy
| | - Leonardo Borregales
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, Weill Cornell Medicine/New York-Presbyterian, New York, NY
| | - Carlotta Palumbo
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Hannah Warren
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Division of Surgery and Interventional Science, University College London, London, UK
| | - Zhenjie Wu
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Anna Calio
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Chiara Ciccarese
- European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands; Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Enes Degirmenci
- Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Resat Aydin
- Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Rebez
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Luigi Schips
- Department of Urology, SS. Annunziata Hospital, G. D'Annunzio University, Chieti, Italy
| | - Giuseppe Simone
- School of Medicine, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Andrea Minervini
- Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, University of Florence, Florence, Italy
| | - Sergio Serni
- Unit of Urological Robotic Surgery and Renal Transplantation, Department of Experimental and Clinical Medicine University of Florence, Florence, Italy
| | - Faruk Ozcan
- Division of Urologic Oncology, Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
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21
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Li XY, Xu YY, Wu SY, Zeng XX, Zhou Y, Cheng GB. Identification of ALDOB as a novel prognostic biomarker in kidney clear cell renal cell carcinoma. Heliyon 2024; 10:e29368. [PMID: 38655323 PMCID: PMC11035059 DOI: 10.1016/j.heliyon.2024.e29368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 04/03/2024] [Accepted: 04/07/2024] [Indexed: 04/26/2024] Open
Abstract
Kidney clear cell renal cell carcinoma (KIRC) is also the most lethal subtype among all kidney cancer subtypes, posing a severe threat to public health. Therefore, it is crucial to identify new, reliable biomarkers in KIRC. Therefore, it is crucial to identify novel, reliable biomarkers associated with KIRC. We analyzed RNA sequence results from TCGA and several GEO datasets. The commonly deregulated gene, ALDOB, was found in multiple data and confirmed its important prognostic value. Subsequently, we explored the specific mechanism by which ALDOB regulates anti-tumor immunity through in vivo and in vitro experiments. We found that ALDOB may play a role in regulating tumor growth by regulating CD8+ T cell infiltration. This is consistent with the results of our immune infiltration-related analysis. In addition, we have also discovered the effect of ALDOB in previous studies on other cancer types. Finally, we concluded that ALDOB may have potential reference value for immunotherapy and can also be used as an independent predictor of prognosis in KIRC.
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Affiliation(s)
- Xiao-yang Li
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
| | - You-yao Xu
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
| | - Sen-yan Wu
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
| | - Xi-xi Zeng
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
- The Joint Innovation Center for Health and Medicine, Quzhou People's Hospital, The Quzhou Afliated Hospital of Wenzhou Medical University, Quzhou, China
| | - Yan Zhou
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
- Department of Nephrology, Quzhou People's Hospital, The Quzhou Afliated Hospital of Wenzhou Medical University, Quzhou, China
| | - Guo-bin Cheng
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
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22
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Kwiatkowski M, Krajewski A, Durślewicz J, Buchholz K, Grzanka D, Gagat M, Zabrzyński J, Klimaszewska-Wiśniewska A. Overexpression of cyclin F/CCNF as an independent prognostic factor for poor survival in clear cell renal cell carcinoma. Sci Rep 2024; 14:9280. [PMID: 38654021 PMCID: PMC11039610 DOI: 10.1038/s41598-024-59437-1] [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: 09/06/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
Cyclin F (encoded by CCNF gene) has been reported to be implicated in the pathobiology of several human cancers. However, its potential clinical significance in clear cell renal cell carcinoma (ccRCC) remains unknown. The present study aimed to evaluate the potential significance of cyclin F, assessed by immunohistochemical (IHC) staining and molecular (bioinformatics) techniques, as a prognostic marker in ccRCC in relation to clinicopathological features and outcomes. IHC staining was performed using two independent ccRCC tissue array cohorts, herein called tissue macroarray (TMA)_1 and tissue microarray (TMA)_2, composed of 108 ccRCCs and 37 histologically normal tissues adjacent to the tumor (NAT) and 192 ccRCCs and 16 normal kidney samples, respectively. The mRNA expression data were obtained from The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) public datasets, followed by bioinformatics analysis of biological mechanisms underlying prognosis. The relationship between immune cell infiltration level and CCNF expression in ccRCC was investigated using the Tumor Immune Estimation Resource 2.0 (TIMER2) and Gene Expression Profiling Interactive Analysis 2 (GEPIA2). Cyclin F expression was significantly elevated in ccRCC lesions compared to both NAT and normal renal tissues. Likewise, CCNF mRNA was markedly increased in ccRCCs relative to non-cancerous tissues. In all analyzed cohorts, tumors with features of more aggressive behavior were more likely to display cyclin F/CCNF-high expression than low. Furthermore, patients with high cyclin F/CCNF expression had shorter overall survival (OS) times than those with low expression. In addition, multivariable analysis revealed that cyclin F/CCNF-high expression was an independent prognostic factor for poor OS in ccRCC. Enrichment analysis for mechanistically relevant processes showed that CCNF and its highly correlated genes initiate the signaling pathways that eventually result in uncontrolled cell proliferation. CCNF expression was also correlated with immune cell infiltration and caused poor outcomes depending on the abundance of tumor-infiltrating immune cells in ccRCC. Our findings suggest that cyclin F/CCNF expression is likely to have an essential role in ccRCC pathobiology through regulating multiple oncogenic signaling pathways and affecting the tumor immune microenvironment and may serve as prognostic biomarker and promising therapeutic target in ccRCC.
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Affiliation(s)
- Maciej Kwiatkowski
- Department of Urology and Urological Oncology, Multidisciplinary Hospital of Ludwik Blażek, Inowrocław, Poland
| | - Adrian Krajewski
- Department of Histology and Embryology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Justyna Durślewicz
- Department of Clinical Pathomorphology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Karolina Buchholz
- Department of Clinical Pathomorphology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
- Department of Histology and Embryology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Dariusz Grzanka
- Department of Clinical Pathomorphology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Maciej Gagat
- Department of Histology and Embryology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
- Faculty of Medicine, Collegium Medicum, Mazovian Academy, Płock, Poland
| | - Jan Zabrzyński
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Anna Klimaszewska-Wiśniewska
- Department of Clinical Pathomorphology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.
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23
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Lin L, Gong S, Deng C, Zhang G, Wu J. PTK6: An emerging biomarker for prognosis and immunotherapeutic response in clear cell renal carcinoma (KIRC). Heliyon 2024; 10:e29001. [PMID: 38596018 PMCID: PMC11002233 DOI: 10.1016/j.heliyon.2024.e29001] [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: 09/09/2023] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024] Open
Abstract
Kidney renal clear cell carcinoma (KIRC), one of the most prevalent form of kidney carcinoma, is highly aggressive cancer known for significant immune infiltration and high mortality rates. The absence of sensitivity to traditional therapy has spurred the search for new treatments. Protein Tyrosine Kinase 6 (PTK6) is implicated in promoting cancer growth, spread, and metastasis. Our review of The Cancer Genome Atlas database revealed PTK6 overexpression in KIRC, though its specific role in this cancer type was unclear. We investigated PTK6's cancer-promoting roles in KIRC using the database and confirmed our findings with patient-derived tissues. Our analysis showed that elevated PTK6 expression is linked to worse outcomes and higher levels of immune infiltration. It also correlates positively with neo-antigens (NEO) and DNA ploidy changes in KIRC. This research delves into PTK6's role in KIRC development, suggesting PTK6 as a possible biomarker for prognosis and treatment in KIRC.
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Affiliation(s)
- Lizhen Lin
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Obesity and its Metabolic Complications, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Siming Gong
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chao Deng
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guanxiong Zhang
- The Department of Dermatology, Xiangya Hospital, Central South University, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, China
- Furong Laboratory, Changsha, Hunan, China
| | - Jing Wu
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Obesity and its Metabolic Complications, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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24
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Hong H, Shi X, Ou W, Ou P. Prognostic biomarker CPEB3 and its associations with immune infiltration in clear cell renal cell carcinoma. Biomed Rep 2024; 20:63. [PMID: 38476610 PMCID: PMC10928475 DOI: 10.3892/br.2024.1751] [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: 09/01/2023] [Accepted: 01/17/2024] [Indexed: 03/14/2024] Open
Abstract
The role and underlying mechanism of cytoplasmic polyadenylation element binding protein 3 (CPEB3) in clear cell renal cell carcinoma [ccRCC progression remain poorly characterized. The present study was designed to evaluate the role of CPEB3 in ccRCC and its clinical associations. The overall response rate of first-line therapies (ICIs combined with VEGFR-TKIs or ICI combination) for ccRCC] is 42.0-59.3%, so a number of patients with ccRCC do not benefit from these therapies. To avoid immunosurveillance and immune killing, tumor cells decrease immunogenicity and recruit immunosuppressive cells such as regulatory T cells (Tregs). Tregs inhibit the development of anti-tumor immunity, thereby hindering immune surveillance of cancer and preventing effective anti-tumor immune response in tumor-bearing hosts. The present study analyzed clinical specimens from patients ccRCC and then examined the role of CPEB3 in ccRCC via bioinformatics analysis. CPEB3 expression was significantly reduced in ccRCC compared with normal tissue and low CPEB3 expression was associated with poor overall survival. Moreover, CPEB3 expression was an independent predictor of survival. CPEB3 expression was positively associated with immune biomarkers [CD274, programmed cell death 1 ligand 2, Hepatitis a virus cellular receptor 2, Chemokine (C-X-C motif) ligand (CXCL)9, CXCL10, Inducible T cell costimulatory, CD40, CD80 and CD38] that improve the outcome of anti-tumor immune responses. CPEB3 expression in ccRCC also affected the status of 24 types of infiltrating immune cell, of which Tregs were the most significantly negatively correlated cell type. CPEB3 may serve as a prognostic biomarker in ccRCC and its mechanism may be related to the regulation of Tregs.
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Affiliation(s)
- Hualan Hong
- Department of Medical Oncology, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350000, P.R. China
- Department of Medical Oncology, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350000, P.R. China
| | - Xi Shi
- Department of Medical Oncology, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350000, P.R. China
- Department of Medical Oncology, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350000, P.R. China
| | - Wenyong Ou
- Department of Surgery 1, Longyan People Hospital, Longyan, Fujian 364000, P.R. China
| | - Pengju Ou
- Department of Medical Oncology, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350000, P.R. China
- Department of Medical Affairs, Guangzhou Lupeng Pharmaceutical Co., Ltd. Guangzhou, Guangdong 510000, P.R. China
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25
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Jia L, Cowell LG, Kapur P. Understanding Factors that Influence Prognosis and Response to Therapy in Clear Cell Renal Cell Carcinoma. Adv Anat Pathol 2024; 31:96-104. [PMID: 38179997 DOI: 10.1097/pap.0000000000000428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
In this review, we highlight and contextualize emerging morphologic prognostic and predictive factors in renal cell carcinoma. We focus on clear cell renal cell carcinoma (ccRCC), the most common histologic subtype. Our understanding of the molecular characterization of ccRCC has dramatically improved in the last decade. Herein, we highlight how these discoveries have laid the foundation for new approaches to prognosis and therapeutic decision-making for patients with ccRCC. We explore the clinical relevance of common mutations, established gene expression signatures, intratumoral heterogeneity, sarcomatoid/rhabdoid morphology and PD-L1 expression, and discuss their impact on predicting response to therapy.
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Affiliation(s)
| | - Lindsay G Cowell
- Peter O'Donnell School of Public Health
- Kidney Cancer Program at Simmons Comprehensive Cancer Center, Dallas, TX
| | - Payal Kapur
- Department of Pathology
- Department of Urology, University of Texas Southwestern Medical Center
- Kidney Cancer Program at Simmons Comprehensive Cancer Center, Dallas, TX
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26
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Lyskjær I, Iisager L, Axelsen CT, Nielsen TK, Dyrskjøt L, Fristrup N. Management of Renal Cell Carcinoma: Promising Biomarkers and the Challenges to Reach the Clinic. Clin Cancer Res 2024; 30:663-672. [PMID: 37874628 PMCID: PMC10870122 DOI: 10.1158/1078-0432.ccr-23-1892] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/23/2023] [Accepted: 09/27/2023] [Indexed: 10/25/2023]
Abstract
The incidence of renal cell carcinoma (RCC) is increasing worldwide, yet research within this field is lagging behind other cancers. Despite increased detection of early disease as a consequence of the widespread use of diagnostic CT scans, 25% of patients have disseminated disease at diagnosis. Similarly, around 25% progress to metastatic disease following curatively intended surgery. Surgery is the cornerstone in the treatment of RCC; however, when the disease is disseminated, immunotherapy or immunotherapy in combination with a tyrosine kinase inhibitor is the patient's best option. Immunotherapy is a potent treatment, with durable treatment responses and potential to cure the patient, but only half of the patients benefit from the administered treatment, and there are currently no methods that can identify which patients will respond to immunotherapy. Moreover, there is a need to identify the patients in greatest risk of relapsing after surgery for localized disease and direct adjuvant treatment there. Even though several molecular biomarkers have been published to date, we are still lacking routinely used biomarkers to guide optimal clinical management. The purpose of this review is to highlight some of the most promising biomarkers, discuss the efforts made within this field to date, and describe the barriers needed to be overcome to have reliable and robust predictive and prognostic biomarkers in the clinic for renal cancer.
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Affiliation(s)
- Iben Lyskjær
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Laura Iisager
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Lars Dyrskjøt
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Fristrup
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
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27
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Gross-Goupil M, Bodnar L, Campbell MT, Michael A, Venugopal B, Żołnierek J, Dutailly P, Procopio G, Albiges L. Cabozantinib in the Routine Management of Renal Cell Carcinoma: A Systematic Literature Review of Real-World Evidence. Clin Genitourin Cancer 2024; 22:84-97. [PMID: 38101983 DOI: 10.1016/j.clgc.2023.11.001] [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: 10/05/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 12/17/2023]
Abstract
Real-world cabozantinib use has increased since its approval to treat patients with advanced renal cell carcinoma (RCC) in 2016. We reviewed cabozantinib use in real-world clinical practice and compared outcomes with pivotal cabozantinib randomized control trials (RCTs). This PRISMA-standard systematic literature review evaluated real-world effectiveness and tolerability of cabozantinib in patients with RCC (PROSPERO registration: CRD42021245854). Systematic MEDLINE, Embase, and Cochrane database searches were conducted on November 2, 2022. Eligible publications included ≥ 20 patients with RCC receiving cabozantinib. After double-screening for eligibility, standardized data were abstracted, qualitatively summarized, and assessed for risk of bias using the Newcastle-Ottawa Scale. Of 353 screened publications, 41 were included, representing approximately 11,000 real-world patients. Most publications reported cabozantinib monotherapy cohort studies (40/41) of retrospective (39/41) and multicenter (32/41) design; most included patients from North America and/or Europe (30/41). Baseline characteristics were demographically similar between real-world and pivotal RCT populations, but real-world populations showed greater variation in prevalence of prior nephrectomy, multiple-site/brain metastasis, and nonclear-cell RCC histology. Cabozantinib activity was reported across real-world treatment lines and tumor types. Overall survival, progression-free survival, and objective response rate values from pivotal RCTs were within the ranges reported for equivalent outcomes across real-world studies. Common real-world grade ≥ 3 adverse events were consistent with those in pivotal RCTs (fatigue, palmar-plantar erythrodysesthesia syndrome, diarrhea, hypertension), but less frequent. No new tolerability concerns were identified. Real-world RCC survival outcomes for cabozantinib monotherapy were broadly consistent with pivotal RCTs, despite greater heterogeneity in real-world populations.
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Affiliation(s)
| | - Lubomir Bodnar
- University of Natural Sciences and Humanities in Siedlce, Institute of Health Sciences, Siedlce, Poland
| | | | - Agnieszka Michael
- University of Surrey, School of Biosciences and Medicine, Guildford, UK
| | - Balaji Venugopal
- Beatson West of Scotland Cancer Centre and University of Glasgow, Glasgow, UK
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28
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Zhao R, Liang Z, Chu J, Zheng Q, Zhao J, Tang S, Chen Q, Huang Y, Zhou X, Pan X. Downregulation of NEBL promotes migration and invasion of clear cell renal cell carcinoma by inducing epithelial-mesenchymal transition. Pathol Res Pract 2024; 254:155068. [PMID: 38215565 DOI: 10.1016/j.prp.2023.155068] [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: 05/27/2023] [Revised: 10/04/2023] [Accepted: 12/27/2023] [Indexed: 01/14/2024]
Abstract
As a member of the nebulin protein family and a structural protein of cytoskeleton, NEBL plays an important role in cardiac diseases. Recently, literature have reported the involvement of NEBL in the occurrence and development of various cancers except clear cell renal cell carcinoma (ccRCC). In this study, we found that mRNA and protein of NEBL are downregulated remarkably in ccRCC tissues based on both the TCGA database and clinical samples we collected. The areas under curve values of NEBL analyzed based on the TCGA database, qRT-PCR and IHC results were 0.9376, 0.9733 and 0.9807, respectively. The lower mRNA level of NEBL was associated with worse outcomes in ccRCC patients. When overexpressing NEBL in ccRCC cell lines, the proliferation, migration and invasion of ccRCC cells were suppressed significantly, suggesting a tumor suppressor role of NEBL. In addition, we identified that NEBL is closely related to epithelial-mesenchymal transition (EMT), thereby reducing the motility of ccRCC cells. Furthermore, the lower expression of NEBL was correlated with ccRCC patients with distant organ metastasis. In summary, we firstly described the aberrant expression of NEBL and revealed its tumor suppressor role in ccRCC. Our data support that NEBL could serve as a valuable diagnostic and prognostic biomarker in ccRCC, as well as a promising therapeutic target.
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Affiliation(s)
- Ran Zhao
- Life Science Institute, Guangxi Medical University, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Ziyuan Liang
- Life Science Institute, Guangxi Medical University, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Jiemei Chu
- Life Science Institute, Guangxi Medical University, China
| | - Qian Zheng
- Life Science Institute, Guangxi Medical University, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Jun Zhao
- Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Shiyue Tang
- Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Qiaoli Chen
- Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Yiying Huang
- Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China
| | - Xiaoying Zhou
- Life Science Institute, Guangxi Medical University, China.
| | - Xinli Pan
- Guangxi Key Laboratory of Marine Natural Products and Combinatorial Biosynthesis Chemistry, Guangxi Academy of Sciences, China.
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29
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Wang K, Dong L, Li S, Liu Y, Niu Y, Li G. CT features based preoperative predictors of aggressive pathology for clinical T1 solid renal cell carcinoma and the development of nomogram model. BMC Cancer 2024; 24:148. [PMID: 38291357 PMCID: PMC10826073 DOI: 10.1186/s12885-024-11870-1] [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: 10/27/2023] [Accepted: 01/12/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND We aimed to identify preoperative predictors of aggressive pathology for cT1 solid renal cell carcinoma (RCC) by combining clinical features with qualitative and quantitative CT parameters, and developed a nomogram model. METHODS We conducted a retrospective study of 776 cT1 solid RCC patients treated with partial nephrectomy (PN) or radical nephrectomy (RN) between 2018 and 2022. All patients underwent four-phase contrast-enhanced CT scans and the CT parameters were obtained by two experienced radiologists using region of interest (ROI). Aggressive pathology was defined as patients with nuclear grade III-IV; upstage to pT3a; type II papillary renal cell carcinoma (pRCC), collecting duct or renal medullary carcinoma, unclassified RCC or sarcomatoid/rhabdoid features. Univariate and multivariate logistic analyses were used to determine significant predictors and develop the nomogram model. To evaluate the accuracy and clinical utility of the nomogram model, we used the receiver operating characteristic (ROC) curve, calibration plot, decision curve analysis (DCA), risk stratification, and subgroup analysis. RESULTS Of the 776 cT1 solid RCC patients, 250 (32.2%) had aggressive pathological features. The interclass correlation coefficient (ICC) of CT parameters accessed by two reviewers ranged from 0.758 to 0.982. Logistic regression analyses showed that neutrophil-to-lymphocyte ratio (NLR), distance to the collecting system, CT necrosis, tumor margin irregularity, peritumoral neovascularity, and RER-NP were independent predictive factors associated with aggressive pathology. We built the nomogram model using these significant variables, which had an area under the curve (AUC) of 0.854 in the ROC curve. CONCLUSIONS Our research demonstrated that preoperative four-phase contrast-enhanced CT was critical for predicting aggressive pathology in cT1 solid RCC, and the constructed nomogram was useful in guiding patient treatment and postoperative follow-up.
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Affiliation(s)
- Keruo Wang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Liang Dong
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Songyang Li
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yaru Liu
- Department of Pulmonary & Critical Care Medicine, 8th Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yuanjie Niu
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.
| | - Gang Li
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.
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30
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Xin Z, Wen X, Zhou M, Lin H, Liu J. Identification of molecular characteristics of FUT8 and alteration of core fucosylation in kidney renal clear cell cancer. Aging (Albany NY) 2024; 16:2299-2319. [PMID: 38277230 PMCID: PMC10911337 DOI: 10.18632/aging.205482] [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: 09/13/2023] [Accepted: 12/04/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Kidney renal clear cell cancer (KIRC) is a type of urological cancer that occurs worldwide. Core fucosylation (CF), as the most common post-translational modification, is involved in the tumorigenesis. METHODS The alterations of CF-related genes were summarized in pan-cancer. The "ConsensusClusterPlus" package was utilized to identify two CF-related KIRC subtypes. The "ssgsea" function was chosen to estimate the CF score, signaling pathways and cell deaths. Multiple algorithms were applied to assess immune responses. The "oncoPredict" was utilized to estimate the drug sensitivity. The IHC and subgroup analysis was performed to reveal the molecular features of FUT8. Single-cell RNA sequencing (scRNA-seq) data were scrutinized to evaluate the CF state. RESULTS In pan-cancer, there was a noticeable alteration in the expression of CF-related genes. In KIRC, two CF-related subtypes (i.e., C1, C2) were obtained. In comparison to C2, C1 exhibited a higher CF score and correlated with poorer overall survival. Additionally, the TME of C2 demonstrated increased activity in neutrophils, macrophages, myeloid dendritic cells, and B cells, alongside a higher presence of silent mast cells, NK cells, and endothelial cells. Compared to normal samples, higher expression of FUT8 is observed in KIRC. The mutation of SETD2 was more frequent in low-FUT8 samples while the mutation of DNAH9 was more frequent in high-FUT8 samples. scRNA-seq analyses revealed that the CF score was predominantly higher in endothelial cells and fibroblast cells. CONCLUSIONS Two CF-related subtypes with distinct prognosis and TME were identified in KIRC. FUT8 exhibited elevated expression in KIRC samples.
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Affiliation(s)
- Zhu Xin
- Department of Nephrology, The First Affiliated Hospital of Dalian Medical University, Key Laboratory of Kidney Disease of Liaoning Province, The Center for the Transformation Medicine of Kidney Disease of Liaoning Province, Dalian, China
- Liaoning Laboratory of Cancer Genomics and Epigenomics, College of Basic Medical Sciences, Dalian Medical University, Dalian, China
| | - Xinyu Wen
- Department of Nephrology, The First Affiliated Hospital of Dalian Medical University, Key Laboratory of Kidney Disease of Liaoning Province, The Center for the Transformation Medicine of Kidney Disease of Liaoning Province, Dalian, China
| | - Mengying Zhou
- Department of Nephrology, The First Affiliated Hospital of Dalian Medical University, Key Laboratory of Kidney Disease of Liaoning Province, The Center for the Transformation Medicine of Kidney Disease of Liaoning Province, Dalian, China
| | - Hongli Lin
- Department of Nephrology, The First Affiliated Hospital of Dalian Medical University, Key Laboratory of Kidney Disease of Liaoning Province, The Center for the Transformation Medicine of Kidney Disease of Liaoning Province, Dalian, China
| | - Jia Liu
- Liaoning Laboratory of Cancer Genomics and Epigenomics, College of Basic Medical Sciences, Dalian Medical University, Dalian, China
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31
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Luo Y, Zhu M, Wei X, Xu J, Pan S, Liu G, Song Y, Hu W, Dai Y, Wu G. Investigation of clear cell renal cell carcinoma grades using diffusion-relaxation correlation spectroscopic imaging with optimized spatial-spectrum analysis. Br J Radiol 2024; 97:135-141. [PMID: 38263829 PMCID: PMC11008501 DOI: 10.1093/bjr/tqad003] [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: 06/12/2023] [Revised: 09/28/2023] [Accepted: 10/10/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVES To differentiate high-grade from low-grade clear cell renal cell carcinoma (ccRCC) using diffusion-relaxation correlation spectroscopic imaging (DR-CSI) spectra in an equal separating analysis. METHODS Eighty patients with 86 pathologically confirmed ccRCCs who underwent DR-CSI were enrolled. Two radiologists delineated the region of interest. The spectrum was derived based on DR-CSI and was further segmented into multiple equal subregions from 2*2 to 9*9. The agreement between the 2 radiologists was assessed by the intraclass correlation coefficient (ICC). Logistic regression was used to establish the regression model for differentiation, and 5-fold cross-validation was used to evaluate its accuracy. McNemar's test was used to compare the diagnostic performance between equipartition models and the traditional parameters, including the apparent diffusion coefficient (ADC) and T2 value. RESULTS The inter-reader agreement decreased as the divisions in the equipartition model increased (overall ICC ranged from 0.859 to 0.920). The accuracy increased from the 2*2 to 9*9 equipartition model (0.68 for 2*2, 0.69 for 3*3 and 4*4, 0.70 for 5*5, 0.71 for 6*6, 0.78 for 7*7, and 0.75 for 8*8 and 9*9). The equipartition models with divisions >7*7 were significantly better than ADC and T2 (vs ADC: P = .002-.008; vs T2: P = .001-.004). CONCLUSIONS The equipartition method has the potential to analyse the DR-CSI spectrum and discriminate between low-grade and high-grade ccRCC. ADVANCES IN KNOWLEDGE The evaluation of DR-CSI relies on prior knowledge, and how to assess the spectrum derived from DR-CSI without prior knowledge has not been well studied.
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Affiliation(s)
- Yuansheng Luo
- Department of Radiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mengying Zhu
- Department of Radiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaobin Wei
- Department of Radiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jianrong Xu
- Department of Radiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Shihang Pan
- Department of Radiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Guiqin Liu
- Department of Radiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Song
- MR Scientific Marketing, Siemens Healthineers Ltd., 200129 Shanghai, China
| | - Wentao Hu
- Department of Radiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yongming Dai
- School of Biomedical Engineering, Shanghai Tech University, 201210 Shanghai, China
| | - Guangyu Wu
- Department of Radiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
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Xi P, Zhang Z, Liu Y, Nie Y, Gong B, Liu J, Huang H, Liu Z, Sun T, Xie W. Multidimensional comprehensive and integrated analysis of the potential function of TMEM25 in renal clear cell carcinoma with low expression status. Aging (Albany NY) 2024; 16:367-388. [PMID: 38189809 PMCID: PMC10817401 DOI: 10.18632/aging.205372] [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: 09/04/2023] [Accepted: 11/21/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Transmembrane 25(TMEM25) stands out as a potential prognostic biomarker and therapeutic target in the realm of cancer, yet its precise mechanism of action within clear cell renal cell carcinoma (ccRCC) remains unclear. MATERIALS AND METHODS Gene expression data and clinically relevant information extracted from The Cancer Genome Atlas (TCGA) and Gene expression omnibus (GEO) databases unveil the expression patterns of TMEM25 within renal clear cell carcinoma, which reveals its prognostic and diagnostic significance. The protein expression data is available via the Human Protein Atlas (HPA) database. Further, qPCR experiments conducted on cells and tissues provide strong evidence of the gene's expression status. Additionally, they explore the correlations between TMEM25 expression and DNA methylation, gene mutations, immune cell infiltration, and drug sensitivity within this specific tumor context. RESULTS At both the RNA and protein levels, TMEM25 displays a noteworthy downregulation in expression, which is consistently linked to an unfavorable prognosis. Receiver Operating Characteristic (ROC) curve analysis, univariate and multivariate Cox regression analyses confirmed the ability of TMEM25 to diagnose and determine prognosis in ccRCC. Its expression related closely with various immune cell types, immune checkpoints, immune inhibitors, and MHC molecules. Within ccRCC tissues, TMEM25 DNA methylation levels are observed to be elevated, and this upregulation is observed across various conditions. TMEM25 mutations also have an impact on the prognosis of ccRCC patients and the results of drug sensitivity analyses are useful for clinical decision-making. CONCLUSIONS TMEM25 in ccRCC could potentially function as a tumor suppressor gene, holding substantial promise as a novel biomarker for diagnosing, treating, and prognosticating ccRCC patients.
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Affiliation(s)
- Ping Xi
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Zhicheng Zhang
- Department of Surgery, Fuzhou First People’s Hospital, Fuzhou 344000, Jiangxi Province, China
| | - Yifu Liu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Yechen Nie
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Binbin Gong
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Ji Liu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Hao Huang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Ziwen Liu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Ting Sun
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Wenjie Xie
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
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Sun X, Li W, Fu B, Peng Y, He J, Wang L, Yang T, Meng X, Li J, Wang J, Huang P, Wang R. TGMIL: A hybrid multi-instance learning model based on the Transformer and the Graph Attention Network for whole-slide images classification of renal cell carcinoma. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 242:107789. [PMID: 37722310 DOI: 10.1016/j.cmpb.2023.107789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND AND OBJECTIVES The pathological diagnosis of renal cell carcinoma is crucial for treatment. Currently, the multi-instance learning method is commonly used for whole-slide image classification of renal cell carcinoma, which is mainly based on the assumption of independent identical distribution. But this is inconsistent with the need to consider the correlation between different instances in the diagnosis process. Furthermore, the problem of high resource consumption of pathology images is still urgent to be solved. Therefore, we propose a new multi-instance learning method to solve this problem. METHODS In this study, we proposed a hybrid multi-instance learning model based on the Transformer and the Graph Attention Network, called TGMIL, to achieve whole-slide image of renal cell carcinoma classification without pixel-level annotation or region of interest extraction. Our approach is divided into three steps. First, we designed a feature pyramid with the multiple low magnifications of whole-slide image named MMFP. It makes the model incorporates richer information, and reduces memory consumption as well as training time compared to the highest magnification. Second, TGMIL amalgamates the Transformer and the Graph Attention's capabilities, adeptly addressing the loss of instance contextual and spatial. Within the Graph Attention network stream, an easy and efficient approach employing max pooling and mean pooling yields the graph adjacency matrix, devoid of extra memory consumption. Finally, the outputs of two streams of TGMIL are aggregated to achieve the classification of renal cell carcinoma. RESULTS On the TCGA-RCC validation set, a public dataset for renal cell carcinoma, the area under a receiver operating characteristic (ROC) curve (AUC) and accuracy of TGMIL were 0.98±0.0015,0.9191±0.0062, respectively. It showcased remarkable proficiency on the private validation set of renal cell carcinoma pathology images, attaining AUC of 0.9386±0.0162 and ACC of 0.9197±0.0124. Furthermore, on the public breast cancer whole-slide image test dataset, CAMELYON 16, our model showed good classification performance with an accuracy of 0.8792. CONCLUSIONS TGMIL models the diagnostic process of pathologists and shows good classification performance on multiple datasets. Concurrently, the MMFP module efficiently diminishes resource requirements, offering a novel angle for exploring computational pathology images.
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Affiliation(s)
- Xinhuan Sun
- Engineering Research Center of Text Computing & Cognitive Intelligence, Ministry of Education, Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, State Key Laboratory of Public Big Data, College of Computer Science and Technology, Guizhou University, Guiyang, 550025, China; Department of Radiology, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Wuchao Li
- Department of Radiology, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Bangkang Fu
- Department of Radiology, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Yunsong Peng
- Department of Radiology, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Junjie He
- Engineering Research Center of Text Computing & Cognitive Intelligence, Ministry of Education, Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, State Key Laboratory of Public Big Data, College of Computer Science and Technology, Guizhou University, Guiyang, 550025, China; Department of Radiology, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Lihui Wang
- Engineering Research Center of Text Computing & Cognitive Intelligence, Ministry of Education, Key Laboratory of Intelligent Medical Image Analysis and Precise Diagnosis of Guizhou Province, State Key Laboratory of Public Big Data, College of Computer Science and Technology, Guizhou University, Guiyang, 550025, China
| | - Tongyin Yang
- Department of Pathology, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Xue Meng
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
| | - Jin Li
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
| | - Jinjing Wang
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
| | - Ping Huang
- Department of Pathology, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Rongpin Wang
- Department of Radiology, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, Guizhou Provincial People's Hospital, Guiyang, 550002, China.
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Jia Z, Fu Z, Kong Y, Wang C, Zhou B, Lin Y, Huang Y. Fatty acid metabolism-related genes as a novel module biomarker for kidney renal clear cell carcinoma: Bioinformatics modeling with experimental verification. Transl Oncol 2023; 38:101774. [PMID: 37708719 PMCID: PMC10502355 DOI: 10.1016/j.tranon.2023.101774] [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: 03/21/2023] [Accepted: 08/24/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUNDS Lipid metabolism reprogramming is a hallmark of cancer, however, the associations between fatty acid metabolism (FAM) and kidney renal clear cell carcinoma (KIRC) prognosis are still less investigated. METHODS The gene expression and clinical data of KIRC were obtained from TCGA. Using Cox regression and LASSO regression, a novel prognostic risk score model based on FAM-related genes was constructed, and a nomogram for prediction of overall survival rate of patients with KIRC was proposed. The correlation between risk score and the immune cell infiltration, immune-related function and tumor mutation burden (TMB) were explored. Finally, a hub gene was extracted from the model, and RT-qPCR, Western blot, Immunohistochemical, EdU, Scratch assay and Transwell experiments were conducted to validate and decipher the biomarker role of the hub gene in KIRC theranostics. RESULTS In this study, a novel risk score model and a nomogram were constructed based on 20 FAM-related genes to predict the prognosis of KIRC patients with AUC>0.7 at 1-, 3-, and 5-years. Patients in different subgroups showed different phenotypes in immune cell infiltration, immune-related function, TMB, and sensitivity to immunotherapy. In particular, the hub gene in the model, i.e., ACADM, was significantly down-expressed in human KIRC samples, and the knockdown of OCLN promoted proliferation, migration and invasion of KIRC cells in vitro. CONCLUSIONS In this study, a novel risk score model and a module biomarker based on FAM-related genes were screened for KIRC prognosis. More clinical carcinogenic validations will be performed for future translational applications of the findings.
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Affiliation(s)
- Zongming Jia
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Zhenyu Fu
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, China; Department of Urology, ChangShu No.2 People's Hospital, 18 Taishan Road, C hangshu, Suzhou 215500, China
| | - Ying Kong
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Chengyu Wang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Bin Zhou
- Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou 215000, China; Jiangsu Key Laboratory of Clinical Immunology, Soochow University, China; Jiangsu Key Laboratory of Gastrointestinal tumor Immunology, China
| | - Yuxin Lin
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, China; Center for Systems Biology, Soochow University, Suzhou 215123, China.
| | - Yuhua Huang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, China.
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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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Zhang B, Han D, Yang L, He Y, Yang S, Wang H, Zhang X, Du Y, Xiong W, Ha H, Shang P. The mitochondrial fusion-associated protein MFN2 can be used as a novel prognostic molecule for clear cell renal cell carcinoma. BMC Cancer 2023; 23:986. [PMID: 37845657 PMCID: PMC10577979 DOI: 10.1186/s12885-023-11419-8] [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: 01/26/2023] [Accepted: 09/19/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Mitofusin 2 (MFN2) plays an important role in many tumors, but how its role in renal clear cell carcinoma needs further research. METHODS In this study, we analyzed the expression of MFN2 in renal clear cell carcinoma tissues and normal kidney tissues through the Cancer Genome Atlas (TCGA) database and our clinical samples.Enrichment analysis was performed to determine MFN2-related pathways and biological functions. The correlation of MFN2 expression with immune cells was analyzed.The correlation of the expression of methylation and the methylation sites of MFN2 were analyzed by UALCAN and TCGA databases. Univariate / multivariate COX risk regression and Kaplan-Meier methods were used to determine the prognostic value of MFN2.Nomograms were drawn to predict overall survival (OS) at 1,3, and 5 years. We investigated the role of MFN2 in renal cancer cells using CCK 8, clone formation, wound healing assay, and methylase qPCR experiments. RESULTS MFN2 is poorly expressed in renal clear cell carcinoma compared to normal kidney tissue,and is significantly negatively associated with TNM stage, histological grade and pathological stage.MFN2 was directly associated with OS after multivariate Cox regression analysis.MFN2 shows a hypomethylation state and shows a positive correlation with multiple methylation sites.Signaling pathways through functional enrichment to B-cell receptors and oxidative stress-induced senescence.Moreover, the low expression of MFN2 was positively correlated with the degree of immune cell infiltration in a variety of immune cells.In vitro experiments showed that overexpression of MFN2 significantly inhibited the proliferation and migration of renal clear cells and promoted methylation. CONCLUSIONS In conclusion, MFN2 can be used as a novel prognostic marker for renal clear cell carcinoma and requires further investigation of its role in tumor development.
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Affiliation(s)
- Bin Zhang
- Department of Urology, Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - Dali Han
- Department of Urology, Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - LiMing Yang
- Department of Skin and Venereal Diseases, Jincheng People's Hospital, Jincheng, 048000, Shanxi, China
| | - Yang He
- Department of Urology, Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - Shujun Yang
- Department of Urology, Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - Hongbo Wang
- Department of Urology, Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - Xingxing Zhang
- Department of Urology, Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - Yuelin Du
- Department of Urology, Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - Wei Xiong
- Department of Urology, Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - Hualan Ha
- Department of Urology, Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - Panfeng Shang
- Department of Urology, Institute of Urology, Key Laboratory of Urological Diseases in Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China.
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Zhu C, Sun Z, Wang J, Meng X, Ma Z, Guo R, Niu J, Tran LJ, Zhang J, Jiang T, Liu Y, Ye F, Ma B. Exploring oncogenes for renal clear cell carcinoma based on G protein-coupled receptor-associated genes. Discov Oncol 2023; 14:182. [PMID: 37816979 PMCID: PMC10564696 DOI: 10.1007/s12672-023-00795-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/19/2023] [Indexed: 10/12/2023] Open
Abstract
G protein-coupled receptors (GPCRs) are a class of receptors on cell membranes that regulate various biological processes in cells, such as cell proliferation, differentiation, migration, apoptosis, and metabolism, by interacting with G proteins. However, the role of G protein-coupled receptors in predicting the prognosis of renal clear cell carcinoma is still unknown. The transcriptome data and clinical profiles of renal clear cell carcinoma patients, were downloaded from TCGA databases, and the validation group data were downloaded from number GSE167573, including 63 tumor samples and 14 normal samples. Single-cell RNA sequencing data were downloaded from the GEO database, No. GSE152938 and selected samples were used for GSEA enrichment analysis, WGCNA subgroup analysis, single-cell data analysis, and mutation analysis to explore the role of G protein-coupled receptor-related genes in the diagnosis and prognosis of renal clear cell carcinoma and to verify their reliability with cellular experiments. Finally, this study establishes a disease model based on G protein-coupled receptor-related genes, which may help to propose targeted therapeutic regimens in different strata of renal cell carcinoma patients.Author names: Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author: Given name [Lisa Jia] Last name [Tran].It's ok!
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Affiliation(s)
- Chengcun Zhu
- Department of Urology, The First People’s Hospital of Jiangxia District, Wuhan, 430200 Hubei China
| | - Zhou Sun
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000 Jilin China
| | - Jie Wang
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000 Jilin China
- Department of Urology, The Second People’s Hospital of Meishan City, Meishan, Sichuan China
| | - Xiangdi Meng
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000 Jilin China
| | - Zhaosen Ma
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000 Jilin China
| | - Rui Guo
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000 Jilin China
| | - Jiqiang Niu
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000 Jilin China
| | - Lisa Jia Tran
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Jing Zhang
- Division of Basic Biomedical Sciences, The University of South Dakota Sanford School of Medicine, Vermillion, SD 57069 USA
| | - Tianxiao Jiang
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Yunfei Liu
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Fangdie Ye
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Baoluo Ma
- Department of Urology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei China
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, 130000 Jilin China
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Bayoğlu İV, Hüseynov J, Topal A, Sever N, Majidova N, Çelebi A, Yaşar A, Arıkan R, Işık S, Hacıoğlu MB, Ercelep Ö, Sarı M, Erdoğan B, Hacıbekiroğlu İ, Topaloğlu S, Köstek O, Çiçin İ. PNI as a Potential Add-On Biomarker to Improve the IMDC Intermediate Prognostic Score. J Clin Med 2023; 12:6420. [PMID: 37835062 PMCID: PMC10573811 DOI: 10.3390/jcm12196420] [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: 07/30/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 10/15/2023] Open
Abstract
INTRODUCTION This study aimed to assess the role of the adjusted PNI-IMDC risk scoring system in stratifying the intermediate group of metastatic RCC patients who received TKIS in the first-line setting. METHODS A total of 185 patients were included. The adjusted PNI and IMDC model was used to divide the intermediate group into two groups: intermediate PNI-high and intermediate PNI-low groups. The statistical data were analyzed using Kaplan-Meier and Cox regression analysis. RESULTS The results showed that the adjusted PNI-IMDC risk score, classic IMDC, and PNI had similar prognostic values. Adjusted PNI-IMDC risk score might be used for a more homogeneous differentiation of the classic intermediate group. On the other hand, multivariate analysis revealed that the presence of nephrectomy, adjusted favorable/intermediate (PNI-high) group, ECOG performance score, and presence of bone metastasis were independent predictors of OS. CONCLUSIONS Pre-treatment PNI, as a valuable and potential add-on biomarker to the adjusted PNI-IMDC classification model, can be helpful for establishing an improved prognostic model for intermediate group mRCC patients treated with first-line TKISs. Further validation studies are needed to clarify these findings.
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Affiliation(s)
- İbrahim Vedat Bayoğlu
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Javid Hüseynov
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Alper Topal
- Department of Medical Oncology, School of Medicine, Trakya University, 22000 Edirne, Turkey; (A.T.)
| | - Nadiye Sever
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Nargiz Majidova
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Abdussamet Çelebi
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Alper Yaşar
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Rukiye Arıkan
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Selver Işık
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Muhammet Bekir Hacıoğlu
- Department of Medical Oncology, School of Medicine, Trakya University, 22000 Edirne, Turkey; (A.T.)
| | - Özlem Ercelep
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Murat Sarı
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - Bülent Erdoğan
- Department of Medical Oncology, School of Medicine, Trakya University, 22000 Edirne, Turkey; (A.T.)
| | - İlhan Hacıbekiroğlu
- Department of Medical Oncology, School of Medicine, Sakarya University, 54290 Sakarya, Turkey
| | - Sernaz Topaloğlu
- Department of Medical Oncology, School of Medicine, Trakya University, 22000 Edirne, Turkey; (A.T.)
| | - Osman Köstek
- Department of Medical Oncology, School of Medicine, Marmara University, 34899 Istanbul, Turkey; (J.H.)
| | - İrfan Çiçin
- Department of Medical Oncology, School of Medicine, Trakya University, 22000 Edirne, Turkey; (A.T.)
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Chen TY, Mihalopoulos M, Zuluaga L, Rich J, Ganta T, Mehrazin R, Tsao CK, Tewari A, Gonzalez-Kozlova E, Badani K, Dogra N, Kyprianou N. Clinical Significance of Extracellular Vesicles in Prostate and Renal Cancer. Int J Mol Sci 2023; 24:14713. [PMID: 37834162 PMCID: PMC10573190 DOI: 10.3390/ijms241914713] [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: 07/15/2023] [Revised: 09/02/2023] [Accepted: 09/03/2023] [Indexed: 10/15/2023] Open
Abstract
Extracellular vesicles (EVs)-including apoptotic bodies, microvesicles, and exosomes-are released by almost all cell types and contain molecular footprints from their cell of origin, including lipids, proteins, metabolites, RNA, and DNA. They have been successfully isolated from blood, urine, semen, and other body fluids. In this review, we discuss the current understanding of the predictive value of EVs in prostate and renal cancer. We also describe the findings supporting the use of EVs from liquid biopsies in stratifying high-risk prostate/kidney cancer and advanced disease, such as castration-resistant (CRPC) and neuroendocrine prostate cancer (NEPC) as well as metastatic renal cell carcinoma (RCC). Assays based on EVs isolated from urine and blood have the potential to serve as highly sensitive diagnostic studies as well as predictive measures of tumor recurrence in patients with prostate and renal cancers. Overall, we discuss the biogenesis, isolation, liquid-biopsy, and therapeutic applications of EVs in CRPC, NEPC, and RCC.
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Affiliation(s)
- Tzu-Yi Chen
- Department of Pathology & Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (T.-Y.C.); (A.T.)
| | - Meredith Mihalopoulos
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.M.); (L.Z.); (J.R.); (R.M.); (K.B.)
| | - Laura Zuluaga
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.M.); (L.Z.); (J.R.); (R.M.); (K.B.)
| | - Jordan Rich
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.M.); (L.Z.); (J.R.); (R.M.); (K.B.)
| | - Teja Ganta
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (T.G.); (C.-K.T.)
| | - Reza Mehrazin
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.M.); (L.Z.); (J.R.); (R.M.); (K.B.)
| | - Che-Kai Tsao
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (T.G.); (C.-K.T.)
| | - Ash Tewari
- Department of Pathology & Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (T.-Y.C.); (A.T.)
| | - Edgar Gonzalez-Kozlova
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Ketan Badani
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.M.); (L.Z.); (J.R.); (R.M.); (K.B.)
| | - Navneet Dogra
- Department of Pathology & Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (T.-Y.C.); (A.T.)
| | - Natasha Kyprianou
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.M.); (L.Z.); (J.R.); (R.M.); (K.B.)
- The Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
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Oladejo M, Nguyen HM, Wood L. CD105 in the progression and therapy of renal cell carcinoma. Cancer Lett 2023; 570:216327. [PMID: 37499740 DOI: 10.1016/j.canlet.2023.216327] [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: 04/18/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 07/29/2023]
Abstract
Molecular biomarkers that interact with the vascular and immune compartments play an important role in the progression of solid malignancies. CD105, which is a component of the transforming growth factor beta (TGF β) signaling cascade, has long been studied for its role in potentiating angiogenesis in numerous cancers. In renal cell carcinoma (RCC), the role of CD105 is more complicated due to its diverse expression profile on the tumor cells, tumor vasculature, and the components of the immune system. Since its discovery, its angiogenic role has overshadowed other potential functions, especially in cancers. In this review, we aim to summarize the recent evidence and findings of the multifunctional roles of CD105 in angiogenesis and immunomodulation in the context of the various subtypes of RCC, with a specific emphasis on the clear cell RCC subtype. Since CD105 is an established biomarker and tumor antigen, we also provide an update on the preclinical and clinical applications of CD105 as a therapeutic platform in RCC.
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Affiliation(s)
- Mariam Oladejo
- Department of Immunotherapeutics and Biotechnology, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Abilene, TX, 79601, USA
| | - Hong-My Nguyen
- Department of Immunotherapeutics and Biotechnology, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Abilene, TX, 79601, USA
| | - Laurence Wood
- Department of Immunotherapeutics and Biotechnology, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Abilene, TX, 79601, USA.
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Lei M, Miao J. Factors affecting survival and prognosis in surgically treated patients with spinal metastases arising from renal cell carcinoma. BMC Urol 2023; 23:118. [PMID: 37443069 DOI: 10.1186/s12894-023-01294-7] [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: 03/25/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The objective of this study was to explore the prognostic factors for renal cell carcinoma (RCC) patients with spinal metastasis who underwent surgical treatment in our hospital. METHODS We retrospectively analyzed the clinical data and survival status of 49 patients with spinal metastases arising from RCC. All patients with spinal metastases underwent surgical treatment. We analyzed a range of factors that may affect the prognosis of patients with RCC. Using Kaplan-Meier method to perform univariate analysis of the factors that might affect spine metastasis free survival (SMFS)and survival after spinal metastasis (OS) respectively. Establish Cox proportional hazards model to extract independent prognostic factors for SMFS and OS. RESULTS The mean time of SMFS was 27 months (median 8, range 0-180 months). The mean time of OS was 12.04 months (median 9, range 2-36 months). RCC with visceral metastasis (p = 0.001,HR 11.245,95%CI 2.824-44.776) and AJCC RCC Stage (p = 0.040,HR 2.809,95%CI 1.046-7.543) can significantly affect SMFS. Furthermore, WHO/ISUP Grade (p < 0.001, HR 2.787,95%CI 1.595-4.870), ECOG Score (p = 0.019, HR 0.305,95%CI 0.113-0.825) and multiple spinal metastases (p < 0.001, HR 0.077,95%CI 0.019-0.319) have significant effects on OS. CONCLUSIONS RCC with visceral metastasis and AJCC RCC Stage were independent prognostic factors for SMFS. WHO/ISUP Grade, ECOG Scores and multiple spinal metastases were independent prognostic factors for OS.
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Affiliation(s)
- Ming Lei
- Graduate School, Tianjin Medical University, No. 22, Qi-xiang-tai Road, He-ping District, Tianjin, 300070, China
| | - Jun Miao
- Department of Orthopedics, Tianjin Hospital, Tianjin University, No.406, Jie-fang South Road, Hexi District, Tianjin, 300210, China.
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Lin H, Sun Q, Li Z, Zheng J, Zhang X, Xiong Y, Chen H, Hou Y, Xi W, Lin J. Comparison and validation of different risk models for papillary renal cell carcinoma. Urol Oncol 2023:S1078-1439(23)00192-8. [PMID: 37394414 DOI: 10.1016/j.urolonc.2023.05.017] [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: 11/03/2022] [Revised: 04/05/2023] [Accepted: 05/18/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Several prognostic algorithms were specifically or nonspecifically used for papillary renal cell carcinoma (PRCC). No consensus was reached upon their efficacy of discrimination. We aim to compare the stratifying ability of current models or systems in predicting the risk of recurrence of PRCC. METHODS A PRCC cohort consisting of 308 patients from our institution and 279 patients from The Cancer Genome Atlas (TCGA) was generated. With ISUP grade, TNM classification, UCLA Integrated Staging System (UISS), STAGE, SIZE, GRADE AND NECROSIS (SSIGN), Leibovich model and VENUSS system, recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) were studied using Kaplan-Meier method and concordance index (c-index) was compared. Differences between risk groups in gene mutation and infiltration of inhibitory immune cells were studied with TCGA database. RESULTS All the algorithms were able to stratify patients in RFS as well as DSS and OS (all P < 0.001). VENUSS score and risk group generally had the highest and balanced c-index (0.815 and 0.797 for RFS). ISUP grade, TNM stage and Leibovich model had the lowest c-indexes in all analysis. Among the 25 most frequently mutated genes in PRCC, eight had different mutation frequency between VENUSS low- and intermediate-/high-risk patients and mutated KMT2D and PBRM1 resulted in worsened RFS (P = 0.053 and P = 0.007). Increased Treg cells in tumors of intermediate-/high- risk patients were also identified. CONCLUSIONS VENUSS system showed better predictive accuracy in RFS, DSS and OS compared with SSIGN, UISS and Leibovich risk models. VENUSS intermediate-/high-risk patients had increased frequency of mutation in KMT2D and PBRM1 and increased infiltration of Treg cells.
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Affiliation(s)
- Haiyue Lin
- Department of Pathology, Xuzhou Medical University Affiliated Hospital of Lianyungang, Lianyungang, China
| | - Qi Sun
- Department of Pathology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China; Department of Pathology, Xiamen Clinical Research Center for Cancer Therapy, Xiamen, China
| | - Zeyang Li
- Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jingmei Zheng
- Department of Pathology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China; Department of Pathology, Xiamen Clinical Research Center for Cancer Therapy, Xiamen, China
| | - Xue Zhang
- Department of Radiology, Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Ying Xiong
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Hao Chen
- Department of Pathology, Xuzhou Medical University Affiliated Hospital of Lianyungang, Lianyungang, China
| | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Wei Xi
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Jinglai Lin
- Department of Urology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China; Department of Urology, Xiamen Clinical Research Center for Cancer Therapy, Xiamen, China.
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Monda SM, Lui HT, Pratsinis MA, Chandrasekar T, Evans CP, Dall'Era MA. The Metastatic Risk of Renal Cell Carcinoma by Primary Tumor Size and Subtype. EUR UROL SUPPL 2023; 52:137-144. [PMID: 37284045 PMCID: PMC10240521 DOI: 10.1016/j.euros.2023.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 06/08/2023] Open
Abstract
Background Current data on the association between tumor size, subtype, and metastases, and thresholds for intervention, for renal cell carcinoma (RCC), are largely based on single-center nephrectomy registries that may under-represent those presenting with metastatic disease. Objective We sought to assess tumor size and histologic subtype in relation to metastatic status at presentation for patients with RCC. Design setting and participants Using Surveillance, Epidemiology and End Results cancer registry data, we identified patients with a diagnosis of RCC made between 2004 and 2019, and a known size of primary tumor. We used nodal and metastatic TNM staging to assess metastatic disease at presentation. Outcome measurements and statistical analysis We report the proportion of metastatic disease across varying tumor sizes for clear cell (ccRCC), papillary (pRCC), and chromophobe (chRCC) RCC. We also examine sarcomatoid RCC and RCC with sarcomatoid features (sarcRCC). Logistic regression models were used to model the likelihood of metastatic disease for each histologic subtype. Results and limitations Of 181 096 RCC patients included, 23 829 had metastatic disease. For any RCC, metastatic rates of 3.6%, 13.1%, 30.3%, and 45.1% were observed for tumors ≤4, 4-≤7, 7-≤10, and >10 cm, respectively. Metastatic rates of chRCC were low at even large sizes, 11.0% at >10 cm. In contrast, sarcRCC had high metastatic rates at all sizes, 27.1% at ≤4 cm. Metastatic rates for ccRCC and pRCC increased steadily above 3 cm. For any RCC and each evaluated subtype, tumor size was found to be associated with metastatic disease on logistic regression (p < 0.001). Conclusions The likelihood of a renal mass being metastatic varies greatly with both its subtype and size. We report higher likelihoods of metastatic disease across tumor sizes compared with what has been reported previously. These results may help clinicians pick appropriate thresholds for intervention and candidates for active surveillance. Patient summary We find that the metastatic probability of renal cell carcinoma varies greatly with subtype and increases with tumor size.
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Affiliation(s)
- Steven M. Monda
- Department of Urologic Surgery, University of California Davis, Davis, CA, USA
| | - Hansen T. Lui
- Department of Urologic Surgery, University of California Davis, Davis, CA, USA
| | - Manolis A. Pratsinis
- Department of Urologic Surgery, University of California Davis, Davis, CA, USA
- Department of Urology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
| | | | | | - Marc A. Dall'Era
- Department of Urologic Surgery, University of California Davis, Davis, CA, USA
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Liang Y, Zhang C, Luo J, He Y, Zhang Y, Quan Z, Yang L. Influence of metabolic syndrome on survival of patients with localized renal clear cell carcinoma: A retrospective cohort study in China. Urol Oncol 2023; 41:257.e19-257.e26. [PMID: 36967252 DOI: 10.1016/j.urolonc.2023.01.023] [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: 07/26/2022] [Revised: 12/08/2022] [Accepted: 01/30/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE To assess the effects of metabolic syndrome (MetS) and its components on the survival and prognosis of patients with localized clear cell renal cell carcinoma (ccRCC). DESIGN AND METHODS This retrospective cohort study in Chongqing, China, identified patients with localized ccRCC from two medical centers of Chongqing Medical University between January 1, 2011, and December 31, 2020. The Chinese Medical Association Diabetes Society criteria of 2004 were used to diagnose MetS. Univariate and multivariate Cox proportional hazards regression analyses were conducted to identify independent risk factors for ccRCC. The outcomes were overall survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS). RESULTS In our cohort, 378 eligible patients with localized ccRCC were included (median age, 56; range, 30-85; 255 men [67.5%]), and 87 patients (23.0%) were diagnosed with MetS. The median follow-up time was 66 months (1-126 months). Kaplan-Meier and log-rank analyses showed shorter PFS (P = 0.043) and CSS (P = 0.009) in patients with MetS. Univariate and multivariate Cox regression analyses found that MetS and dyslipidemia were independent risk factors for CSS in patients with localized ccRCC (P = 0.047; P = 0.035). When we analyzed MetS separately, the 4 components of MetS (hypertension, hyperglycemia, overweight/obesity, and dyslipidemia) did not show significant differences in OS, PFS, and CSS. CONCLUSION MetS and dyslipidemia are independent adverse prognostic factors for CSS in patients with localized ccRCC. It is suggested to assign comprehensive therapy and follow-up to this patient population.
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Affiliation(s)
- Ying Liang
- Department of Urology, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Chengguo Zhang
- Department of Urology, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Luo
- Department of Urology, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Yunfeng He
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yao Zhang
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhen Quan
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lin Yang
- Department of Urology, Bishan Hospital of Chongqing Medical University, Chongqing, China.
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Suppiah S, Mohd Rohani MF, Zanial AZ, Ahmad Shahrir AD, Khairuman KA, Vinjamuri S. A Review on the Usage of Bone Single-Photon Emission Computed Tomography/Computed Tomography in Detecting Skeletal Metastases in the Post-COVID-19 Era: Is it Time to Ditch Planar and Single-Photon Emission Computed Tomography only Gamma Camera Systems? Indian J Nucl Med 2023; 38:191-200. [PMID: 37456181 PMCID: PMC10348494 DOI: 10.4103/ijnm.ijnm_142_22] [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: 08/09/2022] [Accepted: 09/08/2022] [Indexed: 07/18/2023] Open
Abstract
Planar whole-body bone scanning (WBS) is widely used to evaluate skeletal lesions seen in cancer and noncancer cases. Frequently, degenerative, or other benign bony changes may give rise to indeterminate lesions that mimic bone metastases. In the post-COVID-19 era, there is an evolutionary phase that puts importance on global development and adaptability, which encompasses to include nuclear medicine practices worldwide. Single-photon emission computed tomography/computed tomography (SPECT/CT) can be used to improve the characterization of these lesions and help to resolve the diagnostic conundrum while reducing the need for patients to undergo multiple different examinations at various imaging departments. The fusion of SPECT and CT allows morphological characterization of functional abnormality detected by focal tracer uptake on planar scintigraphy, which provides a one-stop center imaging in nuclear medicine departments. The objective of this study was to review the diagnostic accuracy of SPECT/CT in diagnosing bone metastases in a variety of oncology and nononcology cases and to determine the feasibility of performing bone SPECT/CT in all suspected cancer cases, including cases of bone infection instead of planar imaging alone. The utilization of hybrid SPECT/CT in indeterminate bone lesions detected on planar WBS can significantly increase the diagnostic confidence and accuracy of image interpretation. Recognition of patterns of disease identified using hybrid imaging can improve the management of patients with potentially lower costs in the long term. Currently, hybrid SPECT/CT machines are becoming a norm in nuclear medicine departments, thus potentially making single planar application machines obsolete in the near future. We hypothesize that in the interest of providing a meaningful interpretation of isotope bone scans, the default protocol should involve the option of acquiring SPECT/CT images rather than relying on whole-body scans only. Departments choosing to upgrade existing equipment or those choosing to invest in only one gamma camera should proactively opt for hybrid SPECT/CT systems.
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Affiliation(s)
- Subapriya Suppiah
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Department of Nuclear Medicine, Nuclear Imaging Unit, Hospital Pengajar Universiti Putra Malaysia, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Pusat Pengimejan Diagnostik Nuklear, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Mohd Fazrin Mohd Rohani
- Department of Nuclear Medicine, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Ahmad Zaid Zanial
- Department of Nuclear Medicine, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
- Department of Nuclear Medicine, Royal Liverpool and Broadgreen University Hospitals, NHS Trusts, Liverpool, England
| | - Ahmad Danial Ahmad Shahrir
- Department of Nuclear Medicine, Nuclear Imaging Unit, Hospital Pengajar Universiti Putra Malaysia, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Khairul Aliff Khairuman
- Department of Nuclear Medicine, Nuclear Imaging Unit, Hospital Pengajar Universiti Putra Malaysia, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Sobhan Vinjamuri
- Department of Nuclear Medicine, Royal Liverpool and Broadgreen University Hospitals, NHS Trusts, Liverpool, England
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Pan Y, Shu G, Fu L, Huang K, Zhou X, Gui C, Liu H, Jin X, Chen M, Li P, Cen J, Feng Z, Lu J, Chen Z, Li J, Xu Q, Wang Y, Liang H, Wang Z, Deng Q, Chen W, Luo J, Yang J, Zhang J, Wei J. EHBP1L1 Drives Immune Evasion in Renal Cell Carcinoma through Binding and Stabilizing JAK1. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2206792. [PMID: 36775874 PMCID: PMC10104659 DOI: 10.1002/advs.202206792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/03/2023] [Indexed: 06/18/2023]
Abstract
High lymphocyte infiltration and immunosuppression characterize the tumor microenvironment (TME) in renal cell carcinoma (RCC). There is an urgent need to elucidate how tumor cells escape the immune attack and to develop novel therapeutic targets to enhance the efficacy of immune checkpoint blockade (ICB) in RCC. Overactivated IFN-γ-induced JAK/STAT signaling involves in such TME, but the underlying mechanisms remain elusive. Here, EH domain-binding protein 1-like protein 1 (EHBP1L1) is identified as a crucial mediator of IFN-γ/JAK1/STAT1/PD-L1 signaling in RCC. EHBP1L1 is highly expressed in RCC, and high EHBP1L1 expression levels are correlated with poor prognosis and resistance to ICB. EHBP1L1 depletion significantly inhibits tumor growth, which is attributed to enhanced CD8+ T cell-mediated antitumor immunity. Mechanistically, EHBP1L1 interacts with and stabilizes JAK1. By competing with SOCS1, EHBP1L1 protects JAK1 from proteasomal degradation, which leads to elevated JAK1 protein levels and JAK1/STAT1/PD-L1 signaling activity, thereby forming an immunosuppressive TME. Furthermore, the combination of EHBP1L1 inhibition and ICB reprograms the immunosuppressive TME and prevents tumor immune evasion, thus significantly reinforcing the therapeutic efficacy of ICB in RCC patient-derived xenograft (PDX) models. These findings reveal the vital role of EHBP1L1 in immune evasion in RCC, which may be a potential complement for ICB therapy.
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Affiliation(s)
- Yihui Pan
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
- Department of UrologyThe Third Affiliated HospitalSoochow UniversityChangzhouJiangsu213003China
| | - Guannan Shu
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Liangmin Fu
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Kangbo Huang
- Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhou510060China
- Department of UrologySun Yat‐sen University Cancer CenterGuangzhou510060China
| | - Xinwei Zhou
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Chengpeng Gui
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Huashan Liu
- Department of Colorectal Surgery and Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesThe Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhou510655China
| | - Xiaohan Jin
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Minyu Chen
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Pengju Li
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Junjie Cen
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Zihao Feng
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Jun Lu
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Zhenhua Chen
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Jiaying Li
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Quanhui Xu
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Yinghan Wang
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Hui Liang
- Department of UrologyAffiliated Longhua People's HospitalSouthern Medical UniversityShenzhen518109China
| | - Zhu Wang
- Department of UrologyAffiliated Longhua People's HospitalSouthern Medical UniversityShenzhen518109China
| | - Qiong Deng
- Department of UrologyAffiliated Longhua People's HospitalSouthern Medical UniversityShenzhen518109China
| | - Wei Chen
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Junhang Luo
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Jiefeng Yang
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Jiaxing Zhang
- Department of OncologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
| | - Jinhuan Wei
- Department of UrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhou510080China
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Wang J, Tao L, Liu Y, Liu H, Shen X, Tao L. Identification and validation of DLX4 as a prognostic and diagnostic biomarker for clear cell renal cell carcinoma. Oncol Lett 2023; 25:146. [PMID: 36936018 PMCID: PMC10018244 DOI: 10.3892/ol.2023.13732] [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: 07/18/2021] [Accepted: 11/09/2021] [Indexed: 03/04/2023] Open
Abstract
Clear cell renal cell carcinoma (ccRCC) is a lethal cancer, and biomarkers for exact diagnosis and predicting prognosis are urgently needed. The present study aimed to determine the roles of distal-less homeobox (DLX) family genes in ccRCC. The clinicopathological and mRNA expression data of patients with ccRCC were derived from The Cancer Genome Atlas database. Kaplan-Meier curves, univariate and multivariate Cox hazard analyses, in addition to receiver operator characteristic curves were used to evaluate the prognostic and diagnostic values. A single-sample gene set enrichment analysis was used to quantify the infiltration levels of immune cells. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry were conducted to examine the expression levels of DLX4 in tumor and adjacent tissue; the results demonstrated that DLX4 was highly expressed in ccRCC tissues compared with normal renal tissues. Furthermore, DLX4 expression was associated with tumor stage and grade. High proportions of males, advanced pathological stage, higher tumor grade and T, N and M stage were also observed in the high DLX4 expression group. Patients with the high DLX4 expression levels tended to have lower overall survival and disease-free survival rates compared with those with low DLX4 expression. DLX4 expression also showed favorable diagnostic efficiency in ccRCC patients. Based on functional enrichment analysis, cell cycle related pathways, epithelial-mesenchymal transition, glycolysis and inflammatory response were associated with the expression levels of DLX4. Furthermore, DLX4 expression was revealed to be associated with tumor immunosuppressive microenvironment. Overall, the expression level of DLX4 may be considered a novel prognostic indicator in ccRCC and a specific diagnostic biomarker for patients with ccRCC.
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Affiliation(s)
- Jiawei Wang
- Department of Urology, The Second People's Hospital of Wuhu, Wuhu, Anhui 241000, P.R. China
| | - Liangjun Tao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Yingqing Liu
- Department of Urology, The Second People's Hospital of Wuhu, Wuhu, Anhui 241000, P.R. China
| | - Heqian Liu
- Department of Urology, The Second People's Hospital of Wuhu, Wuhu, Anhui 241000, P.R. China
| | - Xudong Shen
- Department of Urology, The Second People's Hospital of Wuhu, Wuhu, Anhui 241000, P.R. China
| | - Lingsong Tao
- Department of Urology, The Second People's Hospital of Wuhu, Wuhu, Anhui 241000, P.R. China
- Correspondence to: Dr Lingsong Tao, Department of Urology, The Second People's Hospital of Wuhu, 259 JiuHuaShan Avenue, Wuhu, Anhui 241000, P.R. China, E-mail:
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Zhang Z, Zhang Y, Zhang R. P4HA3 promotes clear cell renal cell carcinoma progression via the PI3K/AKT/GSK3β pathway. Med Oncol 2023; 40:70. [PMID: 36588128 DOI: 10.1007/s12032-022-01926-2] [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: 09/18/2022] [Accepted: 12/08/2022] [Indexed: 01/03/2023]
Abstract
Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal cell carcinoma. P4HA3 is a key enzyme in collagen biosynthesis and has emerged as important molecules in regulation of proliferation, invasion, and metastasis in various tumor types. The role of P4HA3 in the development of ccRCC has remained to be elucidated. Genes expression, prognostic, and enrichment analyses were carried out with bioinformatics analysis. The efficiency of P4HA3 knockdown was confirmed by real-time quantitative PCR and Western blotting. The cellular functions were analyzed by CCK-8, EdU, wound healing, and transwell assays. The levels of related proteins expression were analyzed by Western blotting. P4HA3 was highly expressed in ccRCC compared with normal tissue samples from the TCGA database. Kaplan-Meier curves results showed that the expression level of P4HA3 was significantly negatively correlated with overall survival of patients. P4HA3 expression knockdown inhibited the proliferation, migration, and invasion of ccRCC cells, as demonstrated by in vitro experiments. In addition, GSEA results revealed that P4HA3 may be related to EMT and involved in the PI3K-AKT-GSK3β pathway in ccRCC; this was tentatively confirmed through Western blotting. P4HA3 may induce ccRCC progression via the PI3K-AKT-GSK3β signaling pathway and could represent a potential therapeutic target.
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Affiliation(s)
- Zhechuan Zhang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, China
- The Second Clinical College, Chongqing Medical University, Chongqing, China
| | - Yuanfeng Zhang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, China.
| | - Ronggui Zhang
- Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, China.
- Department of Urology, Chongqing University Central Hospital, Chongqing University, 1 Jiankang Road, Yuzhong District, Chongqing, China.
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Vitale MG, Maruzzo M, Sabbatini R. Editorial: The ever-changing scenario of first line treatment of metastatic renal cell carcinoma. Front Oncol 2023; 13:1183749. [PMID: 37020872 PMCID: PMC10067904 DOI: 10.3389/fonc.2023.1183749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 04/07/2023] Open
Affiliation(s)
- Maria Giuseppa Vitale
- Medical Oncology, Department of Oncology and Haematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
- *Correspondence: Maria Giuseppa Vitale,
| | - Marco Maruzzo
- Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Italy
| | - Roberto Sabbatini
- Medical Oncology, Department of Oncology and Haematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
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Szabla N, Matillon X, Calves J, Branchereau J, Champy C, Neuzillet Y, Bessede T, Bouhié S, Boutin JM, Caillet K, Cognard N, Culty T, De Fortescu G, Drouin S, Bentellis I, Hubert J, Boissier R, Sallusto F, Sénéchal C, Terrier N, Thuret R, Verhoest G, Waeckel T, Tillou X. Updated National Study of Functional Graft Renal Cell Carcinomas: Are They a Different Entity? Urology 2023; 171:152-157. [PMID: 36243142 DOI: 10.1016/j.urology.2022.09.020] [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: 08/20/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To analyze de novo graft carcinoma characteristics from our updated national multicentric retrospective cohort. METHODS Thirty-two transplant centers have retrospectively completed the database. This database concerns all kidney graft tumors including urothelial, and others type but excludes renal lymphomas over 31 years. RESULTS One hundred and fifty twokidney graft carcinomas were diagnosed in functional grafts. Among them 130 tumors were Renal Cell Carcinomas. The calculated incidence was 0.18%. Median age of the allograft at diagnosis was 45.4 years old. The median time between transplantation and diagnosis was 147.1 months. 60 tumors were papillary carcinomas and 64 were clear cell carcinomas. Median tumor size was 25 mm. 18, 64, 21 and 1 tumors were respectively Fuhrman grade 1, 2, 3 and 4. Nephron sparing surgery (NSS) was performed on 68 (52.3%) recipients. Ablative therapy was performed in 23 cases (17.7%). Specific survival rate was 96.8%. CONCLUSION This study confirmed that renal graft carcinomas are a different entity: with a younger age of diagnosis; a lower stage at diagnosis; a higher incidence of papillary subtypes.
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Affiliation(s)
- Nicolas Szabla
- CHU de Caen, Urology and Transplantation, Caen Calvados, France
| | - Xavier Matillon
- Hôpital Edouard Herriot, Urology and Transplantation, Lyon, Rhone, France
| | - Jehanne Calves
- CHU de Brest, Urology and Transplantation, Brest, Britanny, France
| | | | - Cécile Champy
- CHU Henri Mondor, Urology and Transplantation, Créteil, Val de Marne, France
| | - Yann Neuzillet
- Hôpital Foch, Urology and Transplantation, Suresnes, Huats de siene, France
| | - Thomas Bessede
- Hôpital Kremlin Bicetre, Urology and Transplantation, Paris, Paris, France
| | | | - Jean-Marie Boutin
- Hôpital Bretonneaux, Urology and Transplantation, Tours, Val de Loire, France
| | - Kevin Caillet
- CHU d'Amiens, Urology and Transplantation, Amiens, Somne, France
| | - Noelle Cognard
- CHU de Strasbourg, Urology and Transplantation, Strasbourg, Bas-Rhin, France
| | - Thibaut Culty
- CHU d'Angers, Urology and Transplantation, Angers, Maine et Loire, France
| | | | - Sarah Drouin
- Hôpital La Pitié Salpêtrière, Transplantation, Paris, Paris, France
| | - Imad Bentellis
- CHU Félix Guyon, Urology and Transplantation, La Réunion, La Reunion, France
| | - Jacques Hubert
- CHU de Nancy, Urology and Transplantation, Nancy, Meurthe-et-Moselle, France
| | - Romain Boissier
- Hôpital de la Conception, Urology and Transplantation, Marseille, Provence, France
| | - Federico Sallusto
- CHU de Toulouse, Urology and Transplantation, Toulouse ,Haute Gronnea, France
| | - Cédric Sénéchal
- CHU de Point à Pitre, Urology and Transplantation, Point à Pitre, Guadeloupe, France
| | - Nicolas Terrier
- CHU de Grenoble, Urology and Transplantation, Grenoble, Isare, France
| | - Rodolphe Thuret
- CHU de Montpellier, Urology and Transplantation, Montpellier, Herault, France
| | - Gregory Verhoest
- CHU de Rennes, Urology and Transplantation, Rennes, Ille-et-Vilaine, France
| | - Thibaut Waeckel
- CHU de Bordeaux, Urology and Transplantation, Bordeaux, Gironde, France
| | - Xavier Tillou
- CHU de Caen, Urology and Transplantation, Caen Calvados, France.
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