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Baraban EG, Elias R, Lin MT, Ged Y, Zhu J, Pallavajjala A, Singla N, Lotan TL, Argani P, Eshleman JR, Epstein JI. High-Grade, Nonsarcomatoid Chromophobe Renal Cell Carcinoma: A Series of 22 Cases With Novel Molecular Features on a Subset. Mod Pathol 2024; 37:100472. [PMID: 38492778 DOI: 10.1016/j.modpat.2024.100472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/15/2024] [Accepted: 03/07/2024] [Indexed: 03/18/2024]
Abstract
Chromophobe renal cell carcinoma (ChRCC) is the third most common subtype of renal cell carcinoma and typically exhibits indolent behavior, though a rare subset can exhibit high-grade morphologic features and is associated with a poor prognosis. Although there are limited data on the molecular characteristics of metastatic and sarcomatoid ChRCC, the molecular features of high-grade, nonsarcomatoid ChRCC remain unexplored. Herein, we characterize 22 cases of ChRCC with high-grade, nonsarcomatoid components. High-grade ChRCC frequently demonstrated advanced stage at diagnosis (64% ≥pT3a or N1), with regions of extrarenal extension, nodal metastases, and vascular invasion consisting solely of high-grade ChRCC morphologically. We performed spatially guided panel-based DNA sequencing on 11 cases comparing high-grade and low-grade regions (n = 22 samples). We identified recurring somatic alterations emblematic of ChRCC, including deletions of chromosomes 1, 2, 6, 10, 13, 17, and 21 in 91% (10/11) of cases and recurring mutations in TP53 (81.8%, n = 9/11) and PTEN (36.4%, n = 4/11). Notably, although PTEN and TP53 alterations were found in both high-grade and low-grade regions, private mutations were identified in 3 cases, indicating convergent evolution. Finally, we identified recurring RB1 mutations in 27% (n = 3) of high-grade regions leading to selective protein loss by immunohistochemistry not observed in adjacent low-grade regions. This finding was confirmed in The Cancer Genome Atlas cohort where 2 of 66 cases contained RB1 mutations and demonstrated unequivocal high-grade, nonsarcomatoid morphology. We also detected multiple chromosomal gains confined to the high-grade regions, consistent with imbalanced chromosome duplication. These findings broaden our understanding of the molecular pathogenesis of ChRCC and suggest that subclonal RB1 mutations can drive the evolution to high-grade, nonsarcomatoid ChRCC.
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Affiliation(s)
- Ezra G Baraban
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland.
| | - Roy Elias
- Department of Oncology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Ming-Tseh Lin
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Yasser Ged
- Department of Oncology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Jing Zhu
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | | | - Nirmish Singla
- Department of Urology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Tamara L Lotan
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Pedram Argani
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - James R Eshleman
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Jonathan I Epstein
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland; Department of Oncology, Johns Hopkins Hospital, Baltimore, Maryland; Department of Urology, Johns Hopkins Hospital, Baltimore, Maryland
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Alghamdi M, Chen JF, Jungbluth A, Koutzaki S, Palmer MB, Al-Ahmadie HA, Fine SW, Gopalan A, Sarungbam J, Sirintrapun SJ, Tickoo SK, Reuter VE, Chen YB. L1 Cell Adhesion Molecule (L1CAM) Expression and Molecular Alterations Distinguish Low-Grade Oncocytic Tumor From Eosinophilic Chromophobe Renal Cell Carcinoma. Mod Pathol 2024; 37:100467. [PMID: 38460672 PMCID: PMC11102321 DOI: 10.1016/j.modpat.2024.100467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/06/2024] [Accepted: 03/01/2024] [Indexed: 03/11/2024]
Abstract
Renal low-grade oncocytic tumor (LOT) is a recently recognized renal cell neoplasm designated within the "other oncocytic tumors" category in the 2022 World Health Organization classification system. Although the clinicopathologic, immunohistochemical, and molecular features reported for LOT have been largely consistent, the data are relatively limited. The morphologic overlap between LOT and other low-grade oncocytic neoplasms, particularly eosinophilic chromophobe renal cell carcinoma (E-chRCC), remains a controversial area in renal tumor classification. To address this uncertainty, we characterized and compared large cohorts of LOT (n = 67) and E-chRCC (n = 69) and revealed notable differences between the 2 entities. Clinically, LOT predominantly affected women, whereas E-chRCC showed a male predilection. Histologically, although almost all LOTs were dominated by a small-nested pattern, E-chRCC mainly showed solid and tubular architectures. Molecular analysis revealed that 87% of LOT cases harbored mutations in the tuberous sclerosis complex (TSC)-mTOR complex 1 (mTORC1) pathway, most frequently in MTOR and RHEB genes; a subset of LOT cases had chromosomal 7 and 19q gains. In contrast, E-chRCC lacked mTORC1 mutations, and 60% of cases displayed chromosomal losses characteristic of chRCC. We also explored the cell of origin for LOT and identified L1 cell adhesion molecule (L1CAM), a collecting duct and connecting tubule principal cell marker, as a highly sensitive and specific ancillary test for differentiating LOT from E-chRCC. This distinctive L1CAM immunohistochemical labeling suggests the principal cells as the cell of origin for LOT, unlike the intercalated cell origin of E-chRCC and oncocytoma. The ultrastructural analysis of LOT showed normal-appearing mitochondria and intracytoplasmic lumina with microvilli, different from what has been described for chRCC. Our study further supports LOT as a unique entity with a benign clinical course. Based on the likely cell of origin and its clinicopathologic characteristics, we propose that changing the nomenclature of LOT to "Oncocytic Principal Cell Adenoma of the Kidney" may be a better way to define and describe this entity.
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Affiliation(s)
- Mohammed Alghamdi
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Jie-Fu Chen
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Achim Jungbluth
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sirma Koutzaki
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Matthew B Palmer
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Hikmat A Al-Ahmadie
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Samson W Fine
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anuradha Gopalan
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Judy Sarungbam
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - S Joseph Sirintrapun
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Satish K Tickoo
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Victor E Reuter
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ying-Bei Chen
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
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Lan J, Lan D, Yuan W, Ying Q, He J, Gu Y. Radical nephrectomy for a giant chromophobe renal cell carcinoma diagnosed > 17 years previously: a case report and literature review. Front Oncol 2024; 14:1352689. [PMID: 38634044 PMCID: PMC11021568 DOI: 10.3389/fonc.2024.1352689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/05/2024] [Indexed: 04/19/2024] Open
Abstract
Early diagnosis of renal cell carcinoma relies on imaging tests such as ultrasound, computed tomography, or magnetic resonance imaging. Since surgery is associated with a favorable prognosis, the standard treatment for clinically limited renal cell carcinoma remains surgical resection. Among asymptomatic patients with localized renal cell carcinoma, a small number refuse surgical treatment and survive. We report a case involving a 59-year-old female who underwent a difficult radical nephrectomy 17 years after being diagnosed with malignant tumors due to primary renal cell carcinoma.
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Affiliation(s)
- Jianhua Lan
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Dong Lan
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Wenqiang Yuan
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Qiao Ying
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Jiahong He
- Department of Cardiac and Vascular Surgery, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Yonglin Gu
- Department of Cardiology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
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Chrabańska M, Szweda-Gandor N, Rynkiewicz M, Hraboš D, Drozdzowska B. Association between PD-L1 Expression and the Prognosis and Clinicopathologic Features of Non-Clear Cell Renal Cell Carcinoma. Int J Mol Sci 2024; 25:3916. [PMID: 38612724 PMCID: PMC11011264 DOI: 10.3390/ijms25073916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
PD-L1 is one of the two programmed cell death 1 (PD-1) ligands and a part of an immune checkpoint system (PD-1/PD-L1) with widespread clinical application. The aim of this study was to investigate PD-L1 expression and its association with clinicopathological and prognostic significance in non-clear cell renal cell carcinoma (non-ccRCC) patients. A total of 41 papillary (pRCC) and 20 chromophobe (chRCC) RCC tumors were examined for PD-L1 expression by immunohistochemistry in the cancer cells and tumor-infiltrating mononuclear cells (TIMCs). PD-L1 positivity was detected in 36.6% pRCC and 85.0% chRCC cancer cells, while PD-L1 positivity was observed in 73.2% pRCC and 50.0% chRCC TIMCs. PD-L1 positivity in both pRCC and chRCC tumor cells was not correlated with any of the examined clinicopathological features, while PD-L1 positivity in TIMCs was associated with the age of patients with pRCC. During follow-up, the death was documented among 6 patients with pRCC. Papillary RCC patients with PD-L1-positive tumor cells were significantly associated with an increased risk of death compared with patients with PD-L1-negative cancer cells. A similar trend was observed when comparing PD-L1 expression in TIMCs. However, no differences in overall survival for PD-L1-positive pRCC patients with compared to PD-L1-negative patients were observed in tumor cells or TIMCs.
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Affiliation(s)
- Magdalena Chrabańska
- Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Nikola Szweda-Gandor
- Department and Clinic of Internal Medicine, Diabetology and Nephrology, Medical University of Silesia, 40-055 Zabrze, Poland
| | - Magdalena Rynkiewicz
- Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Dominik Hraboš
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic
| | - Bogna Drozdzowska
- Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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Zhang H, Cong X, Chen C, Liu Z. Sintilimab combined with axitinib in the treatment of advanced chromophobe renal cell carcinoma: a case report. Front Oncol 2024; 14:1325999. [PMID: 38371628 PMCID: PMC10869506 DOI: 10.3389/fonc.2024.1325999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
Chromophobe renal cell carcinoma (ChRCC) is a rare pathological type of renal cell carcinoma (RCC). Related systematic studies involving large numbers of patients are lacking, and more importantly, there is currently no international consensus on post-line treatment guidelines for ChRCC. The rapid development of systemic treatment with molecular targeted therapies and immune checkpoint inhibitors has brought effective approaches for patients with clear cell renal cell carcinoma (ccRCC), while progress in the treatment of ChRCC is still limited. In this case report, the patient was initially diagnosed at the early stage; 4 years post-surgery, she developed lung metastases and the disease progressed once again after being treated with sunitinib monotherapy for 3 years. However, after combining the immunotherapy sintilimab with the targeted therapy axitinib as second-line treatment, imageological examination showed lesions in the lungs that gradually decreased, and the bone metastases remained stable. To date, the patient has been continuously treated for over 2 years and is still undergoing regular treatment and follow-up. This case is the first to report the long-term survival of metastatic disease by using this treatment regimen and to propose a potential therapeutic option for patients with metastatic ChRCC. Since only one case was observed in this report, further study is needed.
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Affiliation(s)
| | | | | | - Ziling Liu
- Cancer Center, The First Hospital of Jilin University, Changchun, China
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Bersanelli M, Rebuzzi SE, Roviello G, Catalano M, Brunelli M, Rizzo M. Immune checkpoint inhibitors in non-conventional histologies of renal-cell carcinoma. Hum Vaccin Immunother 2023; 19:2171672. [PMID: 36758960 PMCID: PMC10012923 DOI: 10.1080/21645515.2023.2171672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
For years, prospective randomized clinical trials excluded patients with non-conventional histologies of renal cell carcinoma (RCC). The paucity of data has led to adopting the same treatment strategies used for clear-cell RCC (ccRCC). In the present narrative review, we explored state of the art about use of immune checkpoint inhibitors (ICIs) in variant histologies of RCC. According to the results collected, ICIs as monotherapy showed promising antitumor activity in advanced non-clear cell (ncc)RCC. The objective response rate (ORR) was similar to that observed with single-agent anti-PD-1 in the ccRCC population, either in the first-line or the second-line setting, and responder patients experienced an early and durable benefit. Combined ICI-based strategies have shown increasing evidence in nccRCC and robust results in the sarcomatoid variants of RCC. A definitive recommendation about treating non-conventional histologies, either in adjuvant or metastatic settings, should be supported by more extensive dedicated trials.
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Affiliation(s)
| | - Sara Elena Rebuzzi
- Medical Oncology Unit, Ospedale San Paolo, Savona, Italy.,Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genoa, Genoa, Italy
| | | | - Martina Catalano
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Matteo Brunelli
- Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy
| | - Mimma Rizzo
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
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Park HK. The Metastasis Pattern of Renal Cell Carcinoma Is Influenced by Histologic Subtype, Grade, and Sarcomatoid Differentiation. Medicina (Kaunas) 2023; 59:1845. [PMID: 37893563 PMCID: PMC10608745 DOI: 10.3390/medicina59101845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/14/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Metastasis is a major cause of death in renal cell carcinoma (RCC) patients; therefore, a better understanding of the metastatic process and the ability to predict metastasis in advance is important for treating patients with RCC. This study aimed to investigate whether histological subtypes of RCC and other factors, such as nuclear grade and sarcomatoid differentiation, could predict the probability and location of metastases in patients with RCC. Materials and Methods: Cases of clear-cell, papillary, chromophobe, and sarcomatoid RCC were retrieved and analyzed from the Surveillance, Epidemiology, and End Results databases. Results: When comparing the metastatic patterns among the three histologic subtypes, patients with clear-cell RCC were significantly more likely to have brain and lung metastases. Moreover, patients with papillary RCC were significantly less likely to develop bone metastases and more likely to develop lymph node metastases. Patients with chromophobe RCC are significantly more likely to develop liver metastases. As the nuclear grade increased, there was also a significantly increased tendency for clear-cell RCC to metastasize to the lungs. Patients with sarcomatoid RCC had a higher rate of metastasis, with a significantly higher probability of metastasis to the bone and lungs, than those with all three histological subtypes did. Conclusions: Histological subtype, nuclear grade, and sarcomatoid differentiation were significant predictors of metastasis in patients with RCC.
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Affiliation(s)
- Hyung Kyu Park
- Department of Pathology, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea
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Jiang J, Yang L, Chen M, Xiao F, Zeng Y, Zhu H, Li Y, Liu L. Smoking enhanced the expression of c-kit in chromophobe renal cell carcinoma. Tob Induc Dis 2023; 21:126. [PMID: 37808589 PMCID: PMC10557055 DOI: 10.18332/tid/170432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 07/30/2023] [Accepted: 08/04/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION Smoking is an important risk factor for inducing renal cell carcinoma (RCC), but its specific mechanism affecting the development of RCC remains to be elucidated. Chromophobe RCC (ChRCC) is a subtype of RCC. Many studies have shown smoking is closely associated with RCC occurrence and c-kit plays a critical role in the progression of RCC, however, few studies focus on ChRCC. This study investigated the molecular mechanism between smoking and the c-kit pathway in ChRCC. METHODS Differentially expressed genes (DEGs) were obtained from The Cancer Genome Atlas (TCGA) in ChRCC and the expression of KIT in ChRCC was analyzed through the TCGA database combined with Gene Expression Omnibus (GEO) and oncomine databases. Moreover, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses and Protein Protein Interaction (PPI) network analysis were performed to explore the function of KIT and correlated DEGs as well as its co-expression genes in ChRCC. Finally, ChRCC patient samples were used to verify the effect of smoking on the c-kit expression. RESULTS The results showed that KIT is one of the DEGs and plays a vital role in ChRCC tumorigenesis. Interestingly, the expression of c-kit in cancer tissues of 27 smoking patients was significantly higher than that of 25 non-smoking patients (p<0.05), which suggests smoking might enhance the expression of c-kit in ChRCC patients. CONCLUSIONS Our results demonstrate that smoking might play a pivotal role in the ChRCC tumorigenesis via a pathway related to c-kit, and provided new insight into the relationship between smoking and the c-kit pathway in ChRCC.
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Affiliation(s)
- Jiahao Jiang
- Department of Urology, Renmin Hospital, Wuhan University, Wuhan, China
| | - Lanxin Yang
- School of Pharmaceutical Sciences, Wuhan University, Wuhan, China
| | - Mingzhu Chen
- School of Pharmaceutical Sciences, Wuhan University, Wuhan, China
| | - Fei Xiao
- Department of Urology, Renmin Hospital, Wuhan University, Wuhan, China
| | - Yan Zeng
- Department of Urology, Renmin Hospital, Wuhan University, Wuhan, China
| | - Hengcheng Zhu
- Department of Urology, Renmin Hospital, Wuhan University, Wuhan, China
| | - Yanqin Li
- School of Pharmaceutical Sciences, Wuhan University, Wuhan, China
| | - Lingqi Liu
- Department of Urology, Renmin Hospital, Wuhan University, Wuhan, China
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Osmanov YI, Kogan EA, Gadzhieva ZK, Prochenko DD. [Morphological and molecular portrait hybrid renal tumors]. Urologiia 2023:113-116. [PMID: 37850290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
A hybrid tumor is not officially included in the latest International Histological Classification of Kidney Tumors (WHO, 2022), however, according to the literature, a number of researchers still consider a hybrid tumor as an independent nosological unit. In this regard, the development of morphological and molecular genetic criteria for a hybrid tumor, today, is the main task in the differential diagnosis of oncocytic renal tumors. AIM Our aim was to carry out to identify immunohistochemical, ultrastructural features and determine the molecular profile of hybrid renal tumors. PATIENTS AND METHODS The study was performed on the surgical material of 12 patients with a hybrid tumor of the kidney. Immunohistochemical study was carried out on paraffin sections according to the standard protocol. Antibodies CK7, CD117, Cyclin D1, EpCAM, Caveolin1, EABA, and S100A1 were used. To study tumor tissues on semi-thin and ultra-thin sections, an electron microscope Philips TECNAI 12 BioTwinD-265 is used. For in situ fluorescent diagnostic detection, defined centromere probes, LSI 13/21, LSI N25 /LSI ARSA and TelVysion telomeric probe. RESULTS In some cases, a hybrid tumor is represented by a solid structure of monomorphic oxyphilic cells with a characteristic immuno-, ultraphenotype and molecular profile. CONCLUSION The results of a comprehensive study confirm that the hybrid tumor is an intermediate link in the process of malignant transformation of oncocytoma into chromophobe renal cell carcinoma.
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Affiliation(s)
- Y I Osmanov
- Institute of Clinical Morphology and Digital Pathology of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department for the Analysis of Personnel Policy, Educational Programs and Scientific Research of the National Medical Research Center on the profile Urology of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - E A Kogan
- Institute of Clinical Morphology and Digital Pathology of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department for the Analysis of Personnel Policy, Educational Programs and Scientific Research of the National Medical Research Center on the profile Urology of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Z K Gadzhieva
- Institute of Clinical Morphology and Digital Pathology of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department for the Analysis of Personnel Policy, Educational Programs and Scientific Research of the National Medical Research Center on the profile Urology of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - D D Prochenko
- Institute of Clinical Morphology and Digital Pathology of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department for the Analysis of Personnel Policy, Educational Programs and Scientific Research of the National Medical Research Center on the profile Urology of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
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Lichtbroun BJ, Shinder B, Sara TG, Srivastava A, Saraiya B, Mayer TM, Cristelli R, Sadimin E, Weiss RE, Singer EA. Chromophobe Renal Cell Carcinoma with Sarcomatoid Differentiation. J Kidney Cancer VHL 2023; 10:1-8. [PMID: 37441361 PMCID: PMC10334999 DOI: 10.15586/jkcvhl.v10i3.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
Chromophobe renal cell carcinoma (chRCC) is one of the less common types of kidney cancer and generally portends a more favorable prognosis. RCC with sarcomatoid differentiation has a more aggressive clinical course with poor outcomes. Four cases of chRCC with varying degrees of sarcomatoid differentiation were retrospectively reviewed at our institution, and clinicopathologic data as well as clinical courses were reported. Patients with higher degrees of sarcomatoid differentiation and larger tumors at presentation generally had and worse overall survival. chRCC with sarcomatoid differentiation portends a poor prognosis with limited data on systemic treatment options for metastatic disease.
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Affiliation(s)
- Benjamin J. Lichtbroun
- Section of Urologic Oncology, Department of Surgery, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Brian Shinder
- Section of Urologic Oncology, Department of Surgery, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Tina Gowda Sara
- Section of Urologic Oncology, Department of Surgery, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Arnav Srivastava
- Section of Urologic Oncology, Department of Surgery, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Biren Saraiya
- Division of Medical Oncology, Department of Medicine, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Tina M. Mayer
- Division of Medical Oncology, Department of Medicine, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Ryan Cristelli
- Division of Urologic Pathology, Department of Pathology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Evita Sadimin
- Division of Urologic Pathology, Department of Pathology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Robert E. Weiss
- Section of Urologic Oncology, Department of Surgery, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Eric A. Singer
- Section of Urologic Oncology, Department of Surgery, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Wang P, Wang L, Du J, Liang G. Chromophobe renal cell carcinoma with ipsilateral ureteral urothelial carcinoma: A case report. Mol Clin Oncol 2023; 18:30. [PMID: 36908976 PMCID: PMC9995567 DOI: 10.3892/mco.2023.2626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
It is very rare for different types of urological tumours to occur together, and it is even rarer for chromophobe renal cell carcinoma (CRCC) to be combined with ipsilateral ureteral urothelial carcinoma (UUC), and the symptoms are relatively homogeneous, mostly presenting as symptoms that can be observed in malignant tumours alone, and therefore are often easily missed. In the present study, a case of a patient who was admitted to the hospital for more than 3 months with no obvious cause of terminal carnivorous hematuria was reported, and ureteral carcinoma was considered in the preoperative diagnosis but not renal carcinoma. After completion of preoperative tests, laparoscopic right nephrectomy and right ureterectomy was performed. The postoperative pathological diagnosis was CRCC of the right side and low-grade UUC of the right side, and the patient did not show any significant abnormality at the postoperative follow-up. By discussing this case and reviewing the relevant literature, the present study provides clinicians with more insight.
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Affiliation(s)
- Peirui Wang
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P.R. China
| | - Ling Wang
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P.R. China
| | - Jiang Du
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P.R. China
| | - Guobiao Liang
- Department of Urology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P.R. China
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Lobo J, Ohashi R, Amin MB, Berney DM, Compérat EM, Cree IA, Gill AJ, Hartmann A, Menon S, Netto GJ, Raspollini MR, Rubin MA, Tan PH, Tickoo SK, Tsuzuki T, Turajlic S, Zhou M, Srigley JR, Moch H. WHO 2022 landscape of papillary and chromophobe renal cell carcinoma. Histopathology 2022; 81:426-438. [PMID: 35596618 DOI: 10.1111/his.14700] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/04/2022] [Accepted: 05/18/2022] [Indexed: 12/01/2022]
Abstract
The 5th edition of the WHO Classification of Tumours of the Urinary and Male Genital Systems contains relevant revisions and introduces a group of molecularly defined renal tumour subtypes. Herein we present the World Health Organization (WHO) 2022 perspectives on papillary and chromophobe renal cell carcinoma with emphasis on their evolving classification, differential diagnosis, and emerging entities. The WHO 2022 classification eliminated the type 1/2 papillary renal cell carcinoma (pRCC) subcategorization, given the recognition of frequent mixed tumour phenotypes and the existence of entities with a different molecular background within the type 2 pRCC category. Additionally, emerging entities such as biphasic squamoid alveolar RCC, biphasic hyalinising psammomatous RCC, papillary renal neoplasm with reverse polarity, and Warthin-like pRCC are included as part of the pRCC spectrum, while additional morphological and molecular data are being gathered. In addition to oncocytomas and chromophobe renal cell carcinoma (chRCC), a category of 'other oncocytic tumours' with oncocytoma/chRCC-like features has been introduced, including emerging entities, most with TSC/mTOR pathway alterations (eosinophilic vacuolated tumour and so-called 'low-grade' oncocytic tumour), deserving additional research. Eosinophilic solid and cystic RCC was accepted as a new and independent tumour entity. Finally, a highly reproducible and clinically relevant universal grading system for chRCC is still missing and is another niche of ongoing investigation. This review discusses these developments and highlights emerging morphological and molecular data relevant for the classification of renal cell carcinoma.
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Affiliation(s)
- João Lobo
- Department of Pathology, Portuguese Oncology Institute of Porto (IPOP), Porto, Portugal
- Cancer Biology and Epigenetics Group, Research Center of IPO Porto (GEBC CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (P.CCC), Porto, Portugal
- Department of Pathology and Molecular Immunology, ICBAS-School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal
| | - Riuko Ohashi
- Histopathology Core Facility, Niigata University Faculty of Medicine, Niigata, Japan
- Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Mahul B Amin
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Sciences Center, Memphis, USA
- Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Daniel M Berney
- Centre for Molecular Oncology, Barts and the London School of Medicine and Dentistry, London, UK
| | - Eva M Compérat
- Department of Pathology, Hôpital Tenon, Sorbonne University, Paris, France
| | - Ian A Cree
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Anthony J Gill
- Sydney Medical School, The University of Sydney, Sydney, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, NSW Health Pathology, St Leonards, New South Wales, Australia
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - George J Netto
- Department of Pathology, University of Alabama, Birmingham, AL, USA
| | - Maria R Raspollini
- Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - Mark A Rubin
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA
- Department for BioMedical Research, University of Bern, Bern, Switzerland
- Englander Institute for Precision Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Puay Hoon Tan
- Division of Pathology, Singapore General Hospital, Singapore
| | - Satish K Tickoo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
| | - Samra Turajlic
- Renal and Skin Units, The Royal Marsden Hospital NHS Foundation Trust, London, UK
- The Francis Crick Institute, London, UK
| | - Ming Zhou
- Department of Pathology, Tufts Medical Center, Boston, Massachusetts, USA
| | - John R Srigley
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Holger Moch
- Department of Pathology and Molecular Pathology, University and University Hospital Zurich, Zurich, Switzerland
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Chrabańska M, Rynkiewicz M, Kiczmer P, Drozdzowska B. Immunohistochemical Expression of CD44, MMP-2, MMP-9, and Ki-67 as the Prognostic Markers in Non-Clear Cell Renal Cell Carcinomas-A Prospective Cohort Study. J Clin Med 2022; 11:jcm11175196. [PMID: 36079127 PMCID: PMC9457518 DOI: 10.3390/jcm11175196] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
CD44 is the most frequently reported marker of the cancer stem cells in renal cell carcinoma (RCC). Matrix metalloproteinases MMP-2 and MMP-9 are key regulators of tumor invasion and metastasis. The aim of this study was to investigate the clinicopathologic and prognostic values of the immunohistochemical expression of CD44, MMP2, MMP9, and Ki-67 in papillary and chromophobe RCCs. In the case of papillary RCC, MMP-2 expression was positively correlated with patient age (p < 0.05), while CD44 expression was positively correlated with tumor stage (τ = 0.26, p < 0.05). Moreover, CD44 expression positively correlated with MMP-9 (τ = 0.39, p < 0.05). In the case of chromophobe RCC, only Ki-67 expression was negatively correlated with tumor stage (τ = −0.44, p < 0.05). During follow-up, a death was documented in 6 patients with papillary RCC. In these patients, CD44 expression was not a significant factor affecting the overall survival of patients (p > 0.05), whereas there was a positive correlation between increased MMP-9 expression and shorter overall survival (p < 0.05). Taken together, carcinogenesis in papillary RCC is probably dependent on both cancer stem cells and metalloproteinases activity. Expression of CD44 and MMP-9 can significantly improve the prediction of papillary RCC prognosis in the future.
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Simmler P, Cortijo C, Koch LM, Galliker P, Angori S, Bolck HA, Mueller C, Vukolic A, Mirtschink P, Christinat Y, Davidson NR, Lehmann KV, Pellegrini G, Pauli C, Lenggenhager D, Guccini I, Ringel T, Hirt C, Marquart KF, Schaefer M, Rätsch G, Peter M, Moch H, Stoffel M, Schwank G. SF3B1 facilitates HIF1-signaling and promotes malignancy in pancreatic cancer. Cell Rep 2022; 40:111266. [PMID: 36001976 DOI: 10.1016/j.celrep.2022.111266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/16/2022] [Accepted: 08/04/2022] [Indexed: 11/22/2022] Open
Abstract
Mutations in the splicing factor SF3B1 are frequently occurring in various cancers and drive tumor progression through the activation of cryptic splice sites in multiple genes. Recent studies also demonstrate a positive correlation between the expression levels of wild-type SF3B1 and tumor malignancy. Here, we demonstrate that SF3B1 is a hypoxia-inducible factor (HIF)-1 target gene that positively regulates HIF1 pathway activity. By physically interacting with HIF1α, SF3B1 facilitates binding of the HIF1 complex to hypoxia response elements (HREs) to activate target gene expression. To further validate the relevance of this mechanism for tumor progression, we show that a reduction in SF3B1 levels via monoallelic deletion of Sf3b1 impedes tumor formation and progression via impaired HIF signaling in a mouse model for pancreatic cancer. Our work uncovers an essential role of SF3B1 in HIF1 signaling, thereby providing a potential explanation for the link between high SF3B1 expression and aggressiveness of solid tumors.
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Zhang L, Hobeika CS, Khabibullin D, Yu D, Filippakis H, Alchoueiry M, Tang Y, Lam HC, Tsvetkov P, Georgiou G, Lamb C, Stone E, Puigserver P, Priolo C, Henske EP. Hypersensitivity to ferroptosis in chromophobe RCC is mediated by a glutathione metabolic dependency and cystine import via solute carrier family 7 member 11. Proc Natl Acad Sci U S A 2022; 119:e2122840119. [PMID: 35867762 DOI: 10.1073/pnas.2122840119] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Chromophobe (Ch) renal cell carcinoma (RCC) arises from the intercalated cell in the distal nephron. There are no proven treatments for metastatic ChRCC. A distinguishing characteristic of ChRCC is strikingly high levels of reduced (GSH) and oxidized (GSSG) glutathione. Here, we demonstrate that ChRCC-derived cells exhibit higher sensitivity to ferroptotic inducers compared with clear-cell RCC. ChRCC-derived cells are critically dependent on cystine via the cystine/glutamate antiporter xCT to maintain high levels of glutathione, making them sensitive to inhibitors of cystine uptake and cyst(e)inase. Gamma-glutamyl transferase 1 (GGT1), a key enzyme in glutathione homeostasis, is markedly suppressed in ChRCC relative to normal kidney. Importantly, GGT1 overexpression inhibits the proliferation of ChRCC cells in vitro and in vivo, suppresses cystine uptake, and decreases levels of GSH and GSSG. Collectively, these data identify ferroptosis as a metabolic vulnerability in ChRCC, providing a potential avenue for targeted therapy for these distinctive tumors.
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Erlmeier F, Sun N, Shen J, Feuchtinger A, Buck A, Prade VM, Kunzke T, Schraml P, Moch H, Autenrieth M, Weichert W, Hartmann A, Walch A. MALDI Mass Spectrometry Imaging-Prognostic Pathways and Metabolites for Renal Cell Carcinomas. Cancers (Basel) 2022; 14:cancers14071763. [PMID: 35406537 PMCID: PMC8996951 DOI: 10.3390/cancers14071763] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Renal cell carcinoma (RCC) is the seventh most common cancer type and accounts for more than 80% of all renal tumors. Nevertheless, prognostic biomarkers for RCC are still missing. Therefore, we analyzed a large, multicenter cohort including the three most common RCC subtypes (clear cell RCC (ccRCC), papillary RCC (pRCC) and chromophobe RCC (chRCC)) by high mass resolution matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MSI) for prognostic biomarker detection. This is a suitable method for biomarker detection for several tumor entities. We detected several pathways and metabolites with prognostic power for RCC in general and also for different RCC subtypes. Abstract High mass resolution matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MSI) is a suitable method for biomarker detection for several tumor entities. Renal cell carcinoma (RCC) is the seventh most common cancer type and accounts for more than 80% of all renal tumors. Prognostic biomarkers for RCC are still missing. Therefore, we analyzed a large, multicenter cohort including the three most common RCC subtypes (clear cell RCC (ccRCC), papillary RCC (pRCC) and chromophobe RCC (chRCC)) by MALDI for prognostic biomarker detection. MALDI-Fourier-transform ion cyclotron resonance (FT-ICR)-MSI analysis was performed for renal carcinoma tissue sections from 782 patients. SPACiAL pipeline was integrated for automated co-registration of histological and molecular features. Kaplan–Meier analyses with overall survival as endpoint were executed to determine the metabolic features associated with clinical outcome. We detected several pathways and metabolites with prognostic power for RCC in general and also for different RCC subtypes.
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Affiliation(s)
- Franziska Erlmeier
- Institute of Pathology, University Hospital Erlangen-Nuremberg, 91054 Erlangen, Germany;
- Correspondence: (F.E.); (N.S.)
| | - Na Sun
- Research Unit Analytical Pathology, Helmholtz Zentrum München–German Research Center for Environmental Health, 85764 Neuherberg, Germany; (J.S.); (A.F.); (A.B.); (V.M.P.); (T.K.); (A.W.)
- Correspondence: (F.E.); (N.S.)
| | - Jian Shen
- Research Unit Analytical Pathology, Helmholtz Zentrum München–German Research Center for Environmental Health, 85764 Neuherberg, Germany; (J.S.); (A.F.); (A.B.); (V.M.P.); (T.K.); (A.W.)
| | - Annette Feuchtinger
- Research Unit Analytical Pathology, Helmholtz Zentrum München–German Research Center for Environmental Health, 85764 Neuherberg, Germany; (J.S.); (A.F.); (A.B.); (V.M.P.); (T.K.); (A.W.)
| | - Achim Buck
- Research Unit Analytical Pathology, Helmholtz Zentrum München–German Research Center for Environmental Health, 85764 Neuherberg, Germany; (J.S.); (A.F.); (A.B.); (V.M.P.); (T.K.); (A.W.)
| | - Verena M. Prade
- Research Unit Analytical Pathology, Helmholtz Zentrum München–German Research Center for Environmental Health, 85764 Neuherberg, Germany; (J.S.); (A.F.); (A.B.); (V.M.P.); (T.K.); (A.W.)
| | - Thomas Kunzke
- Research Unit Analytical Pathology, Helmholtz Zentrum München–German Research Center for Environmental Health, 85764 Neuherberg, Germany; (J.S.); (A.F.); (A.B.); (V.M.P.); (T.K.); (A.W.)
| | - Peter Schraml
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland; (P.S.); (H.M.)
| | - Holger Moch
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland; (P.S.); (H.M.)
| | - Michael Autenrieth
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, 81675 Munich, Germany;
| | - Wilko Weichert
- Institute of Pathology, Technical University Munich, 81675 Munich, Germany;
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen-Nuremberg, 91054 Erlangen, Germany;
| | - Axel Walch
- Research Unit Analytical Pathology, Helmholtz Zentrum München–German Research Center for Environmental Health, 85764 Neuherberg, Germany; (J.S.); (A.F.); (A.B.); (V.M.P.); (T.K.); (A.W.)
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Li X, Nie P, Zhang J, Hou F, Ma Q, Cui J. Differential diagnosis of renal oncocytoma and chromophobe renal cell carcinoma using CT features: a central scar-matched retrospective study. Acta Radiol 2022; 63:253-260. [PMID: 33497276 DOI: 10.1177/0284185120988109] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Renal oncocytoma (RO) and chromophobe renal cell carcinoma (chRCC) have a common cellular origin and different clinical management and prognosis. PURPOSE To explore the utility of computed tomography (CT) in the differentiation of RO and chRCC. MATERIAL AND METHODS Twenty-five patients with RO and 73 patients with chRCC presenting with the central scar were included retrospectively. Two experienced radiologists independently reviewed the CT imaging features, including location, tumor size, relative density ratio, segmental enhancement inversion (SEI), necrosis, and perirenal fascia thickening, among others. Interclass correlation coefficient (ICC, for continuous variables) or Kappa coefficient test (for categorical variables) was used to determine intra-observer and inter-observer bias between the two radiologists. RESULTS The inter- and intra-reader reproducibility of the other CT imaging parameters were nearly perfect (>0.81) except for the measurements of fat (0.662). RO differed from chRCC in the cortical or medullary side (P = 0.005), relative density ratio (P = 0.020), SEI (P < 0.001), and necrosis (P = 0.045). The logistic regression model showed that location (right kidney), hypo-density on non-enhanced CT, SEI, and perirenal fascia thickening were highly predictive of RO. The combined indicators from logistic regression model were used for ROC analysis. The area under the ROC curve was 0.923 (P < 0.001). The sensitivity and specificity of the four factors combined for diagnosing RO were 88% and 86.3%, respectively. The correlation coefficient between necrosis and tumor size in all tumors including both of RO and chRCC was 0.584, indicating a positive correlation (P < 0.001). CONCLUSION The CT imaging features of location (right kidney), hypo-density on non-enhanced CT, SEI, and perirenal fascia thickening were valuable indicators in distinguishing RO from chRCC.
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Affiliation(s)
- Xiaoli Li
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China
| | - Pei Nie
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China
| | - Jing Zhang
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China
| | - Feng Hou
- Department of Pathology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China
| | - Qianli Ma
- Department of Radiology, Qingdao Municipal Hospital, Qingdao, Shandong, PR China
| | - Jiufa Cui
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China
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Alhalabi O, Msaouel P. Truncating CDKN1A mutations: an insight into the biology of urinary tract carcinomas? Am J Cancer Res 2021; 11:6214-6217. [PMID: 35018253 PMCID: PMC8727807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023] Open
Abstract
A recent in silico study by Arnoff and El-Deiry found that urothelial carcinomas of the bladder and upper tract as well as chromophobe renal cell carcinoma are more likely than other malignancies to harbor alterations in the CDKN1A gene, encoding for the cyclin-dependent kinase inhibitor p21Waf1, a major target of p53 regulatory pathways. Most of these mutations were truncating and thus presumably resulting in loss of p21Waf1 function. Herein, we discuss the prognostic and therapeutic implications of these findings.
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Affiliation(s)
- Omar Alhalabi
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer CenterHouston, TX, USA
- David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas, MD Anderson Cancer CenterHouston, USA
| | - Pavlos Msaouel
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer CenterHouston, TX, USA
- David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas, MD Anderson Cancer CenterHouston, USA
- Department of Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas M.D. Anderson Cancer CenterHouston, TX, USA
- Center for Precision Environmental Health, Baylor College of MedicineHouston, USA
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Halefoglu AM, Ozagari AA. Comparison of cortico-medullary phase contrast-enhanced MDCT and T2-weighted MR imaging in the histological subtype differentiation of renal cell carcinoma: radiology-pathology correlation. Pol J Radiol 2021; 86:e583-93. [PMID: 34876939 DOI: 10.5114/pjr.2021.111013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/22/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose Renal cell carcinoma (RCC) subtype differentiation is of crucial importance in the management and prognosis of these patients. In this study, we investigated the usefulness of unenhanced and cortico-medullary phase contrast-enhanced multidetector-row computed tomography (MDCT) and T2-weighted fast spin-echo (FSE) magnetic resonance imaging (MRI) modalities in the discrimination of the 3 main subtype RCC patients in correlation with their histopathological findings. Material and methods A total of 80 pathologically proven RCC patients who had undergone either partial or total nephrectomy were retrospectively investigated in this study. Their histological subtypes were 54 clear cell renal cell carcinoma (ccRCC), 15 papillary renal cell carcinoma (pRCC), and 11 chromophobe renal cell carcinoma (cRCC), based on pathological evaluation. There were 62 male (77.5%) and 18 female (22.5%) patients. Among the 54 ccRCC patients, 29 patients had both non-contrast and cortico-medullary phase CT, 1 had only non-contrast CT, 5 only had cortico-medullary phase CT, and 38 had MRI examination. In the pRCC group, 10 patients had both non-contrast and cortico-medullary phase CT, 1 had only non-contrast CT, 1 had only cortico-medullary phase CT, and 12 had MRI. Finally, in the remaining 11 cRCC patients, 9 had both non-contrast and cortico-medullary phase CT, and only 5 had MRI. We calculated both tumour attenuation values as HU (Hounsfield units) on unenhanced and cortico-medullary phase MDCT images and also tumour mean signal intensity values on FSE T2-weighted MRI images by using the region of interest (ROI) including normal renal cortex measurements. Besides quantitative evaluation, we also performed qualitative visual assessment of tumours on contrast-enhanced MDCT and FSE T2-weighted MRI. Results There was no statistically significant difference among the attenuation values of the 3 tumour subtypes on pre-contrast CT images. ccRCC demonstrated a prominent degree of contrast enhancement compared to the chromophobe and papillary ones on cortico-medullary phase MDCT. We found no statistically significant difference between chromophobe and papillary subtypes, although chromophobe tumours showed slightly higher attenuation values compared to papillary ones. ccRCCs usually demonstrated a heterogenous contrast enhancement on cortico-medullary phase CT images, while the papillary subtype usually had a homogenous appearance on visual assessment. On FSE T2-weighted MR images, the signal intensity values of ccRCC patients were found to be significantly higher than both chromophobe and papillary subtypes. Although cRCC patients had a prominently lower T2 signal intensity than clear cell subtype, there was no statistically significant signal intensity difference between chromophobe and papillary subtypes. Regarding visual assessment, papillary subtype tumours showed a mostly homogenous appearance on T2-weighted images and a statistically significant difference was present. On the other hand, there was no significant difference of visual assessment of the clear cell and chromophobe subtypes. Conclusions The measurement of the attenuation values on cortico-medullary phase MDCT and the mean signal intensity values on FSE T2-weighted MRI can provide useful information in the differentiation of RCC main subtypes. Also, visual assessment of tumours on both modalities can contribute to this issue by providing additional imaging properties.
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Arnoff TE, El-Deiry WS. CDKN1A/p21 WAF1, RB1, ARID1A, FLG, and HRNR mutation patterns provide insights into urinary tract environmental exposure carcinogenesis and potential treatment strategies. Am J Cancer Res 2021; 11:5452-5471. [PMID: 34873472 PMCID: PMC8640812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023] Open
Abstract
Bladder carcinoma has a 6% 5-year survival-rate for metastatic disease, with poorly understood links between genetic and environmental drivers of disease development, progression, and treatment response. Rhode Island has among the highest annual age-adjusted incidence rate of bladder cancer at 26.0/100,000, compared to 20.0 in the US, with a paucity of known driver genes for targeted therapies or predictive biomarkers. Bladder carcinomas have the highest frequency of alterations in CDKN1A/p21WAF1 (10%) across all cancer types analyzed in The Cancer Genome Atlas (TCGA) PanCancer Atlas Studies, displaying a predominance of truncating mutations (86%). We found that lung carcinomas lack CDKN1A truncating mutations, despite the shared role of tobacco as a risk factor for bladder cancer. Bladder carcinomas also have the highest frequency of RB1 alterations in TCGA (25%). We find that chromophobe renal cell carcinomas with CDKN1A and RB1 mutations are 100% truncating. Analysis of 1,868 bladder tumors demonstrated that truncating CDKN1A mutations co-occur with truncating RB1 mutations, suggesting an environmental exposure signature. Moreover, we found that HRNR and FLG mutations are enriched in tumors with CDKN1A alteration, suggesting potential novel roles in promoting bladder tumorigenesis. Association of HRNR with AKT activation offers possible therapeutic avenues, and FLG may provide insight into carcinogen exposure within the bladder. We suggest that because APOBEC mutations largely shape the bladder cancer mutational landscape, these events likely contribute to dysfunctional DNA repair genes, leading to frameshifts and the predominance of truncations in CDKN1A, RB1, ARID1A, or other drivers. We propose that patients with co-occurrence of CDKN1A and RB1 truncations may display enhanced responsiveness to targeted therapies combining cisplatin with ATR, ATM, CHK1, and CHK2 inhibitors, expanding therapeutic options for patients in need of improved precision treatments.
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Affiliation(s)
- Taylor E Arnoff
- Laboratory of Translational Oncology and Experimental Cancer Therapeutics, The Warren Alpert Medical School, Brown UniversityProvidence, RI, USA
| | - Wafik S El-Deiry
- Laboratory of Translational Oncology and Experimental Cancer Therapeutics, The Warren Alpert Medical School, Brown UniversityProvidence, RI, USA
- Hematology/Oncology Division, Department of Medicine, Lifespan Health System and The Warren Alpert Medical School, Brown UniversityProvidence, RI, USA
- The Joint Program in Cancer Biology, Lifespan Health System and The Warren Alpert Medical School, Brown UniversityProvidence, RI, USA
- Cancer Center at Brown University, The Warren Alpert Medical School, Brown UniversityProvidence, RI, USA
- Department of Pathology and Laboratory Medicine, Lifespan Health System and The Warren Alpert Medical School, Brown UniversityProvidence, RI, USA
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Chalokia R, Anosike C, Robinson L, Manson C, Kumar M. An Unusual and Rare Metachronous Ipsilateral Ureteric Stump Metastasis Post Radical Nephrectomy. Cureus 2021; 13:e17727. [PMID: 34659941 PMCID: PMC8491794 DOI: 10.7759/cureus.17727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 11/15/2022] Open
Abstract
We report a case of recurrence of chromophobe renal cell cancer in the ipsilateral ureteric stump eight years later after the primary tumor was excised successfully. Before this detection of the recurrence, the patient had presented with recurrent episodes of hematuria four years after the radical nephrectomy was performed and the investigations were inconclusive. Eventually, the lesion was detected on flexible cystoscopy in the area of the right ureteric orifice protruding in the bladder. Transurethral resection of the tumor surprisingly revealed a chromophobe renal cancer with similar features seen in the primary tumor specimen. The patient underwent robotic-assisted laparoscopic excision of the ureteric stump with a cuff of the bladder and has been recurrence-free for five years on regular surveillance scans.
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Affiliation(s)
- Ramandeep Chalokia
- Urology, Warrington and Halton Teaching Hospitals National Health Service Foundation Trust, Warrington, GBR
| | - Chinedum Anosike
- Radiology, Warrington and Halton Teaching Hospitals National Health Service Foundation Trust, Warrington, GBR
| | - Lee Robinson
- Urology, Warrington and Halton Teaching Hospitals National Health Service Foundation Trust, Warrington, GBR
| | - Catherine Manson
- Pathology, Warrington and Halton Teaching Hospitals National Health Service Foundation Trust, Warrington, GBR
| | - Manal Kumar
- Urology, Arrowe Park Hospital, Wirral University Teaching Hospital National Health Service Foundation Trust, Birkenhead, GBR
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22
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Liang RX, Wang H, Zhang HP, Ye Q, Zhang Y, Zheng MJ, Xue ES, Zhu YF. The value of real-time contrast-enhanced ultrasound combined with CT enhancement in the differentiation of subtypes of renal cell carcinoma. Urol Oncol 2021; 39:837.e19-837.e28. [PMID: 34654644 DOI: 10.1016/j.urolonc.2021.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 08/03/2021] [Accepted: 09/09/2021] [Indexed: 11/25/2022]
Abstract
AIM This study aimed to evaluate the value of real-time contrast-enhanced ultrasound (CEUS) combined with contrast-enhanced computed tomography (CECT) in the differential diagnosis of clear cell renal cell carcinoma (CCRCC), papillary renal cell carcinoma (PRCC), and chromophobe renal cell carcinoma (CRCC). MATERIALS AND METHODS In the present study, 82 patients with CCRCC, 24 patients with PRCC, and 19 patients with CRCC were confirmed by pathology of the resected tumor. All patients were evaluated by CEUS and CECT before the operation. In addition, the contrast enhancement mode of CEUS and CECT and the contrast parameters of the region of interest (ROI) time-intensity curve between the lesions and the surrounding normal renal parenchyma by CEUS were compared and analyzed. RESULTS Compared with the pathological results, the diagnostic accuracy of ultrasound in the 3 groups was 87.8% (72/82), 83.3% (20/24) and 73.7% (14/19). There was no significant difference between CEUS and CECT in the diagnostic accuracy of all groups (P>0.05). Meanwhile, compared with the surrounding renal parenchyma by CEUS, 82.5% (66/80) of CCRCC lesions showed "fast-forward and fast/slow-retrograde," while 83.3% (20/24) of PRCC, and 84.2% (16/19) showed "slow-forward and fast/slow-retrograde." Significant differences in the enhancement modes of CEUS were found among the CCRCC, PRCC, and CRCC lesions (P < 0.05). And the enhancement modes could be quantitatively analyzed by the ROI time-intensity curve of the lesion. Moreover, lesions enhanced by CECT and 74.4% (61/82) of CCRCC lesions showed "fast-forward and fast/slow-retrograde," while 66.7% (16/24) of PRCC and 84.2% (16/19) of CRCC showed "slow-forward and fast/slow-retrograde." The contrast modes and enhancement uniformity of CEUS and CECT showed no significant differences among the CCRCC, PRCC, and CRCC lesions (P > 0.05). CONCLUSION CEUS and quantitative analysis of ROI time-intensity curve can be used for differential diagnosis of the 3 RCC subtypes. The combination of CEUS and CECT can help us differentiate RCC subtypes and is of great significance for clinical treatment strategies and prognostication.
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Affiliation(s)
- Rong-Xi Liang
- Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
| | - Hua Wang
- Department of Radiology, Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
| | - Hui-Ping Zhang
- Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
| | - Qin Ye
- Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.
| | - Yu Zhang
- Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
| | - Mei-Juan Zheng
- Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
| | - En-Sheng Xue
- Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
| | - Yi-Fan Zhu
- Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
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23
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Morozova MM, Ivanova EI, Chardarov NK, Dolzhanskiy OV, Shatveryan GA, Kamalov YR. [Multiple hepatocellular adenomas and renal cell carcinoma associated with anabolic androgenic steroids]. Khirurgiia (Mosk) 2021:105-109. [PMID: 34608788 DOI: 10.17116/hirurgia2021101105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors report a rare case of combination of chromophobe renal cell carcinoma Grade 2 pT2aN0 with multiple hepatocellular adenomas in a 31-year-old bodybuilder who received anabolic androgenic steroids at high doses for 8 years. According to MRI data, over 15 liver adenomas and tumor in the lower segment of the right kidney were detected. The patients underwent laparascopic resection of the right kidney and liver segments 2, 3 and 4 with large adenomas. Histological study and immunohistochemistry revealed no malignancy signs in hepatocellular adenomas. Nuclear β-catenin expression was absent. Kidney tumor had a structure of chromophobe renal cell carcinoma. The patient is currently being followed-up due to residual small liver adenomas. In our opinion, liver adenomatosis and renal cancer have the same cause in this case (chronic toxic effect of androgens).
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Affiliation(s)
- M M Morozova
- Petrovsky Russian Research Center of Surgery, Moscow, Russia
| | - E I Ivanova
- Petrovsky Russian Research Center of Surgery, Moscow, Russia
| | - N K Chardarov
- Petrovsky Russian Research Center of Surgery, Moscow, Russia
| | - O V Dolzhanskiy
- Petrovsky Russian Research Center of Surgery, Moscow, Russia
| | - G A Shatveryan
- Petrovsky Russian Research Center of Surgery, Moscow, Russia
| | - Yu R Kamalov
- Petrovsky Russian Research Center of Surgery, Moscow, Russia
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24
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Jaggi A, Mastrodicasa D, Charville GW, Jeffrey RB, Napel S, Patel B. Quantitative image features from radiomic biopsy differentiate oncocytoma from chromophobe renal cell carcinoma. J Med Imaging (Bellingham) 2021; 8:054501. [PMID: 34514033 DOI: 10.1117/1.jmi.8.5.054501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 08/05/2021] [Indexed: 11/14/2022] Open
Abstract
Purpose: To differentiate oncocytoma and chromophobe renal cell carcinoma (RCC) using radiomics features computed from spherical samples of image regions of interest, "radiomic biopsies" (RBs). Approach: In a retrospective cohort study of 102 CT cases [68 males (67%), 34 females (33%); mean age ± SD, 63 ± 12 years ], we pathology-confirmed 42 oncocytomas (41%) and 60 chromophobes (59%). A board-certified radiologist performed two RB rounds. From each RB round, we computed radiomics features and compared the performance of a random forest and AdaBoost binary classifier trained from the features. To control for overfitting, we performed 10 rounds of 70% to 30% train-test splits with feature-selection, cross-validation, and hyperparameter-optimization on each split. We evaluated the performance with test ROC AUC. We tested models on data from the other RB round and compared with the same round testing with the DeLong test. We clustered important features for each round and measured a bootstrapped adjusted Rand index agreement. Results: Our best classifiers achieved an average AUC of 0.71 ± 0.024 . We found no evidence of an effect for RB round ( p = 1 ). We also found no evidence for a decrease in model performance when tested on the other RB round ( p = 0.85 ). Feature clustering produced seven clusters in each RB round with high agreement ( Rand index = 0.981 ± 0.002 , p < 0.00001 ). Conclusions: A consistent radiomic signature can be derived from RBs and could help distinguish oncocytoma and chromophobe RCC.
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Affiliation(s)
- Akshay Jaggi
- Stanford University School of Medicine, Department of Radiology, Stanford, California, United States
| | - Domenico Mastrodicasa
- Stanford University School of Medicine, Department of Radiology, Stanford, California, United States
| | - Gregory W Charville
- Stanford University School of Medicine, Department of Pathology, Stanford, California, United States
| | - R Brooke Jeffrey
- Stanford University School of Medicine, Department of Radiology, Stanford, California, United States
| | - Sandy Napel
- Stanford University School of Medicine, Department of Radiology, Stanford, California, United States
| | - Bhavik Patel
- Mayo Clinic Arizona, Department of Radiology, Phoenix, Arizona, United States.,Arizona State University, Ira A. Fulton School of Engineering, Phoenix, Arizona, United States
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25
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Hu D, Meng N, Lou X, Li Z, Teng Y, Tu B, Zou Y, Wang F. Prognostic Values of E2F1/2 Transcriptional Expressions in Chromophobe Renal Cell Carcinoma Patients: Evidence from Bioinformatics Analysis. Int J Gen Med 2021; 14:3593-3609. [PMID: 34295182 PMCID: PMC8291967 DOI: 10.2147/ijgm.s321585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background Numerous studies on the E2F transcription factors have led to increasing insights that E2Fs could be an important driver of the formation and progression of many human cancers. Little is known about the function of distinct E2Fs in chromophobe renal cell carcinoma (chRCC). Methods We utilized the UALCAN, GEPIA, Cancer Genome Atlas (TCGA) database, cBioPortal, Metascape, STRING, Cytoscape, GeneMANIA, TIMER, TISIDB, GSCALite, and MEXPRESS databases to investigate the transcription level, genetic alteration, methylation, and biological function of E2Fs in chRCC patients, and its association with the occurrence, progress, prognosis, and immune cell infiltration in patients with chRCC. Results We found that E2F1/2/4/7/8 were more expressed in chRCC tissues than in normal tissues, while the expression of E2F5/6 was lower in the former than in the latter, and the expression levels of E2F1/2/4/5/6//7/8 were also associated with the histological parameters of chRCC, including T-stage and N-stage. Higher expression of E2F1/2/7/8 was found to be significantly correlated with worse overall survival (OS) in chRCC patients. Cox regression and time-dependent ROC analysis further suggested that E2F1/2 could be the potential independent biomarkers for chRCC prognosis. Besides, a moderate mutation rate of E2Fs (34%) was noticed in chRCC, and the genetic mutations in E2Fs were associated with poor survival of chRCC patients. We noticed that the expression of E2Fs was statistically correlated with the immune cell infiltration in chRCC. Moreover, we also found that the expression of E2F1 was significantly correlated with tumor-infiltrating lymphocytes and immunomodulators, E2F7 expression was associated with MHC molecules, and the expression of E2F1/8 was correlated to their methylation levels. Conclusion Our results provide novel insights for selecting the prognostic biomarkers for chRCC and suggest that E2F1/2 could act as potential prognostic biomarkers for the survival of chRCC patients. However, more in-depth experiments are required to identify the underlying mechanisms and verify the clinical value of E2F1/2 in the prognosis of chRCC.
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Affiliation(s)
- Dingtao Hu
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Nana Meng
- Department of Quality Management Office, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Xiaoqi Lou
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Zhen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Ying Teng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Bizhi Tu
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Yanfeng Zou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Fang Wang
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
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26
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Li L, Chen X, Hao L, Chen Q, Liu H, Zhou Q. Exploration of immune-related genes in high and low tumor mutation burden groups of chromophobe renal cell carcinoma. Biosci Rep 2020; 40:BSR20201491. [PMID: 32662515 DOI: 10.1042/BSR20201491] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/05/2020] [Accepted: 07/13/2020] [Indexed: 02/05/2023] Open
Abstract
Renal cell carcinoma (RCC) is one of most common cancers with gradually increasing incidence and high mortality. Chromogenic RCC (chRCC) is the third most common histological subtype of RCC, accounting for approximately 5–7% of RCC. In our study, the transcriptome expression profile data (n=89) of chRCC, corresponding clinical data (n=113) and the somatic mutation data (n=66) were obtained from the TCGA database. We first analyzed the mutation data of chRCC patients and divided chRCC patients into high and low tumor mutation burden (TMB) groups based on the median TMB. We found that high TMB was significantly associated with worse prognosis and could promote tumor metastasis and development. Moreover, four different immune-related genes (BIRC5, PDGFRL, INHBE, IL20RB) were also identified. We found that BIRC5 was significantly overexpressed in the high TMB group and correlated with worse prognosis. The results of univariate and multivariate COX analyses demonstrated that BIRC5 (hazard ratio (HR) = 2.094) may serve as a prognostic indicator for patients with chRCC with high TMB. In addition, we identified the possible functional pathways of BIRC5 through gene set enrichment analysis (GSEA) enrichment. A positive correlation was obtained between BIRC5 and the abundance of CD4+ T cells. The results of our study revealed their correlation between the immune-related genes and clinicopathologic features as well as potential functional pathways as well as immune infiltrating cells, which may provide more data about the development of chRCC immunotherapy.
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27
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Kowalik A, Wincewicz A, Ossoliński K, Zięba S, Kopczyński J, Ossoliński T, Góźdź S, Koda M, Sulkowski S. Review on significance of GDNF, PTCH1 and RNF213 in chromophobe renal cell carcinoma illustrated by the case of 71-years-old man. POL J PATHOL 2020; 71:195-9. [PMID: 33112109 DOI: 10.5114/pjp.2020.99785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Here we review the role of GDNF, PTCH1, RNF213 illustrated by a case of renal cell carcinoma, chromophobe type (pT2a 8th pTNM edition) of the left kidney of 71-year-old man. Status of potential hotspots in 409 tumor genes were studied by means of next generation sequencing (NGS) technology (IonTorrent - Thermo Fisher Scientific, USA) using Ion AmpliSeq™ Comprehensive Cancer Panel. Next-generation sequencing (NGS) revealed mutations of GDNF (NM_001190468: c. 328C>T, p.R110W, allelic frequency 46%), PTCH1 (NM_001083607:c. 2969C<T, p.A990V, allelic frequency 7%) RNF213 (NM_001256071: c.6967C<T, p.Q2323X, allelic frequency 7%). Our findings in relation to concise description of significance of GDNF, PTCH1, RNF213 supplement molecular characterization in area of gene profiling of renal cell carcinoma, chromophobe type, which is going to certainly deepen our knowledge on hazards in development of this peculiar kind of renal cancer.
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28
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Alexander CM, Martin JA, Oxman E, Kasza I, Senn KA, Dvinge H. Alternative Splicing and Cleavage of GLUT8. Mol Cell Biol 2020; 41:e00480-20. [PMID: 33077497 DOI: 10.1128/MCB.00480-20] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/01/2020] [Indexed: 11/20/2022] Open
Abstract
The GLUT (SLC2) family of membrane-associated transporters are described as glucose transporters. However, this family is divided into three classes and, though the regulated transporter activity of class I proteins is becoming better understood, class III protein functions continue to be obscure. We have cataloged the relative expression and splicing of SLC2 mRNA isomers in tumors and normal tissues, with a focus on breast tumors and cell lines. mRNA for the class III protein GLUT8 is the predominant SLC2 species expressed alongside GLUT1 in many tissues, but GLUT8 mRNA exists mostly as an untranslated splice form in tumors. We confirm that GLUT8 is not presented at the cell surface and does not transport glucose directly. However, we reveal a lysosome-dependent reaction that cleaves the GLUT8 protein and releases the carboxy-terminal peptide to a separate vesicle population. Given the localization of GLUT8 at a major metabolic hub (the late endosomal/lysosomal interface) and its regulated cleavage reaction, we evaluated TXNIP-mediated hexosamine homeostasis and speculate that GLUT8 may function as a sensory component of this reaction.
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29
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Chen C, Geng X, Liang R, Zhang D, Sun M, Zhang G, Hou J. Nomograms-based prediction of overall and cancer-specific survivals for patients with chromophobe renal cell carcinoma. Exp Biol Med (Maywood) 2020; 246:729-739. [PMID: 33302735 DOI: 10.1177/1535370220977107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
This study built and tested two effective nomograms for the purpose of predicting cancer-specific survival and overall survival of chromophobe renal cell carcinoma (chRCC) patients. Multivariate Cox regression analysis was employed to filter independent prognostic factors predictive of cancer-specific survival and overall survival, and the nomograms were built based on a training set incorporating 2901 chRCC patients in a retrospective study (from 2004 to 2015) downloaded from the surveillance, epidemiology, and end results (SEER) database. The nomograms were verified on a validation cohort of 1934 patients, subsequently the performances of the nomograms were examined according to the receiver operating characteristic curve, calibration curves, the concordance (C-index), and decision curve analysis. The results showed that tumor grade, AJCC and N stages, race, marital status, age, histories of chemotherapy, radiotherapy and surgery were the individual prognostic factors for overall survival, and that AJCC, N and SEER stages, histories of surgery, radiotherapy and chemotherapy, age, tumor grade were individual prognostic factors for cancer-specific survival. According to C-indexes, receiver operating characteristic curves, and decision curve analysis outcomes, the nomograms showed a higher accuracy in predicting overall survival and OSS when compared with TNM stage and SEER stage. All the calibration curves were significantly consistent between predictive and validation sets. In this study, the nomograms, which were validated to be highly accurate and applicable, were built to facilitate individualized predictions of the cancer-specific survival and overall survival to patients diagnosed with chRCC between 2004 and 2015.
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Affiliation(s)
- Chunyang Chen
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China
| | - Xinyu Geng
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China
| | - Rui Liang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China
| | - Dongze Zhang
- Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China.,Jiangsu Key Laboratory of Clinical Immunology, Soochow University, Suzhou 215006, People's Republic of China
| | - Meiyun Sun
- Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China.,Jiangsu Key Laboratory of Clinical Immunology, Soochow University, Suzhou 215006, People's Republic of China
| | - Guangbo Zhang
- Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China.,Jiangsu Key Laboratory of Clinical Immunology, Soochow University, Suzhou 215006, People's Republic of China
| | - Jianquan Hou
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China
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30
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Wang D, Huang X, Bai L, Zhang X, Wei J, Zhou J. Differential diagnosis of chromophobe renal cell carcinoma and papillary renal cell carcinoma with dual-energy spectral computed tomography. Acta Radiol 2020; 61:1562-1569. [PMID: 32088966 DOI: 10.1177/0284185120903447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Computed tomography (CT) image features of chromophobe renal cell carcinoma (ChRCC) and papillary renal cell carcinoma (PRCC) are, occasionally, sometimes difficult to identify. However, spectral CT might provide quantitative parameters to differentiate them. PURPOSE To differentiate between ChRCC and PRCC with quantitative parameters using spectral CT. MATERIAL AND METHODS Forty cases of RCC confirmed with pathological tests were analyzed retrospectively (27 cases of PRCC and 13 cases of ChRCC). All patients underwent non-enhanced CT and dual-phase contrast-enhanced CT scans. For each lesion, the CT value of monochromatic images as well as iodine and water concentrations were measured, and the slope of spectrum curve was calculated. Data were analyzed using Student's t-test. Sensitivity and specificity of the quantitative parameters were analyzed using the receiver operating characteristic (ROC) curve. RESULTS During the cortex phase (CP) and parenchyma phase (PP), the CT value and slope of spectrum curve of ChRCC were higher than those of PRCC, and significant differences were observed at low energy levels (40-70 keV). Normalized iodine concentration of ChRCC and that of PRCC was significantly different during CP and PP (P < 0.05). The water (iodine) concentrations of ChRCC and PRCC in CP and PP were not statistically different (P > 0.05). All the ROCs for parameters were above the reference line. CONCLUSION Spectral CT may help increase the diagnostic accuracy of differentiating PRCC from ChRCC using a quantitative analysis.
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Affiliation(s)
- Dan Wang
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
| | - Xiaoyu Huang
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
| | - Liangcai Bai
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
| | - Xueling Zhang
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
| | - Jinyan Wei
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
| | - Junlin Zhou
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
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31
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Wu G, Xia P, Yan S, Chen D, Xie L, Fan G. Identification of unique long non-coding RNAs as putative biomarkers for chromophobe renal cell carcinoma. Per Med 2020; 18:9-19. [PMID: 33052074 DOI: 10.2217/pme-2020-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: To investigate whether long non-coding RNAs (lncRNAs) can be utilized as molecular biomarkers in predicting the occurrence and progression of chromophobe renal cell carcinoma. Methods & results: Genetic and related clinical traits of chromophobe renal cell carcinoma were downloaded from the Cancer Genome Atlas and used to construct modules using weighted gene coexpression network analysis. In total, 44,889 genes were allocated into 21 coexpression modules depending on intergenic correlation. Among them, the green module was the most significant key module identified by module-trait correlation calculations (R2 = 0.43 and p = 4e-04). Gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses demonstrated that genes in the green module were enriched in many pathways. Coexpression, protein-protein interaction networks, screening for differentially expressed genes, and survival analysis were used to select hub lncRNAs. Five hub lncRNAs (TTK, CENPE, KIF2C, BUB1, and RAD51AP1) were selected out. Conclusion: Our findings suggest that the five lncRNAs may act as potential biomarkers for chromophobe renal cell carcinoma progression and prognosis.
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Affiliation(s)
- Guanlin Wu
- Experimental & Clinical Research Center, Charité-Universitätsmedizin Berlin, Berlin-Buch, Germany.,Max DelbrückCenter for Molecular Medicine (MDC) in the Helmholtz Association, Berlin-Buch, Germany
| | - Pengfei Xia
- Max DelbrückCenter for Molecular Medicine (MDC) in the Helmholtz Association, Berlin-Buch, Germany
| | - Shixian Yan
- Experimental & Clinical Research Center, Charité-Universitätsmedizin Berlin, Berlin-Buch, Germany.,Max DelbrückCenter for Molecular Medicine (MDC) in the Helmholtz Association, Berlin-Buch, Germany
| | - Dongming Chen
- Department of Cerebral Surgery, First People's Hospital of Tianmen, Tianmen, PR China
| | - Lei Xie
- Department of Urology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, PR China
| | - Gang Fan
- Department of Urology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, PR China.,The 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, PR China
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32
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Kriegsmann M, Casadonte R, Maurer N, Stoehr C, Erlmeier F, Moch H, Junker K, Zgorzelski C, Weichert W, Schwamborn K, Deininger SO, Gaida M, Mechtersheimer G, Stenzinger A, Schirmacher P, Hartmann A, Kriegsmann J, Kriegsmann K. Mass Spectrometry Imaging Differentiates Chromophobe Renal Cell Carcinoma and Renal Oncocytoma with High Accuracy. J Cancer 2020; 11:6081-6089. [PMID: 32922548 PMCID: PMC7477404 DOI: 10.7150/jca.47698] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/29/2020] [Indexed: 12/18/2022] Open
Abstract
Background: While subtyping of the majority of malignant chromophobe renal cell carcinoma (cRCC) and benign renal oncocytoma (rO) is possible on morphology alone, additional histochemical, immunohistochemical or molecular investigations are required in a subset of cases. As currently used histochemical and immunohistological stains as well as genetic aberrations show considerable overlap in both tumors, additional techniques are required for differential diagnostics. Mass spectrometry imaging (MSI) combining the detection of multiple peptides with information about their localization in tissue may be a suitable technology to overcome this diagnostic challenge. Patients and Methods: Formalin-fixed paraffin embedded (FFPE) tissue specimens from cRCC (n=71) and rO (n=64) were analyzed by MSI. Data were classified by linear discriminant analysis (LDA), classification and regression trees (CART), k-nearest neighbors (KNN), support vector machine (SVM), and random forest (RF) algorithm with internal cross validation and visualized by t-distributed stochastic neighbor embedding (t-SNE). Most important variables for classification were identified and the classification algorithm was optimized. Results: Applying different machine learning algorithms on all m/z peaks, classification accuracy between cRCC and rO was 85%, 82%, 84%, 77% and 64% for RF, SVM, KNN, CART and LDA. Under the assumption that a reduction of m/z peaks would lead to improved classification accuracy, m/z peaks were ranked based on their variable importance. Reduction to six most important m/z peaks resulted in improved accuracy of 89%, 85%, 85% and 85% for RF, SVM, KNN, and LDA and remained at the level of 77% for CART. t-SNE showed clear separation of cRCC and rO after algorithm improvement. Conclusion: In summary, we acquired MSI data on FFPE tissue specimens of cRCC and rO, performed classification and detected most relevant biomarkers for the differential diagnosis of both diseases. MSI data might be a useful adjunct method in the differential diagnosis of cRCC and rO.
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Affiliation(s)
- Mark Kriegsmann
- Institute of Pathology, Heidelberg University, Heidelberg, Germany
| | | | - Nadine Maurer
- Institute of Pathology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Christine Stoehr
- Institute of Pathology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Franziska Erlmeier
- Institute of Pathology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Holger Moch
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - Klaus Junker
- Department of Urology and Pediatric Urology, University of Saarland, Homburg/Saar, Germany
| | | | | | | | | | | | | | | | | | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Joerg Kriegsmann
- Proteopath Trier, Trier, Germany.,Centre for Histology, Cytology and molecular Diagnostics Trier, Trier, Germany.,Danube Private University, Krems, Austria
| | - Katharina Kriegsmann
- Department Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
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Chrabańska M, Kiczmer P, Drozdzowska B. Correlation among different pathologic features of renal cell carcinoma: a retrospective analysis of 249 cases. Int J Clin Exp Pathol 2020; 13:1720-1726. [PMID: 32782695 PMCID: PMC7414505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/20/2020] [Indexed: 06/11/2023]
Abstract
Renal cell carcinoma (RCC) represents 90% of renal malignancies and is the most lethal neoplasm of the urologic system. RCC is not a single entity but rather a heterogeneous group of neoplasms with varying genetic, morphologic and clinical features and outcome. The aim of this study was to correlate pathologic features of RCC that can be helpful during the decision-making process. We present a retrospective analysis of 249 RCCs (203 clear cell, 32 papillary and 14 chromophobe RCCs). We found that 77.8% of tumors of ≤4 cm and only 28.8% of RCC of >7 cm were limited to the kidney. The likelihood of lymphovascular invasion, fibrous renal capsule/perinephric fat/renal sinus fat, and vascular infiltration increased dramatically with increasing tumor size, particularly over 4.5 cm. Fat tissue was more often invaded through the renal sinus than through the renal capsule. Nuclear grade was significantly related to the pT stage, tumor size, percentage of necrotic area, lymphovascular invasion, fibrous renal capsule/perinephric fat/renal sinus fat and vascular infiltration. Tumor size represents one of the most important factors determining biological behavior of renal cancer. Renal sinus and perinephric fat should be carefully investigated, particularly in case of tumors >4-5 cm. Despite increasing acceptance for partial nephrectomy in tumors >7 cm, these cancers invade renal sinus fat 11 times more often and perinephric fat 5.6 times more often than smaller ones.
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Affiliation(s)
- Magdalena Chrabańska
- Department and Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia Katowice, Poland. Ul. 3 Maja 13-15, 41-800 Zabrze, Poland
| | - Paweł Kiczmer
- Department and Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia Katowice, Poland. Ul. 3 Maja 13-15, 41-800 Zabrze, Poland
| | - Bogna Drozdzowska
- Department and Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia Katowice, Poland. Ul. 3 Maja 13-15, 41-800 Zabrze, Poland
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Yang G, Gong A, Nie P, Yan L, Miao W, Zhao Y, Wu J, Cui J, Jia Y, Wang Z. Contrast-Enhanced CT Texture Analysis for Distinguishing Fat-Poor Renal Angiomyolipoma From Chromophobe Renal Cell Carcinoma. Mol Imaging 2020; 18:1536012119883161. [PMID: 31625454 PMCID: PMC6801892 DOI: 10.1177/1536012119883161] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objective: To evaluate the value of 2-dimensional (2D) and 3-dimensional (3D) computed tomography
texture analysis (CTTA) models in distinguishing fat-poor angiomyolipoma (fpAML) from
chromophobe renal cell carcinoma (chRCC). Methods: We retrospectively enrolled 32 fpAMLs and 24 chRCCs. Texture features were extracted
from 2D and 3D regions of interest in triphasic CT images. The 2D and 3D CTTA models
were constructed with the least absolute shrinkage and selection operator algorithm and
texture scores were calculated. The diagnostic performance of the 2D and 3D CTTA models
was evaluated with respect to calibration, discrimination, and clinical usefulness. Results: Of the 177 and 183 texture features extracted from 2D and 3D regions of interest,
respectively, 5 2D features and 8 3D features were selected to build 2D and 3D CTTA
models. The 2D CTTA model (area under the curve [AUC], 0.811; 95% confidence interval
[CI], 0.695-0.927) and the 3D CTTA model (AUC, 0.915; 95% CI, 0.838-0.993) showed good
discrimination and calibration (P > .05). There was no significant
difference in AUC between the 2 models (P = .093). Decision curve
analysis showed the 3D model outperformed the 2D model in terms of clinical
usefulness. Conclusions: The CTTA models based on contrast-enhanced CT images had a high value in
differentiating fpAML from chRCC.
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Affiliation(s)
- Guangjie Yang
- PET-CT Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Aidi Gong
- PET-CT Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Pei Nie
- Radiology Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Lei Yan
- PET-CT Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenjie Miao
- PET-CT Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yujun Zhao
- PET-CT Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jie Wu
- Pathology Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jingjing Cui
- Huiying Medical Technology Co, Ltd, Beijing, China
| | - Yan Jia
- Huiying Medical Technology Co, Ltd, Beijing, China
| | - Zhenguang Wang
- PET-CT Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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35
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Lu HC, Patterson NH, Judd AM, Reyzer ML, Sehn JK. Imaging Mass Spectrometry Is an Accurate Tool in Differentiating Clear Cell Renal Cell Carcinoma and Chromophobe Renal Cell Carcinoma: A Proof-of-concept Study. J Histochem Cytochem 2020; 68:403-411. [PMID: 32466698 DOI: 10.1369/0022155420931417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Clear cell renal cell carcinoma (ccRCC) and chromophobe renal cell carcinoma (chRCC) are relatively common tumors that can have significant risk for mortality. Treatment and prognostication in renal cell carcinoma (RCC) are dependent upon correct histologic typing. ccRCC and chRCC are generally straightforward to diagnose based on histomorphology alone. However, high-grade ccRCC and chRCC can sometimes resemble each other morphologically, particularly in small biopsies. Multiple immunostains and/or colloidal iron stain are sometimes required to differentiate the two. Imaging mass spectrometry (IMS) allows simultaneous spatial mapping of thousands of biomarkers, using formalin-fixed paraffin-embedded tissue sections. In this study, we evaluate the ability of IMS to differentiate between World Health Organization/International Society for Urological Pathology grade 3 ccRCC and chRCC. IMS spectra from a training set of 14 ccRCC and 13 chRCC were evaluated via support vector machine algorithm with a linear kernel for machine learning, building a classification model. The classification model was applied to a separate validation set of 6 ccRCC and 6 chRCC, with 19 to 20, 150-μm diameter tumor foci in each case sampled by IMS. Most evaluated tumor foci were classified correctly as ccRCC versus chRCC (99% accuracy, kappa=0.98), demonstrating that IMS is an accurate tool in differentiating high-grade ccRCC and chRCC.
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Affiliation(s)
- Hsiang-Chih Lu
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Nathan Heath Patterson
- Mass Spectrometry Research Center, Department of Biochemistry, Vanderbilt University, Nashville, TN
| | - Audra M Judd
- Mass Spectrometry Research Center, Department of Biochemistry, Vanderbilt University, Nashville, TN
| | - Michelle L Reyzer
- Mass Spectrometry Research Center, Department of Biochemistry, Vanderbilt University, Nashville, TN
| | - Jennifer K Sehn
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO
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Honda‐Takinami R, Ishibashi K, Onagi A, Tanji R, Matsuoka K, Hoshi S, Koguchi T, Hata J, Yabe M, Sato Y, Akaihata H, Kataoka M, Ogawa S, Haga N, Kojima Y. Spindle cell renal cell carcinoma diagnosed after sunitinib treatment for chromophobe renal cell carcinoma. IJU Case Rep 2020; 3:36-39. [PMID: 32743465 PMCID: PMC7292175 DOI: 10.1002/iju5.12135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/23/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Chromophobe renal cell carcinoma presents in early pathological stages with a lower risk of metastasis. However, aggressive features and metastasis can occur. A rare case of rapidly progressive disease with histological changes is presented. CASE PRESENTATION A 56-year-old woman had a right renal tumor with multiple lymph node metastases, and the pathological diagnosis of the biopsy specimens from the primary tumor was chromophobe renal cell carcinoma. After sunitinib treatment, the metastatic lymph node had decreased in size and the numbers of circulating tumor cells were decreased, consequently, cytoreductive nephrectomy was performed. However, rapid progression of lymph node metastases was observed. Histopathological examination showed that the renal tumor was diagnosed as spindle cell renal carcinoma. CONCLUSION It appears that the primary tumor underwent epithelial-mesenchymal transition; further tissue specimen collection and analysis might be needed.
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Affiliation(s)
| | - Kei Ishibashi
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Akifumi Onagi
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Ryo Tanji
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Kanako Matsuoka
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Seiji Hoshi
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Tomoyuki Koguchi
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Junya Hata
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Michihiro Yabe
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Yuichi Sato
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Hidenori Akaihata
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Masao Kataoka
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Soichiro Ogawa
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Nobuhiro Haga
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
| | - Yoshiyuki Kojima
- Department of UrologyFukushima Medical University School of MedicineFukushimaJapan
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Ohashi R, Angori S, Batavia AA, Rupp NJ, Ajioka Y, Schraml P, Moch H. Loss of CDKN1A mRNA and Protein Expression Are Independent Predictors of Poor Outcome in Chromophobe Renal Cell Carcinoma Patients. Cancers (Basel) 2020; 12:E465. [PMID: 32079343 DOI: 10.3390/cancers12020465] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/24/2020] [Accepted: 02/13/2020] [Indexed: 01/10/2023] Open
Abstract
Chromophobe renal cell carcinoma (chRCC) patients have good prognosis. Only 5%-10% patients die of metastatic disease after tumorectomy, but tumor progression cannot be predicted by histopathological parameters alone. chRCC are characterized by losses of many chromosomes, whereas gene mutations are rare. In this study, we aim at identifying genes indicating chRCC progression. A bioinformatic approach was used to correlate chromosomal loss and mRNA expression from 15287 genes from The Cancer Genome Atlas (TCGA) database. All genes in TCGA chromophobe renal cancer dataset (KICH) for which a significant correlation between chromosomal loss and mRNA expression was shown, were identified and their associations with outcome was assessed. Genome-wide DNA copy-number alterations were analyzed by Affymetrix OncoScan® CNV FFPE Microarrays in a second cohort of Swiss chRCC. In both cohorts, tumors with loss of chromosomes 2, 6, 10, 13, 17 and 21 had signs of tumor progression. There were 4654 genes located on these chromosomes, and 13 of these genes had reduced mRNA levels, which was associated with poor outcome in chRCC. Decreased CDKN1A expression at mRNA (p = 0.02) and protein levels (p = 0.02) were associated with short overall survival and were independent predictors of prognosis (p <0.01 and <0.05 respectively). CDKN1A expression status is a prognostic biomarker independent of tumor stage. CDKN1A immunohistochemistry may be used to identify chRCC patients at greater risk of disease progression.
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Pivovarčíková K, Michalová K, Hes O. Immunohistochemistry and renal neoplasias. Cesk Patol 2020; 56:130-139. [PMID: 33076665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Tento přehledový článek stručně shrnuje možnosti využití imunohistochemie při vyšetřování především renálních karcinomů a základní molekulárně genetické znaky vybraných neoplázií. Článek však v žádném případě nelze brát jako univerzální návod pro diagnostiku renálních tumorů. Renální karcinomy dokážou mít velmi variabilní morfologický vzhled a to i v rámci jedné léze (nádorová heterogenita) a často velmi nepředvídatelný a neuniformní imunohistochemický profil. Některé renální neoplázie jsou diagnostikovány striktně na podkladě molekulárně-genetických vlastností, bez ohledu na morfologický vzhled.
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Jin L, Xie F. Untargeted Contrast-Enhanced Ultrasound Versus Contrast-Enhanced Computed Tomography: A Differential Diagnostic Performance (DDP) Study for Kidney Lesions. Clinics (Sao Paulo) 2020; 75:e1489. [PMID: 32130354 PMCID: PMC7026943 DOI: 10.6061/clinics/2020/e1489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 12/13/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Histopathology is the 'gold standard' for diagnosing renal cell carcinoma but is limited by sample size. Contrast-enhanced ultrasound can differentiate malignant and benign lesions, but the Chinese guidelines on the management of renal cell carcinoma do not include this method. The purpose of this study was to compare the diagnostic parameters of contrast-enhanced ultrasound against those of contrast-enhanced computed tomography for detecting kidney lesions, with histopathology considered the reference standard. METHODS Patients with suspected kidney lesions from prior grayscale ultrasonography and computed tomography were included in the analysis (n=191). The contrast-enhanced ultrasound, contrast-enhanced computed tomography, and histopathology data were collected and analyzed. A solid, enhanced mass was considered a malignant lesion, and an unenhanced mass or cyst was considered a benign lesion. The Bosniak criteria were used to characterize the lesions. RESULTS Contrast-enhanced ultrasound and contrast-enhanced computed tomography both detected that 151 patients had malignant tumors and 40 patients had benign tumors. No significant differences in the tumors and their subtypes were reported between contrast-enhanced ultrasound and histopathology (p=0.804). Chromophobe renal cell carcinoma was detected through contrast-enhanced computed tomography (n=1), but no such finding was reported by contrast-enhanced ultrasound. A total of 35 cases of papillary renal cell carcinoma were reported through contrast-enhanced ultrasound while 32 were reported through histopathology. CONCLUSIONS Contrast-enhanced ultrasound might be safe and as accurate as histopathology in diagnosing kidney lesions, especially renal cell carcinoma. Additionally, this study provides additional information over histopathology and has an excellent safety profile. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Li Jin
- Department of Ultrasound, the First People’s Hospital of Tian Shui GanSu Province, Tianshui, 741000, China
| | - Feng Xie
- Department of Ultrasound, the Second People’s Hospital of Lanzhou, Lanzhou, 730000, China
- *Corresponding author. E-mail:
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40
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Ohashi R, Schraml P, Angori S, Batavia AA, Rupp NJ, Ohe C, Otsuki Y, Kawasaki T, Kobayashi H, Kobayashi K, Miyazaki T, Shibuya H, Usuda H, Umezu H, Fujishima F, Furusato B, Osakabe M, Sugai T, Kuroda N, Tsuzuki T, Nagashima Y, Ajioka Y, Moch H. Classic Chromophobe Renal Cell Carcinoma Incur a Larger Number of Chromosomal Losses Than Seen in the Eosinophilic Subtype. Cancers (Basel) 2019; 11:E1492. [PMID: 31623347 DOI: 10.3390/cancers11101492] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/21/2019] [Accepted: 09/26/2019] [Indexed: 12/26/2022] Open
Abstract
Chromophobe renal cell carcinoma (chRCC) is a renal tumor subtype with a good prognosis, characterized by multiple chromosomal copy number variations (CNV). The World Health Organization (WHO) chRCC classification guidelines define a classic and an eosinophilic variant. Large cells with reticular cytoplasm and prominent cell membranes (pale cells) are characteristic for classic chRCC. Classic and eosinophilic variants were defined in 42 Swiss chRCCs, 119 Japanese chRCCs and in whole-slide digital images of 66 chRCCs from the Cancer Genome Atlas (TCGA) kidney chromophobe (KICH) dataset. 32 of 42 (76.2%) Swiss chRCCs, 90 of 119 (75.6%) Japanese chRCCs and 53 of 66 (80.3%) TCGA-KICH were classic chRCCs. There was no survival difference between eosinophilic and classic chRCC in all three cohorts. To identify a genotype/phenotype correlation, we performed a genome-wide CNV analysis using Affymetrix OncoScan® CNV Assay (Affymetrix/Thermo Fisher Scientific, Waltham, MA, USA) in 33 Swiss chRCCs. TCGA-KICH subtypes were compared with TCGA CNV data. In the combined Swiss and TCGA-KICH cohorts, losses of chromosome 1, 2, 6, 10, 13, and 17 were significantly more frequent in classic chRCC (p < 0.05, each), suggesting that classic chRCC are characterized by higher chromosomal instability. This molecular difference justifies the definition of two chRCC variants. Absence of pale cells could be used as main histological criterion to define the eosinophilic variant of chRCC.
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Jorge S, Capelo JL, LaFramboise W, Dhir R, Lodeiro C, Santos HM. Development of a Robust Ultrasonic-Based Sample Treatment To Unravel the Proteome of OCT-Embedded Solid Tumor Biopsies. J Proteome Res 2019; 18:2979-2986. [PMID: 31173681 DOI: 10.1021/acs.jproteome.9b00248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
An effective three-step proteomics workflow is proposed to overcome the pitfalls caused by polymers present in optimum cutting temperature (OCT)-embedded tissue during its preparation for mass spectrometry analysis. First, the OCT-embedded tissue biopsies are cleaned using ethanol and water in a sequential series of ultrasonic washes in an ultrasound bath (35 kHz ultrasonic frequency, 100% ultrasonic amplitude, 2 min of ultrasonic duty time). Second, a fast ultrasonic-assisted extraction of proteins is done using an ultrasonic probe (30 kHz ultrasonic frequency, 50% ultrasonic amplitude, 2 min of ultrasonic duty time, 1 mm diameter tip). Third, a rapid ultrasonic digestion of complex proteomes is performed using a microplate horn assembly device (20 kHz ultrasonic frequency, 25% ultrasonic amplitude, 4 min of ultrasonic duty time). As a proof of concept, the new workflow was applied to human normal and tumor kidney biopsies including chromophobe renal cell carcinomas (chRCCs) and renal oncocytomas (ROs). A successful cluster of proteomics profiles was obtained comprising 511 and 172 unique proteins found in chRCC and RO samples, respectively. The new method provides high sample throughput and comprehensive protein recovery from OCT samples.
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Affiliation(s)
- Susana Jorge
- BIOSCOPE Research Group, LAQV, REQUIMTE, Department of Chemistry, Faculdade de Ciências e Tecnologia , Universidade NOVA de Lisboa , 2829-516 Caparica , Portugal.,PROTEOMASS Scientific Society , Madan Park, Rua dos Inventores , 2825-152 Caparica , Portugal
| | - José L Capelo
- BIOSCOPE Research Group, LAQV, REQUIMTE, Department of Chemistry, Faculdade de Ciências e Tecnologia , Universidade NOVA de Lisboa , 2829-516 Caparica , Portugal.,PROTEOMASS Scientific Society , Madan Park, Rua dos Inventores , 2825-152 Caparica , Portugal
| | - William LaFramboise
- Department of Pathology , University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania 15261 , United States
| | - Rajiv Dhir
- Department of Pathology , University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania 15261 , United States
| | - Carlos Lodeiro
- BIOSCOPE Research Group, LAQV, REQUIMTE, Department of Chemistry, Faculdade de Ciências e Tecnologia , Universidade NOVA de Lisboa , 2829-516 Caparica , Portugal.,PROTEOMASS Scientific Society , Madan Park, Rua dos Inventores , 2825-152 Caparica , Portugal
| | - Hugo M Santos
- BIOSCOPE Research Group, LAQV, REQUIMTE, Department of Chemistry, Faculdade de Ciências e Tecnologia , Universidade NOVA de Lisboa , 2829-516 Caparica , Portugal.,PROTEOMASS Scientific Society , Madan Park, Rua dos Inventores , 2825-152 Caparica , Portugal
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Molnar A, Horvath CA, Czovek P, Szanto A, Kovacs G. FOXI1 Immunohistochemistry Differentiates Benign Renal Oncocytoma from Malignant Chromophobe Renal Cell Carcinoma. Anticancer Res 2019; 39:2785-2790. [PMID: 31177114 DOI: 10.21873/anticanres.13405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Renal oncocytoma (RO) and chromophobe renal cell carcinoma (chRCC) are suggested to develop from α- and β-intercalated (IC) cells of the collecting duct expressing solute carrier family 4 member 1 (SLC4A1) and SLC26A4 under control of forkhead box 1 (FOXI1) transcription factor. The aim of this study was to clarify the possible cellular origin and of RO and chRCC. MATERIALS AND METHODS Immunohistochemistry for aquaporin 2 (AQP2), FOXI1, SLC4A1 and SLC16A4 was applied to distinct types of renal cell tumors. RESULTS Nuclear FOXI1 staining occurred in 96% of 83 ROs, in 3% of 90 chRCCs and none of the other tumor types. The α-IC cell marker SLC4A1 was seen in 60% of RO and 11% of chRCC, whereas staining for the β-IC cell marker SLC26A4 was negative in all but one tumor. CONCLUSION Although the origin of RO remains unclear, our findings suggest that FOXI1 immunohistochemistry is useful in differential diagnosis of RO from chRCC with overlapping histology.
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Affiliation(s)
- Agnes Molnar
- Department of Urology, Medical School, University of Pecs, Pecs, Hungary
| | | | - Petra Czovek
- Department of Urology, Medical School, University of Pecs, Pecs, Hungary
| | - Arpad Szanto
- Department of Urology, Medical School, University of Pecs, Pecs, Hungary
| | - Gyula Kovacs
- Department of Urology, Medical School, University of Pecs, Pecs, Hungary .,Medical Faculty, Ruprecht Karls University, Heidelberg, Germany
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Wang S, Yu ZH, Chai KQ. Identification of CFTR as a novel key gene in chromophobe renal cell carcinoma through bioinformatics analysis. Oncol Lett 2019; 18:1767-1774. [PMID: 31423244 PMCID: PMC6607225 DOI: 10.3892/ol.2019.10476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/30/2019] [Indexed: 12/25/2022] Open
Abstract
Chromophobe renal cell carcinoma (chRCC), the third most common histological subtype of RCC, comprises 5–7% of all RCC cases. The aim of the present study was to identify potential biomarkers for chRCC and to examine the underlying mechanisms. A total of 4 profile datasets were downloaded from the Gene Expression Omnibus database to identify differentially expressed genes (DEGs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of DEGs were performed with the Database for Annotation, Visualization and Integrated Discovery. A protein-protein interaction (PPI) network was constructed to predict hub genes. Hub gene expression within chRCC across multiple datasets, as well as overall survival, were investigated by utilizing the Oncomine platform and UALCAN dataset, separately. A total of 266 DEGs (88 upregulated genes and 168 downregulated genes) were identified from 4 profile datasets. Integrating the results from the PPI network, Oncomine platform and survival analysis, CFTR was screened as a key factor in the prognosis of chRCC. GO and KEGG analysis revealed that 266 DEGs were mainly enriched in 17 terms and 9 pathways. The present study identified key genes and potential molecular mechanisms underlying the development of chRCC, and CFTR may be a potential prognostic biomarker and novel therapeutic target for chRCC.
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Affiliation(s)
- Sheng Wang
- The Second Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang 310053, P.R. China.,Department of Oncology, Tongde Hospital of Zhejiang, Hangzhou, Zhejiang 310053, P.R. China
| | - Zhi-Hong Yu
- Department of Oncology, Tongde Hospital of Zhejiang, Hangzhou, Zhejiang 310053, P.R. China
| | - Ke-Qun Chai
- Department of Oncology, Tongde Hospital of Zhejiang, Hangzhou, Zhejiang 310053, P.R. China
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Trpkov K, Williamson SR, Gao Y, Martinek P, Cheng L, Sangoi AR, Yilmaz A, Wang C, San Miguel Fraile P, Perez Montiel DM, Bulimbasić S, Rogala J, Hes O. Low-grade oncocytic tumour of kidney (CD117-negative, cytokeratin 7-positive): a distinct entity? Histopathology 2019; 75:174-184. [PMID: 30895640 DOI: 10.1111/his.13865] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/18/2019] [Indexed: 12/18/2022]
Abstract
AIM To describe a group of distinct low-grade oncocytic renal tumours that demonstrate CD117 negative/cytokeratin (CK) 7-positive immunoprofile. METHODS AND RESULTS We identified 28 such tumours from four large renal tumour archives. We performed immunohistochemistry for: CK7, CD117, PAX8, CD10, AMACR, e-cadherin, CK20, CA9, AE1/AE3, vimentin, BerEP4, MOC31, CK5/6, p63, HMB45, melan A, CD15 and FH. In 14 cases we performed array CGH, with a successful result in nine cases. Median patient age was 66 years (range 49-78 years) with a male-to-female ratio of 1:1.8. Median tumour size was 3 cm (range 1.1-13.5 cm). All were single tumours, solid and tan-brown, without a syndromic association. On microscopy, all cases showed solid and compact nested growth. There were frequent areas of oedematous stroma with loosely arranged cells. The tumour cells had oncocytic cytoplasm with uniformly round to oval nuclei, but without significant irregularities, and showed only focal perinuclear halos. Negative CD117 and positive CK7 reactivity were present in all cases (in two cases there was focal and very weak CD117 reactivity). Uniform reactivity was found for PAX8, AE1/AE3, e-cadherin, BerEP4 and MOC31. Negative stains included CA9, CK20, vimentin, CK5/6, p63, HMB45, Melan A and CD15. CD10 and AMACR were either negative or focally positive; FH was retained. On array CGH, there were frequent deletions at 19p13.3 (seven of nine), 1p36.33 (five of nine) and 19q13.11 (four of nine); disomic status was found in two of nine cases. On follow-up (mean 31.8 months, range 1-118), all patients were alive with no disease progression. CONCLUSION Low-grade oncocytic tumours that are CD117-negative/CK7-positive demonstrate consistent and readily recognisable morphology, immunoprofile and indolent behaviour.
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Affiliation(s)
- Kiril Trpkov
- University of Calgary and Calgary Laboratory Services, Calgary, AB, Canada
| | - Sean R Williamson
- School of Medicine, Henry Ford Health System and Wayne State University, Detroit, MI, USA
| | - Yuan Gao
- University of Calgary and Calgary Laboratory Services, Calgary, AB, Canada
| | - Petr Martinek
- Charles University and University Hospital Pilsen, Pilsen, Czech Republic
| | - Liang Cheng
- Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Asli Yilmaz
- University of Calgary and Calgary Laboratory Services, Calgary, AB, Canada
| | - Cheng Wang
- QEII Health Sciences Centre and Dalhousie University, Halifax, NS, Canada
| | | | | | | | | | - Ondrej Hes
- Charles University and University Hospital Pilsen, Pilsen, Czech Republic
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Abstract
Ovarian metastasis is common with secondary tumors representing up to 15% of ovarian neoplasms. The malignancies most commonly involving the ovaries are carcinomas of the stomach, colon, breast, endocervix, endometrium, and lymphoma. Secondary ovarian involvement by kidney carcinoma occurs very rarely and is usually associated with widespread dissemination. We conducted a review of kidney carcinoma with ovarian metastasis in the literature using the keywords clear cell renal cell carcinoma, papillary renal cell carcinoma, chromophobe renal cell carcinoma collecting duct carcinoma, and ovarian metastasis on Google Scholar and PubMed indices in April 2018, including a case diagnosed in our department. To date, 30 articles presenting 41 cases of kidney carcinoma with ovarian metastasis are reported in the literature. All reviewed cases were analyzed for diagnosis, surgical and systemic therapy, and outcome. Diagnosis may sometimes be challenging, requiring appropriate immunohistochemical markers in difficult cases. A combination of surgery and adjuvant therapy offers significant benefit in disease control or palliation of symptoms. Due to inconsistency in the reported data, further studies are needed to make safe conclusions regarding survival.
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Affiliation(s)
| | - Despoina Nasi
- Department of Oncology, "Saint Savvas" Cancer Hospital, Athens, GRC
| | | | - Stefania Kokkali
- Department of Oncology, "Saint Savvas" Cancer Hospital, Athens, GRC
| | - Stamatios Theocharis
- Department of Pathology, National and Kapodistrian University of Athens, Athens, GRC
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46
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Dolzhansky OV, Paltseva EM, Bukaeva AA, Zaklyazminskaya EV, Solovyeva SE, Fedorov DN. [The morphological and molecular genetic characteristics of sarcomatoid chromophobe renal cell carcinoma]. Arkh Patol 2018; 80:39-46. [PMID: 30059070 DOI: 10.17116/patol201880439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The paper describes a case of chromophobe renal cell carcinoma growing into the muscular layer of the descending colon and with metastases in 4 lymph nodes of paranephral tissue in a 66-year-old woman. The tumor had a zonal structure with an alternation of epithelioid and sarcomatoid structural sites and with the signs of grades I, II and III according to the grading system by Paner and et al. (2010). The sarcomatoid renal component occupied about 70.0% of the tumor. There was a pronounced immunohistochemical reaction with VEGF-A (5 scores), a high Ki-67 proliferation index (70%), and a large number of tumor cells with nuclear p53 expression (85%) in the areas with minimal differentiation and sarcomatoid elements (Grade III). These signs can serve as criteria for the aggressive behavior of the tumor. A large volume of the sarcomatoid carcinoma component and a strong reaction with VEGF-A are indications for targeted therapy with anti-VEGF drugs.
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Affiliation(s)
- O V Dolzhansky
- Acad. B.V. Petrovsky Russian Surgery Research Centre Ministry of Health of Russia, Moscow, Russia
| | - E M Paltseva
- Acad. B.V. Petrovsky Russian Surgery Research Centre Ministry of Health of Russia, Moscow, Russia
| | - A A Bukaeva
- Acad. B.V. Petrovsky Russian Surgery Research Centre Ministry of Health of Russia, Moscow, Russia
| | - E V Zaklyazminskaya
- Acad. B.V. Petrovsky Russian Surgery Research Centre Ministry of Health of Russia, Moscow, Russia
| | - S E Solovyeva
- Acad. B.V. Petrovsky Russian Surgery Research Centre Ministry of Health of Russia, Moscow, Russia
| | - D N Fedorov
- Acad. B.V. Petrovsky Russian Surgery Research Centre Ministry of Health of Russia, Moscow, Russia
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47
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Panagiotidis E, Seshadri N, Vinjamuri S. Renal Manifestation of Birt-Hogg-Dubé Syndrome Depicted by 18F-fludeoxyglucose Positron Emission Tomography/Computed Tomography in a Patient with Hurtle Cell Thyroid Malignancy. World J Nucl Med 2018; 17:123-125. [PMID: 29719489 PMCID: PMC5905258 DOI: 10.4103/wjnm.wjnm_93_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Birt-Hogg-Dubé (BHD) syndrome is an autosomal dominant genetic disorder characterized by small papular skin lesions (fibrofolliculomas) causing susceptibility to kidney cancer, renal and pulmonary cysts, spontaneous pneumothoraces, and several noncutaneous tumors. We report a case of a 67-year-old woman, with a previous history of right hemithyroidectomy for adenomatous lesion. She presented with a swelling in the right thyroid bed that on subsequent biopsy revealed features of metastatic carcinoma. 18F-fludeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) performed for the detection of primary malignancy showed increased high-grade metabolic activity in the right supraclavicular soft tissue mass extending into the superior mediastinum. Moreover, on low-dose CT, there have been bilateral renal interpolar cortical lesions with mild metabolic activity. Given the fact that the right neck mass was highly unlikely to represent renal metastases in the absence of widespread metastatic disease, surgical excision of the right neck mass was performed. The histology of the mass was in keeping with hurtle cell thyroid carcinoma. In regard to renal lesions, bilateral partial nephrectomy was performed, which was consistent with chromophobe renal cell carcinoma, raising the suspicion of BHD that was confirmed by the subsequent genetic evaluation. It is well established that 18F-FDG PET/CT study is not an optimal modality for evaluation of renal lesions. However, careful assessment of the CT features in conjunction with the associated metabolic activity of the 18F-FDG PET component increases the diagnostic accuracy of PET/CT.
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Affiliation(s)
- Emmanouil Panagiotidis
- Department of Nuclear Medicine, Royal Liverpool University Hospital, Liverpool, Merseyside, UK
| | - Nagabhushan Seshadri
- Department of Nuclear Medicine, Royal Liverpool University Hospital, Liverpool, Merseyside, UK
| | - Sobhan Vinjamuri
- Department of Nuclear Medicine, Royal Liverpool University Hospital, Liverpool, Merseyside, UK
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48
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Ricketts CJ, De Cubas AA, Fan H, Smith CC, Lang M, Reznik E, Bowlby R, Gibb EA, Akbani R, Beroukhim R, Bottaro DP, Choueiri TK, Gibbs RA, Godwin AK, Haake S, Hakimi AA, Henske EP, Hsieh JJ, Ho TH, Kanchi RS, Krishnan B, Kwiatkowski DJ, Liu W, Merino MJ, Mills GB, Myers J, Nickerson ML, Reuter VE, Schmidt LS, Shelley CS, Shen H, Shuch B, Signoretti S, Srinivasan R, Tamboli P, Thomas G, Vincent BG, Vocke CD, Wheeler DA, Yang L, Kim WY, Robertson AG, Spellman PT, Rathmell WK, Linehan WM. The Cancer Genome Atlas Comprehensive Molecular Characterization of Renal Cell Carcinoma. Cell Rep 2018; 23:313-326.e5. [PMID: 29617669 PMCID: PMC6075733 DOI: 10.1016/j.celrep.2018.03.075] [Citation(s) in RCA: 449] [Impact Index Per Article: 74.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 03/09/2018] [Accepted: 03/19/2018] [Indexed: 01/05/2023] Open
Abstract
Renal cell carcinoma (RCC) is not a single disease, but several histologically defined cancers with different genetic drivers, clinical courses, and therapeutic responses. The current study evaluated 843 RCC from the three major histologic subtypes, including 488 clear cell RCC, 274 papillary RCC, and 81 chromophobe RCC. Comprehensive genomic and phenotypic analysis of the RCC subtypes reveals distinctive features of each subtype that provide the foundation for the development of subtype-specific therapeutic and management strategies for patients affected with these cancers. Somatic alteration of BAP1, PBRM1, and PTEN and altered metabolic pathways correlated with subtype-specific decreased survival, while CDKN2A alteration, increased DNA hypermethylation, and increases in the immune-related Th2 gene expression signature correlated with decreased survival within all major histologic subtypes. CIMP-RCC demonstrated an increased immune signature, and a uniform and distinct metabolic expression pattern identified a subset of metabolically divergent (MD) ChRCC that associated with extremely poor survival.
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Affiliation(s)
- Christopher J Ricketts
- Urologic Oncology Branch, National Cancer Institute, Center for Cancer Research, Bethesda, MD 20892, USA
| | | | - Huihui Fan
- Van Andel Research Institute, Grand Rapids, MI 49503, USA
| | - Christof C Smith
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Martin Lang
- Urologic Oncology Branch, National Cancer Institute, Center for Cancer Research, Bethesda, MD 20892, USA
| | - Ed Reznik
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Reanne Bowlby
- Canada's Michael Smith Genome Sciences Centre, Vancouver, BC V5Z 4S6, Canada
| | - Ewan A Gibb
- Canada's Michael Smith Genome Sciences Centre, Vancouver, BC V5Z 4S6, Canada
| | - Rehan Akbani
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Rameen Beroukhim
- The Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA 02142, USA
| | - Donald P Bottaro
- Urologic Oncology Branch, National Cancer Institute, Center for Cancer Research, Bethesda, MD 20892, USA
| | | | | | - Andrew K Godwin
- University of Kansas Medical Center, Kansas City, KS 66206, USA
| | - Scott Haake
- Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - A Ari Hakimi
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | | | - James J Hsieh
- Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Thai H Ho
- Mayo Clinic Arizona, Phoenix, AZ 85054, USA
| | - Rupa S Kanchi
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Bhavani Krishnan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | | | - Wenbin Liu
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Maria J Merino
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA
| | - Gordon B Mills
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | - Michael L Nickerson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Victor E Reuter
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Laura S Schmidt
- Urologic Oncology Branch, National Cancer Institute, Center for Cancer Research, Bethesda, MD 20892, USA; Basic Science Program, Leidos Biomedical Research, Inc. Frederick National Laboratory of Cancer Research, Frederick, MD 21702, USA
| | | | - Hui Shen
- Van Andel Research Institute, Grand Rapids, MI 49503, USA
| | | | | | - Ramaprasad Srinivasan
- Urologic Oncology Branch, National Cancer Institute, Center for Cancer Research, Bethesda, MD 20892, USA
| | - Pheroze Tamboli
- The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - George Thomas
- Oregon Health & Science University, Portland, OR 97239, USA
| | - Benjamin G Vincent
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Cathy D Vocke
- Urologic Oncology Branch, National Cancer Institute, Center for Cancer Research, Bethesda, MD 20892, USA
| | | | - Lixing Yang
- Harvard Medical School, Boston, MA 02115, USA
| | - William Y Kim
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - A Gordon Robertson
- Canada's Michael Smith Genome Sciences Centre, Vancouver, BC V5Z 4S6, Canada
| | | | | | - W Marston Linehan
- Urologic Oncology Branch, National Cancer Institute, Center for Cancer Research, Bethesda, MD 20892, USA.
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Abstract
Oncocytoma is a well-defined benign renal tumor, with classic gross and histologic features, including a tan or mahogany-colored mass with central scar, microscopic nested architecture, bland cytology, and round, regular nuclei with prominent central nucleoli. As a result of variations in this classic appearance, difficulty in standardizing diagnostic criteria, and entities that mimic oncocytoma, such as eosinophilic variant chromophobe renal cell carcinoma and succinate dehydrogenase-deficient renal cell carcinoma, pathologic diagnosis remains a challenge. This review addresses the current state of pathologic diagnosis of oncocytoma, with emphasis on modern diagnostic markers, areas of controversy, and emerging techniques for less invasive diagnosis, including renal mass biopsy and advanced imaging.
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50
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Park CK, Kim WK, Kim H. Clinicopathological characteristics of KIT and protein kinase C-δ expression in adenoid cystic carcinoma: comparison with chromophobe renal cell carcinoma and gastrointestinal stromal tumour. Histopathology 2017; 71:529-542. [PMID: 28561935 DOI: 10.1111/his.13270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 05/28/2017] [Indexed: 12/16/2022]
Abstract
AIMS KIT overexpression is frequently observed in adenoid cystic carcinomas (AdCCs), chromophobe renal cell carcinomas (ChRCCs), and gastrointestinal stromal tumours (GISTs). Persistent KIT activation has been reported to be mediated by protein kinase C (PKC)-δ in a subset of colon cancers with wild-type KIT overexpression, and by PKC-θ in GISTs with mutant KIT overexpression. To elucidate the clinical implications of PKC-δ and PKC-θ expression in KIT-expressing tumours, we investigated the expression of KIT, PKC-δ and PKC-θ in AdCCs and ChRCCs in comparison with GISTs. METHODS AND RESULTS KIT expression, PKC-δ expression and PKC-θ expression were analysed in whole sections from 41 AdCCs, 40 ChRCCs and 56 GISTs by immunohistochemistry. Membranous expression of KIT was found in 34 AdCCs and all ChRCCs, whereas cytoplasmic expression of KIT was found in 46 GISTs. In AdCCs, PKC-δ expression was associated with histological grade (P = 0.049), lymphovascular invasion (P = 0.004), perineural invasion (P = 0.002), and KIT positivity (P = 0.002). PKC-δ positivity was associated with shorter relapse-free survival (RFS) (P = 0.017) and a tendency for there to be shorter overall survival (OS) (P = 0.090) in patients with AdCCs. No clinicopathological associations were observed between PKC-δ and KIT expression in ChRCCs. In GISTs, PKC-θ expression was associated with higher mitotic count (P = 0.011) and high grade according to the modified National Institutes of Health criteria (P < 0.001). PKC-θ positivity was associated with shorter RFS (P = 0.016) and a tendency for there to be shorter OS (P = 0.051) in patients with GISTs. CONCLUSIONS PKC-δ expression is associated with KIT expression and the prognosis of patients with AdCCs, suggesting that PKC-δ may be a potential therapeutic target for AdCCs.
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Affiliation(s)
- Cheol Keun Park
- Department of Pathology, Armed Forces Capital Hospital, Seongnam, Republic of Korea.,Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Won Kyu Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.,Brain Korea 21 PLUS Projects for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hoguen Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.,Brain Korea 21 PLUS Projects for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.,Healthcare Review and Assessment Committee, Health Insurance Review & Assessment Service, Seoul, Republic of Korea
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