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Nikolic G, Zivotic M, Cirovic S, Despotovic S, Dundjerovic D, Radojevic Skodric S. The Utility of Mitochondrial Detection Methods Applied as an Additional Tool for the Differentiation of Renal Cell Tumors. Diagnostics (Basel) 2023; 13:2319. [PMID: 37510063 PMCID: PMC10377759 DOI: 10.3390/diagnostics13142319] [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: 04/21/2023] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/30/2023] Open
Abstract
The precise differentiation of renal cell tumors (RCTs) is sometimes hard to achieve using standard imaging and histopathological methods, especially for those with eosinophilic features. It has been suggested that the vast overabundance of mitochondria, as a well-known hallmark of eosinophilic cytoplasm, and could be a characteristic of distinct tumor types with opposing clinical outcomes. Thus, we intended to explore the associations between mitochondrial distribution patterns in different RCTs, including 43 cell renal cell carcinomas (ccRCCs), 15 papillary renal cell carcinomas (pRCCs), 20 chromophobe renal cell carcinomas (chRCCs), and 18 renal oncocytomas (ROs). Tumor samples were stained with two anti-mitochondrial antibodies (mitochondrial antibody Ab-2, clone MTC02; prohibitin, II-14-10, MA5-12858), applying immunohistochemistry and immunofluorescence to define mitochondrial distribution patterns (coarse scanty, moderate granular, and diffuse granular). Our results revealed significantly different expression patterns among the investigated RCTs (p < 0.001). The majority of ccRCCs exhibited coarse scanty mitochondrial staining, while all chRCCs had moderate granular expression. Nevertheless, all ROs, all pRCCs, and two cases of ccRCC presenting with higher nuclear grade and eosinophilic cytoplasm had diffuse granular mitochondrial expression. Moreover, with increased distribution of mitochondria, the intensity of staining was higher (p < 0.001). Here we present a strategy that utilizes fast and easy mitochondrial detection to differentiate RO from chRCC, as well as other eosinophilic variants of RCC with high accuracy.
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Affiliation(s)
- Gorana Nikolic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Maja Zivotic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Sanja Cirovic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Sanja Despotovic
- Institute for Histology and Embryology "Aleksandar Đ. Kostić", Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Dusko Dundjerovic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Elsayed Sharaf D, Shebel H, El-Diasty T, Osman Y, Khater S, Abdelhamid M, Abou El Atta H. Nomogram predictive model for differentiation between renal oncocytoma and chromophobe renal cell carcinoma at multi-phasic CT: a retrospective study. Clin Radiol 2022; 77:767-775. [DOI: 10.1016/j.crad.2022.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/21/2022] [Accepted: 05/26/2022] [Indexed: 11/03/2022]
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Jorge S, Capelo JL, LaFramboise W, Satturwar S, Korentzelos D, Bastacky S, Quiroga-Garza G, Dhir R, Wiśniewski JR, Lodeiro C, Santos HM. Absolute quantitative proteomics using the total protein approach to identify novel clinical immunohistochemical markers in renal neoplasms. BMC Med 2021; 19:196. [PMID: 34482820 PMCID: PMC8420025 DOI: 10.1186/s12916-021-02071-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/22/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Renal neoplasms encompass a variety of malignant and benign tumors, including many with shared characteristics. The diagnosis of these renal neoplasms remains challenging with currently available tools. In this work, we demonstrate the total protein approach (TPA) based on high-resolution mass spectrometry (MS) as a tool to improve the accuracy of renal neoplasm diagnosis. METHODS Frozen tissue biopsies of human renal tissues [clear cell renal cell carcinoma (n = 7), papillary renal cell carcinoma (n = 5), chromophobe renal cell carcinoma (n = 5), and renal oncocytoma (n = 5)] were collected for proteome analysis. Normal adjacent renal tissue (NAT, n = 5) was used as a control. Proteins were extracted and digested using trypsin, and the digested proteomes were analyzed by label-free high-resolution MS (nanoLC-ESI-HR-MS/MS). Quantitative analysis was performed by comparison between protein abundances of tumors and NAT specimens, and the label-free and standard-free TPA was used to obtain absolute protein concentrations. RESULTS A total of 205 differentially expressed proteins with the potential to distinguish the renal neoplasms were found. Of these proteins, a TPA-based panel of 24, including known and new biomarkers, was selected as the best candidates to differentiate the neoplasms. As proof of concept, the diagnostic potential of PLIN2, TUBB3, LAMP1, and HK1 was validated using semi-quantitative immunohistochemistry with a total of 128 samples assessed on tissue micro-arrays. CONCLUSIONS We demonstrate the utility of combining high-resolution MS and the TPA as potential new diagnostic tool in the pathology of renal neoplasms. A similar TPA approach may be implemented in any cancer study with solid biopsies.
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Affiliation(s)
- Susana Jorge
- BIOSCOPE Group, LAQV-REQUIMTE, Chemistry Department, NOVA School of Science and Technology, FCT NOVA, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal
- PROTEOMASS Scientific Society, Madan Park, 2829-516, Caparica, Portugal
| | - José L Capelo
- BIOSCOPE Group, LAQV-REQUIMTE, Chemistry Department, NOVA School of Science and Technology, FCT NOVA, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal
- PROTEOMASS Scientific Society, Madan Park, 2829-516, Caparica, Portugal
| | - William LaFramboise
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Swati Satturwar
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Dimitrios Korentzelos
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sheldon Bastacky
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Rajiv Dhir
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jacek R Wiśniewski
- Biochemical Proteomics Group, Department of Proteomics and Signal Transduction, Max-Planck-Institute of Biochemistry, Martinsried, Germany
| | - Carlos Lodeiro
- BIOSCOPE Group, LAQV-REQUIMTE, Chemistry Department, NOVA School of Science and Technology, FCT NOVA, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal
- PROTEOMASS Scientific Society, Madan Park, 2829-516, Caparica, Portugal
| | - Hugo M Santos
- BIOSCOPE Group, LAQV-REQUIMTE, Chemistry Department, NOVA School of Science and Technology, FCT NOVA, Universidade NOVA de Lisboa, 2829-516, Caparica, Portugal.
- PROTEOMASS Scientific Society, Madan Park, 2829-516, Caparica, Portugal.
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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Microwave ablation of cT1a renal cell carcinoma: oncologic and functional outcomes at a single center. Clin Imaging 2021; 76:199-204. [PMID: 33964597 DOI: 10.1016/j.clinimag.2021.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/12/2021] [Accepted: 04/25/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE Percutaneous ablation is an established alternative to surgical intervention for small renal masses. Radiofrequency and cryoablation have been studied extensively in the literature. To date, series assessing the efficacy and safety of microwave ablation (MWA) are limited. We present a cohort of 110 renal tumors treated with MWA. METHODS A review of the medical record between January 2015 and July 2019 was performed, retrospectively identifying 101 patients (110 tumors). All ablations were performed by a single board-certified urologist/interventional radiologist. Demographic information, intraoperative, postoperative, and follow-up surveillance data were recorded. RESULTS Median (IQR) age was 69.7 years (60.8-77.0); 27 (24%) were female. Median (IQR) BMI was 27.0 (25.1-30.2) and Charleston Comorbidity Index was 5.0 (4.0-6.0). 82 tumors were biopsy-confirmed renal cell carcinoma/oncocytic neoplasms. Median (IQR) tumor size was 2.0 cm (1.5-2.6). Median (IQR) RENAL nephrometry score was 6.0 (5.0-8.0). Technical success was achieved in all patients and all but one patient were discharged on the same day. Median (IQR) eGFR at baseline and 1 year were 71.9 mL/min/1.73 m2 (56.5-82) and 63.0 mL/min/1.73 m2 (54.0-78.2); the difference was -5.3 (p = 0.12). Two Clavien-Dindo type-I complications, one type-II complication, and one type-III complication were experienced in this cohort. Median radiographic follow-up was 376.5 days with 2 tumors (2.4% of RCC/oncocytic neoplasms) having recurred to date. CONCLUSIONS MWA is a safe and efficacious treatment option for small renal masses with minimal adverse events and low rates of recurrence in this cohort of 101 patients. Continued follow-up is needed to assess long-term outcomes.
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Meagher MF, Lane BR, Capitanio U, Mehrazin R, Bradshaw AW, Noyes S, Larcher A, Eldefrawy A, Ghali F, Patel D, Bruinius J, Dutt R, Keiner C, Miller N, Wan F, Montorsi F, Derweesh IH. Comparison of renal functional outcomes of active surveillance and partial nephrectomy in the management of oncocytoma. World J Urol 2020; 39:1195-1201. [PMID: 32556559 DOI: 10.1007/s00345-020-03299-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/03/2020] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To compare functional outcomes of partial nephrectomy (PN) and active surveillance (AS) in oncocytoma. METHODS Multicenter retrospective analysis of patients with oncocytoma managed with PN or AS (biopsy-confirmed). Primary outcome development of de novo chronic kidney disease (CKD) (eGFR < 60 mL/min/1.73m2). Cox regression Multivariable analysis (MVA) was carried out for predictors of de novo CKD. Linear regression was carried out for factors associated with increasing deltaGFR. Kaplan-Meier Analysis (KMA) was performed to analyze 5-year CKD-free survival. RESULTS 295 patients were analyzed (224 PN/71 AS, median follow-up 37.4 months). No differences were noted for clinical tumor size (AS 2.6 vs. PN 2.9 cm, p = 0.108), and baseline eGFR (AS 79.6 vs. PN 77, p = 0.9670). Median change in tumor diameter for AS was 0.42 cm. Compared to PN, AS had deltaGFR (-15.3 vs. -6.4 mL/min/1.73m2, p < 0.001) and de novo CKD (28.2% vs. 12.1%, p = 0.002). AS patients who developed CKD had higher RENAL score (p = 0.005) and lower baseline eGFR (73 vs. 91.2 mL/min/1.73m2, p < 0.001) than AS patients who did not. MVA demonstrated increasing age (OR = 1.03, p = 0.025), tumor size (HR = 1.26, p = 0.032) and AS (HR = 4.91, p < 0.001) to be predictive for de novo CKD. Linear regression demonstrated AS was associated with larger decrease in deltaGFR (B = -0.219, p < 0.001). KMA revealed 5-year CKD survival was higher in PN (87%) vs. AS (62%, p < 0.001). CONCLUSION AS was associated with greater functional decline than PN in oncocytoma. PN may be considered to optimalize renal functional preservation in select circumstances. Further investigation into mechanisms of functional decline in oncocytoma is requisite.
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Affiliation(s)
- Margaret F Meagher
- Department of Urology, UC San Diego School of Medicine, 3855 Health Sciences Drive, 0987, La Jolla, CA, 92093-0987, USA
| | - Brian R Lane
- Department of Urology, Spectrum Health, Grand Rapids, MI, USA
| | | | - Reza Mehrazin
- Department of Urology, Mt. Sinai School of Medicine, New York, NY, USA
| | - Aaron W Bradshaw
- Department of Urology, UC San Diego School of Medicine, 3855 Health Sciences Drive, 0987, La Jolla, CA, 92093-0987, USA
| | - Sabrina Noyes
- Department of Urology, Spectrum Health, Grand Rapids, MI, USA
| | | | - Ahmed Eldefrawy
- Department of Urology, UC San Diego School of Medicine, 3855 Health Sciences Drive, 0987, La Jolla, CA, 92093-0987, USA
| | - Fady Ghali
- Department of Urology, UC San Diego School of Medicine, 3855 Health Sciences Drive, 0987, La Jolla, CA, 92093-0987, USA
| | - Devin Patel
- Department of Urology, UC San Diego School of Medicine, 3855 Health Sciences Drive, 0987, La Jolla, CA, 92093-0987, USA
| | - Jacob Bruinius
- Department of Urology, Spectrum Health, Grand Rapids, MI, USA
| | - Raksha Dutt
- Department of Urology, UC San Diego School of Medicine, 3855 Health Sciences Drive, 0987, La Jolla, CA, 92093-0987, USA
| | - Cathrine Keiner
- Department of Urology, UC San Diego School of Medicine, 3855 Health Sciences Drive, 0987, La Jolla, CA, 92093-0987, USA
| | - Nathan Miller
- Department of Urology, UC San Diego School of Medicine, 3855 Health Sciences Drive, 0987, La Jolla, CA, 92093-0987, USA
| | - Fang Wan
- Department of Urology, UC San Diego School of Medicine, 3855 Health Sciences Drive, 0987, La Jolla, CA, 92093-0987, USA
| | | | - Ithaar H Derweesh
- Department of Urology, UC San Diego School of Medicine, 3855 Health Sciences Drive, 0987, La Jolla, CA, 92093-0987, USA.
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Cytology of Kidney Tumors. KIDNEY CANCER 2020. [DOI: 10.1007/978-3-030-28333-9_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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The Utility of ERBB4 and RB1 Immunohistochemistry in Distinguishing Chromophobe Renal Cell Carcinoma From Renal Oncocytoma. Int J Surg Pathol 2019; 28:259-264. [DOI: 10.1177/1066896919883016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives. Differentiating renal oncocytoma (RO) from chromophobe renal cell carcinoma (ChRCC) can occasionally be challenging. We evaluated the expression of RB1 and ERBB4 in RO and ChRCC, and compared the immunohistochemistry (IHC) results to RB1 and ERBB4 gene abnormalities detected by fluorescence in situ hybridization (FISH). Materials and Methods. Fifty-three kidney resections (ChRCC, n=28; RO, n=25) were stained for RB1 and ERBB4 IHC and FISH was performed to evaluate gene copy number analysis. Results. A loss of RB1 staining was identified in 64% (18/28) of ChRCCs, which was not found in any ROs (0/25; P <.001). FISH analysis revealed 36% (10/28) of ChRCCs contained a RB1 hemizygous deletion with a concordance of 56% (10/18) between the IHC and FISH findings. No RB1 gene copy number variations were detected in any of the ROs (0/25; P <.001) and retained expression of RB1 by IHC. ERBB4 showed cytoplasmic/membranous staining in all ROs and ChRCCs. However, 75% (21/28) of ChRCCs also contained nuclear positivity for ERBB4, which was uncommonly seen in ROs (3/25, 12%; P < .001). A hemizygous ERBB4 gene deletion was detected in 46% of ChRCCs (13/28), but none of the ROs (0/25; 0%). Loss of labeling by RB1 or nuclear staining for ERBB4 IHC identified 25 of 28 (89%) of ChRCCs. Conclusion. In summary, the loss of RB1 expression is a highly specific diagnostic biomarker in distinguishing ChRCC from RO. Nuclear ERBB4 expression also appears to be a sensitive diagnostic biomarker for ChRCC, albeit the mechanism is unknown.
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Abstract
CONTEXT.— Core biopsy has been increasingly used for clinical decision-making in the management of patients with renal masses. The sensitivity and specificity of histologic diagnoses of renal mass biopsies depend on many factors such as adequate sampling and tissue processing, diagnostic skill and experience, and appropriate use of ancillary techniques. OBJECTIVE.— To review the indications, emphasize the importance of obtaining adequate diagnostic material, and introduce a general diagnostic approach, in conjunction with immunohistochemistry, in diagnosis of renal mass biopsies. DATA SOURCES.— Literature review and personal experiences in daily practice and consultation diagnosis of renal masses in a large tertiary medical center. CONCLUSIONS.— For renal mass biopsies, it is critical to obtain adequate diagnostic material and establish a standard laboratory procedure in working with small biopsy specimens. The key for the diagnosis is to be familiar with different tumor entities with characteristic morphology and to understand the wide spectrum of tumor heterogeneity. By developing a systematic approach, one can categorize the tumor and create a sensible differential diagnosis based on the growth pattern and cellular morphology. Immunohistochemistry is particularly helpful for renal mass biopsy diagnosis in selected situations.
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Affiliation(s)
- Steven S Shen
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Jae Y Ro
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
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Active Surveillance of Small Renal Masses. Urology 2019; 123:157-166. [DOI: 10.1016/j.urology.2018.09.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/10/2018] [Accepted: 09/18/2018] [Indexed: 01/12/2023]
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Amin J, Xu B, Badkhshan S, Creighton TT, Abbotoy D, Murekeyisoni C, Attwood KM, Schwaab T, Hendler C, Petroziello M, Roche CL, Kauffman EC. Identification and Validation of Radiographic Enhancement for Reliable Differentiation of CD117(+) Benign Renal Oncocytoma and Chromophobe Renal Cell Carcinoma. Clin Cancer Res 2018; 24:3898-3907. [PMID: 29752278 DOI: 10.1158/1078-0432.ccr-18-0252] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/23/2018] [Accepted: 05/07/2018] [Indexed: 12/13/2022]
Abstract
Purpose: The diagnostic differential for CD117/KIT(+) oncocytic renal tumor biopsies is limited to benign renal oncocytoma versus chromophobe renal cell carcinoma (ChRCC); however, further differentiation is often challenging and requires surgical resection. We investigated clinical variables that might improve preoperative differentiation of CD117(+) renal oncocytoma versus ChRCC to avoid the need for benign tumor resection.Experimental Design: A total of 124 nephrectomy patients from a single institute with 133 renal oncocytoma or ChRCC tumors were studied. Patients from 2003 to 2012 comprised a retrospective cohort to identify clinical/radiographic variables associated with renal oncocytoma versus ChRCC. Prospective validation was performed among consecutive renal oncocytoma/ChRCC tumors resected from 2013 to 2017.Results: Tumor size and younger age were associated with ChRCC, and multifocality with renal oncocytoma; however, the most reliable variable for ChRCC versus renal oncocytoma differentiation was the tumor:cortex peak early-phase enhancement ratio (PEER) using multiphase CT. Among 54 PEER-evaluable tumors in the retrospective cohort [19 CD117(+), 13 CD117(-), 22 CD117-untested], PEER classified each correctly as renal oncocytoma (PEER >0.50) or ChRCC (PEER ≤0.50), except for four misclassified CD117(-) ChRCC variants. Prospective study of PEER confirmed 100% accuracy of renal oncocytoma/ChRCC classification among 22/22 additional CD117(+) tumors. Prospective interobserver reproducibility was excellent for PEER scoring (intraclass correlation coefficient, ICC = 0.97) and perfect for renal oncocytoma/ChRCC assignment (ICC = 1.0).Conclusions: In the largest clinical comparison of renal oncocytoma versus ChRCC to our knowledge, we identified and prospectively validated a reproducible radiographic measure that differentiates CD117(+) renal oncocytoma from ChRCC with potentially 100% accuracy. PEER may allow reliable biopsy-based diagnosis of CD117(+) renal oncocytoma, avoiding the need for diagnostic nephrectomy. Clin Cancer Res; 24(16); 3898-907. ©2018 AACR.
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Affiliation(s)
- Jay Amin
- Department of Urology, Roswell Park Cancer Institute, Buffalo, New York
| | - Bo Xu
- Department of Pathology and Laboratory Medicine, Roswell Park Cancer Institute, Buffalo, New York
| | - Shervin Badkhshan
- Department of Urology, Roswell Park Cancer Institute, Buffalo, New York
| | | | - Daniel Abbotoy
- Department of Urology, Roswell Park Cancer Institute, Buffalo, New York
| | | | - Kristopher M Attwood
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, New York
| | - Thomas Schwaab
- Department of Urology, Roswell Park Cancer Institute, Buffalo, New York.,Department of Immunology, Roswell Park Cancer Institute, Buffalo, New York.,Department of Urology, State University of New York at Buffalo, Buffalo, New York
| | - Craig Hendler
- Department of Diagnostic Radiology, Roswell Park Cancer Institute, Buffalo, New York
| | - Michael Petroziello
- Department of Diagnostic Radiology, Roswell Park Cancer Institute, Buffalo, New York
| | - Charles L Roche
- Department of Diagnostic Radiology, Roswell Park Cancer Institute, Buffalo, New York
| | - Eric C Kauffman
- Department of Urology, Roswell Park Cancer Institute, Buffalo, New York. .,Department of Urology, State University of New York at Buffalo, Buffalo, New York.,Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, New York
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