National Cancer Institute®
Last Modified: February 1, 2002
UI - 11519377
AU - Leibovitch I; Lev R; Mor Y; Golomb J; Dotan ZA; Ramon J
TI - Extensive necrosis in renal cell carcinoma specimens: potential clinical and prognostic implications.
SO - Isr Med Assoc J 2001 Aug;3(8):563-5
AD - Department of Urology, Sheba Medical Center, Tel-Hashomer, Israel. firstname.lastname@example.org
BACKGROUND: Extensive necrosis is rare in primary renal cell carcinoma. This finding may reflect the biological characteristics of the carcinoma and therefore could be of prognostic and clinical value. OBJECTIVES: To assess the incidence of necrosis in renal cell carcinoma and its potential prognostic value. METHODS: We conducted a consecutive retrospective study of 173 patients after radical nephrectomy for renal cell carcinoma. Clinical and pathological data were collected from hospital medical records and compiled into a computerized database. RESULTS: Extensive necrosis was found in 31 tumor specimens (17.9%). Univariate analysis showed that the specimens with extensive necrosis were significantly larger and manifested more perirenal and venous extension than the tumors without necrosis. The size of the renal tumor was the only parameter that remained significant in multivariate analysis (P = 0.0001). Overall disease-free survival did not differ significantly between patients with necrotic tumors and those without (68% and 66% respectively). CONCLUSIONS: The finding of extensive necrosis in renal cell carcinoma specimens does not seem to be related to tumor biology but rather may reflect the relation between size and vascularity of the tumor.
UI - 11734338
AU - Teratani T; Watanabe T; Kuwahara F; Kumagai H; Kobayashi S; Aoki U;
TI - Ishikawa A; Arai K; Nozawa R Induced transcriptional expression of calcium-binding protein S100A1 and S100A10 genes in human renal cell carcinoma.
SO - Cancer Lett 2002 Jan 10;175(1):71-7
AD - Laboratory of Host Defenses, Graduate School of Health Science, University of Shizuoka, Yada, 422-8526, Shizuoka, Japan.
Expression of 16 S100 family calcium-binding protein genes was evaluated by PCR in ten human tissue cDNA libraries. Six to 12 S100 genes were expressed in a tissue-specific manner. Then, the expression in the surgically resected renal cell carcinoma (RCC) and a cultured RCC cell line was studied by RT-PCR. Although eight to nine S100 genes were transcribed in the normal kidney library and non-cancerous part of resected kidney tumors, S100A1 and S100A10 genes were not expressed. However, these genes were newly expressed in the RCC lesions (n=7) and the RCC cell line, indicating that expression of S100A1 and S100A10 genes is accompanied by RCC.
UI - 11641973
AU - Atduev VA; Shakhov EV; Ovchinnikov VA; Kamaeva LM
TI - [Organ-salvaging operations in tumors of renal parenchyma]
SO - Urologiia 2001 Sep-Oct;(5):19-22
An original method of kidney resection with the use of ultrasonic surgical destructor-aspirator is proposed. The method was applied in the treatment of 19 patients (20 renal resections and 1 tumor enucleation). No complications occurred. The use of ultrasonic destructoraspirator in renal resection enabled isolation of all the intraparenchymatous tubal structures of the kidney, each of them could be ligated and cut if visualization is adequate. This provided a complete hemostasis on the wound surface of the kidney and hemostatic suturing of the kidney wound became unnecessary. This method of renal resection reduced hospital stay of the patients because they had no hemorrhages, purulent complications and urinary fistulas.
UI - 11775224
AU - Zhuang L; Guo H; Xin D; Zhang Z; Li H; Yuan X; Tang D; Ding Y; Liu L;
TI - Guo Y Different Wnt-5A gene expressions in the renal cell carcinoma GRC-1 cell line during the cell cycle.
SO - Chin Med J (Engl) 2000 Apr;113(4):306-9
AD - Urological Department, First Hospital, Institute of Urology, Beijing Medical University, Beijing 100034, China.
OBJECTIVE: To investigate the gene expression at transcription level of growth factor Wnt-5A in different phase during the cell cycle. METHODS: We synchronized the renal cell carcinoma GRC-1 cell line by double thymidine blocks and high-pressure N2O gae methods and amplified Wnt-5A cDNAs from different phase using Semi-quantitative RT-PCR (reverse transcriptase polymerase chain reaction). The PCR products were electrophoresized on the agrose gel and detected by Gel Doc 1000 computer controlled system integrating the volumes of each band, representing the intensities of all pixels in a defined band. RESULTS: The different mRNA expressions of growth factor Wnt-5A was detected in RCC GRC-1 cell line. In S phase, the highest level of Wnt-5A transcript was observed, and in G1 and M phase, medial and lowest, respectively. The differences between S and M stages were statistically significant (P < 0.05). CONCLUSION: Growth factor Wnt-5A has the potential effect on tumorigenesis. It contributes to all phases during cell cycle but in S phase especially.
UI - 11810927
AU - Pasechnik DG
TI - [Modern histological classification of renal neoplasms]
SO - Arkh Patol 2001 Nov-Dec;63(6):50-5
AD - State Medical University, 344029, Rostov/Don.
The review presents current literary information on basic forms of kidney cancer (clear cell carcinoma, chromophil or papillary cancer, chromophobe renal cell carcinoma, oncocytoma, Bellini carcinoma, sarcomatoid carcinoma and neuroendocrine carcinoma), their morphological characteristics and principles of classification. Modern histological classification of renal cancer is based on immunohistochemical evidence on markers of various nephron segments, this allowing to specify histogenesis of separate forms of renal cell carcinoma. In addition, cytogenetic studies of renal carcinoma reveal correlations between genetic changes in cancer cells and tumor phenotype found at light microscopy. Thus, current classification of renal carcinoma characterizes biology of these neoplasms. This should be taken into account in prognostication and design of new treatment methods.
UI - 11503213
AU - Klade CS; Voss T; Krystek E; Ahorn H; Zatloukal K; Pummer K; Adolf GR
TI - Identification of tumor antigens in renal cell carcinoma by serological proteome analysis.
SO - Proteomics 2001 Jul;1(7):890-8
AD - Boehringer Ingelheim, Research and Development, Vienna, Austria. email@example.com
We have investigated the suitability of proteomics for identification of tumor-associated antigens. First, we compared the proteomes of nontumorous kidney and renal cell carcinoma (RCC) by two-dimensional gel electrophoresis (2-DE) and silver staining. Protein patterns were markedly different (approximately 800 spots in RCCs versus approximately 1400 spots in kidney). 2-DE immunoblotting revealed five RCC-specific spots, reproducibly reactive with RCC-patient but not healthy donor control sera. Two of these antigens were isolated by preparative 2-DE, and identified by Edman sequencing of tryptic peptides. The first antigen, smooth muscle protein 22-alpha (SM22-alpha), is an actin-binding protein of unknown function predominantly expressed in smooth muscle cells. In situ hybridization revealed that SM22-alpha is not expressed in the malignant cells but in mesenchymal cells of the tumor stroma. The second antigen represents carbonic anhydrase I (CAI), an isoform usually not expressed in kidney. Interestingly, a different isoform (CAXII) has previously been identified by serological expression cloning as an antigen overexpressed in some RCCs. In additional assays, antibodies to recombinant CAI or SM22-alpha were detected in sera from 3/11 or 5/11 RCC patients, respectively, whereas sera from 13 healthy individuals did not react. In conclusion, serological proteome analysis may be a new tool for the identification of tumor-associated antigens.
UI - 11561679
AU - Zon RT; McClean J; Helman D; Ansari R; Picus J; Sandler A; Williams SD;
TI - Loehrer PJ Sr Altretamine for the treatment of metastatic renal cell carcinoma. A Hoosier Oncology Group trial.
SO - Invest New Drugs 2001;19(3):229-31
AD - Indiana University Cancer Center, Indianapolis 46202-5298, USA.
Thirty patients with advanced renal cell carcinoma were treated on a phase 11 trial with altretamine. Altretamine was administered orally at a dosage of 260 mg/m2 days 1 through 14 with cycles repeated every 28 days. Nausea and vomiting were the most common toxicities. Ten percent (3 of 30) experienced Grade 3 gait abnormalities. None of the thirty evaluable patients achieved a complete or partial response. In summary, altretamine did not show antitumor activity in the treatment of advanced renal cell carcinoma.
UI - 11561684
AU - Vogelzang NJ; Aklilu M; Stadler WM; Dumas MC; Mikulski SM
TI - A phase II trial of weekly intravenous ranpirnase (Onconase), a novel ribonuclease in patients with metastatic kidney cancer.
SO - Invest New Drugs 2001;19(3):255-60
AD - Cancer Research Center, University of Chicago, IL 60637-1470, USA. firstname.lastname@example.org
Ranpirnase (Onconase) is the first ribonuclease to enter cancer clinical trials. In prior phase II trials, responses were seen in mesothelioma and other solid tumors. This phase II trial tested ranpirnase (480 microg/m2/w) in 14 patients with refractory advanced renal cell cancer. The median performance status was zero and the median age was 55. All patients had prior immunotherapy and three had prior chemotherapy. No responses were seen in 14 patients. The median survival from on study was 16 months (range two to 28 months). At this dose and schedule ranpirnase has minimal activity in metastatic renal cell cancer.
UI - 11776380
AU - Podolski J; Byrski T; Zajaczek S; Druck T; Zimonjic DB; Popescu NC; Kata
TI - G; Borowka A; Gronwald J; Lubinski J; Huebner K Characterization of a familial RCC-associated t(2;3)(q33;q21) chromosome translocation.
SO - J Hum Genet 2001;46(12):685-93
AD - Department of Human Ecology, University of Szczecin, Poland.
A Polish family was identified in which multifocal clear cell renal carcinoma segregated with a balanced constitutional chromosome translocation, t(2:3)(q33;q21), similar to the renal cell cancer-associated t(2;3)(q35;q21) reported in a Dutch family. Bacterial artificial chromosome (BAC) contigs encompassing the 2q and 3q breakpoints were constructed and BACs crossing the breakpoints were partially sequenced. All known regional markers, genes, and expressed sequence tags (ESTs) were mapped relative to the contigs, as well as to the breakpoint sequences. Two single ESTs mapped within the 2q breakpoint BAC, whereas the repeat-rich 3q breakpoint region was gene poor. Physical mapping suggested that the 3q break was in 3q13, possibly near the border with 3q21. Physical mapping illustrated that the 2q break was closely telomeric to the 2q31 FRA2G site, consistent with the G-band assignment. Characterization of full-length cDNAs for the ESTs near the 2q break will determine if a gene(s) is altered by this familial translocation.
UI - 11464111
AU - Wunderlich H; Wilhelm S; Reichelt O; Zermann DH; Borner R; Schubert J
TI - Renal cell carcinoma in renal graft recipients and donors: incidence and consequence.
SO - Urol Int 2001;67(1):24-7
AD - Department of Urology, Friedrich Schiller University, Jena, Germany.
INTRODUCTION AND OBJECTIVES: Numerous studies have reported an increasing incidence of small renal cell carcinoma (RCC). De novo RCC in a renal allograft is a rare event and has special implications in renal transplant recipients. The objective of this study was to retrospectively evaluate the incidence of RCC in renal graft recipients and donors and to determine a procedure in cases with newly detected small renal tumors at the time of kidney preparation before transplantation. MATERIAL AND METHODS: We mailed a questionnaire to 38 German transplant clinics and received answers from 27 centers. A total of 10,997 renal graft recipients were included in the period of 1990-1998. RESULTS: In 30 kidneys (0.273%) RCC was detected at the time of preparation before transplantation. There were 23 male and 3 female donors. No bilateral RCC was described. The mean age of the donors with RCC was 50.9 years (range 37-72 years). The tumors had a mean size of 2.2 cm (range 0.4-6 cm). 67% of the patients had a renal tumor smaller than 20 mm. In 26/27 centers the decision to transplant relies on the result of the immediate section for microscopic examination. 16 patients (0.145%) developed RCC 3-12 years after renal transplantation (mean 7.4 years). The mean tumor size was 2.5 cm (range 2-2.8 cm). In 50% a grade 1 and in the other 50% a grade 2 carcinoma was found. CONCLUSIONS: Because of the RCC incidence in donor candidates we recommend an ultrasound screening of the native kidneys before renal explantation and an immediate preparation of the kidney surface especially in donors older than 45 years. In cases with small renal lesions we recommend an immediate section for microscopic examination before transplantation to prevent tumor implantation into an otherwise healthy patient. The frequency of RCCs after renal transplantation necessitates careful clinical and instrumental examinations in organ-transplanted recipients both before and at regular intervals after transplantation, including the patient's kidneys. Copyright 2001 S. Karger AG, Basel
UI - 11464112
AU - Khaitan A; Hemal AK; Seth A; Gupta NP; Gulati MS; Dogra PN
TI - Management of renal angiomyolipoma in complex clinical situations.
SO - Urol Int 2001;67(1):28-33
AD - Department of Urology and Radiology, All India Institute of Medical Sciences, New Delhi, India.
Renal angiomyolipoma (AML) is associated with complex clinical situations such as tumour in a solitary kidney, bilateral, large or multicentric tumours or those associated with tuberous sclerosis (TS) or pregnancy. Management in these situations may be challenging. Fifteen patients (20 kidneys) were admitted with symptomatic AML over last 10 years. Eleven patients had one or the other complicating factor. Ten patients had a tumour of >10 cm, 4 had TS, 5 had multiple and bilateral tumours, 1 patient was pregnant and 1 had a solitary functioning kidney. With the newer imaging modalities correct diagnosis was possible in 12 cases and renal cell carcinoma (RCC) was suspected in 3 cases. Selective angioembolization (SAE) was done in 3 patients, which successfully controlled bleeding in all. Nephron-sparing surgery (NSS) was performed in 5 patients. Total nephrectomy was done in 4 cases, in 3 due to suspicion of RCC and in 1 due to extensive involvement of the kidney. Three patients with multiple and bilateral tumours were chosen for conservative treatment and none developed recurrence of bleeding on strict follow-up. In a pregnant patient, bleeding was successfully controlled with angioembolization. However, 1 patient with a solitary functioning kidney with large-sized tumour (20 x 18 cm) underwent NSS. In conclusion, the basis of management of AML is preservation of renal tissue, which can be effectively achieved with SAE or NSS. In a solitary functioning kidney, NSS or SAE is the ideal treatment, if feasible. The patients in the TS group are usually more complicated and require life-long follow-up after initial management with NSS or SAE. Pregnant AML patients can be safely managed with SAE. Conservative treatment without any intervention and regular follow-up may be more helpful in some patients with multiple, bilateral extensive tumours. Copyright 2001 S. Karger AG, Basel
UI - 11490206
AU - Ficarra V; Righetti R; Martignoni G; D'Amico A; Pilloni S; Rubilotta E;
TI - Malossini G; Mobilio G Prognostic value of renal cell carcinoma nuclear grading: multivariate analysis of 333 cases.
SO - Urol Int 2001;67(2):130-4
AD - Department of Urology, University of Verona, Italy. email@example.com
OBJECTIVE: To evaluate the independent predictive value of the nuclear grading system according to Fuhrman in relation to the disease-specific survival of patients with renal clear cell carcinoma. MATERIAL AND METHODS: 333 patients who underwent radical nephrectomy for renal clear cell carcinoma between 1983 and 1999 were evaluated. In all patients we retrospectively studied nuclear grading, average tumor size, multifocality, pathologic stage of primary tumor, vein invasion, lymph node involvement and distant metastases. The Kaplan-Meier method was applied to evaluate disease-specific survival rates. The log rank test was used to compare survival curves and for univariate analysis. The Cox proportional hazards model was used for the multivariate analysis. RESULTS: Histologic grade was G1 in 83 cases (25%), G2 in 117 cases (35%), G3 in 110 cases (33%) and G4 in 23 cases (7%). Our data showed that nuclear grading according to Fuhrman is related to medium tumor size (p < 0.0001), pathologic stage of cancer (p < 0.001), venous system invasion (p < 0.001), lymph node involvement (p < 0.001) and distant metastases (p < 0.001). The disease-specific survival after 5 and 10 years was 94 and 88%, respectively, in patients with G1, 86 and 75% in patients with G2, 59 and 40% in patients with G3 and 31% in patients with G4 (log rank p value < 0.0001). Multivariate analysis showed that nuclear grading by Fuhrman has a prognostic independent predictive value (hazard ratio = 1.8461, p = 0.002). CONCLUSIONS: Nuclear grading is an important independent predictive factor of disease-specific survival in patients with renal cell carcinoma. Copyright 2001 S. Karger AG, Basel.
UI - 11490207
AU - Koga F; Nagamatsu H; Ishimaru H; Mizuo T; Yoshida K
TI - Risk factors for the development of bladder transitional cell carcinoma following surgery for transitional cell carcinoma of the upper urinary tract.
SO - Urol Int 2001;67(2):135-41
AD - Department of Urology, Tokyo Rosai Hospital, Tokyo, Japan. firstname.lastname@example.org
To determine the risk factors for development of transitional cell carcinoma (TCC) of the bladder (BTCC) following surgery for TCC of the upper urinary tract (UUT-TCC) in patients without history of BTCC, 85 patients surgically treated for UUT-TCC (34 female, 51 male; median age 66, range 42-85 years) were reviewed retrospectively. The Cox proportional hazards model was used to assess the association of relevant clinicopathologic factors with BTCC-free survival in patients without a history of BTCC and TCC-specific survival in all. Median follow-up duration was 35 (range 1-193) months. Six patients (7%) had previous histories of BTCC, and 6 others (7%) had concurrent BTCC at the time of surgery for UUT-TCC. Of 70 patients who had no history of BTCC and underwent follow-up cystoscopy, 24 (34%) developed BTCC during follow-up after surgery. Univariate analysis identified female sex, postoperative systemic chemotherapy, and incomplete distal ureterectomy as significant risk factors for new development of BTCC. After multivariate analysis adjusted for age and pathological (p) T stage in the TNM classification, all three factors remained significant, with respective hazard ratios of 5.56 (95% confidence interval (CI), 1.99-15.6; p = 0.001), 3.19 (95% CI, 1.34-7.62; p = 0.009) and 2.99 (95% CI, 1.08-8.26; p = 0.03). Only pT stage was a significant independent risk factor for TCC-specific death. Female sex and postoperative systemic chemotherapy, as well as incomplete distal ureterectomy, are possible riks factors for development of BTCC following surgery for UUT-TCC. Copyright 2001 S. Karger AG, Basel
UI - 11813698
AU - Wartenberg D; Siegel Scott C
TI - Carcinogenicity of trichloroethylene.
SO - Environ Health Perspect 2002 Jan;110(1):A13-4
UI - 11796275
AU - Sawai Y; Kinouchi T; Mano M; Meguro N; Maeda O; Kuroda M; Usami M
TI - Ipsilateral adrenal involvement from renal cell carcinoma: retrospective study of the predictive value of computed tomography.
SO - Urology 2002 Jan;59(1):28-31
AD - Department of Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-ku, Osaka, Japan.
OBJECTIVES: To compare the radiologic evidence of adrenal involvement on computed tomography (CT) with pathologic reports and to assess the accuracy of CT in the diagnosis of adrenal involvement with renal cell patients with renal cell carcinoma. In this study, we retrospectively analyzed 73 patients who had been examined by CT before surgery and had undergone radical nephrectomy, including removal of the ipsilateral adrenal gland. The abnormal integrity of the adrenal glands on CT and the pathologic adrenal involvement of renal cell carcinoma were demonstrated by a radiologist and pathologist, respectively. RESULTS: The blinded review by a radiologist of the CT results of 73 patients with renal cell carcinoma identified a normal appearance of the ipsilateral adrenal gland in 54 patients (74%), none of whom had pathologic evidence of malignant involvement. The adrenal gland was diagnosed as abnormal on CT in 19 patients (26%), including enlargement in 7 patients, nodule formation in 7, and an irregular surface in 8. Two of these 19 patients had adrenal involvement. Both were staged at T3M1, and their primary tumors were large, measuring more than 10 cm. In this study, CT demonstrated 100% sensitivity, 76% specificity, 11% positive predictive value, and 100% negative predictive value for ipsilateral adrenal involvement of renal cell carcinoma. CONCLUSIONS: Normal adrenal images on CT could exclude adrenal involvement by renal cell carcinoma. However, radical nephrectomy, including removal of the ipsilateral adrenal gland, should be performed in patients with large tumors.
UI - 11796271
AU - Ng CS; Novick AC; Tannenbaum CS; Bukowski RM; Finke JH
TI - Mechanisms of immune evasion by renal cell carcinoma: tumor-induced T-lymphocyte apoptosis and NFkappaB suppression.
SO - Urology 2002 Jan;59(1):9-14
AD - Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
UI - 11800647
AU - Makhlouf HR; Ishak KG; Shekar R; Sesterhenn IA; Young DY; Fanburg-Smith
TI - JC Melanoma markers in angiomyolipoma of the liver and kidney: a comparative study.
SO - Arch Pathol Lab Med 2002 Jan;126(1):49-55
AD - Department of Hepatic and Gastrointestinal Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
CONTEXT: Melanoma markers, especially the new microphthalmia transcription factor (mitf), have not been previously compared in hepatic and renal angiomyolipomas. OBJECTIVES: To evaluate expression of the novel melanocytic markers mitf and tyrosinase in angiomyolipomas, and to compare these markers with the established markers HMB-45 and melan-A in both hepatic and renal tumors. DESIGN: Clinical, histopathologic, and immunohistochemical features of 15 hepatic angiomyolipomas were compared with those of 10 renal angiomyolipomas. RESULTS: No significant differences between patients with hepatic angiomyolipomas and renal angiomyolipomas were found with respect to age, gender, race, and tumor size. Hepatic angiomyolipomas exhibited a predominance of the epithelioid smooth muscle cell component, in contrast to their renal counterparts, which were predominantly spindled. The smooth muscle cells expressed HMB-45 in 100% of cases in both groups, melan-A in 14 of 15 hepatic angiomyolipomas and 8 of 9 renal angiomyolipomas, mitf in 5 of 12 hepatic angiomyolipomas versus 6 of 10 renal angiomyolipomas, and tyrosinase in 3 of 12 and 2 of 10 hepatic angiomyolipomas and renal angiomyolipomas, respectively. The extent and intensity of immunostaining with HMB-45 and melan-A were dependent on whether spindled or epithelioid cells predominated; the epithelioid cells showed stronger and more widespread reactivity than the spindled cells.CONCLUSION: We believe that the best immunohistochemical marker for confirming the diagnosis of angiomyolipoma is HMB-45, followed by melan-A. Routine use of mitf and/or tyrosinase is not indicated.
UI - 11743661
AU - Kaufmann R; Junker U; Nuske K; Westermann M; Henklein P; Scheele J;
TI - Junker K PAR-1- and PAR-3-type thrombin receptor expression in primary cultures of human renal cell carcinoma cells.
SO - Int J Oncol 2002 Jan;20(1):177-80
AD - Department of General and Visceral Surgery, Medical Faculty at the Friedrich Schiller University Jena, D-07740 Jena, Germany. email@example.com
In this study, we report coexpression of proteinase-activated receptor (PAR)-1- and PAR-3-type thrombin receptors in primary cultures obtained from surgically resected specimens of renal cell carcinomas (RCCs). Receptor expression on RNA level was evaluated by using the RT-PCR technique. Results demonstrated the presence of mRNA encoding PAR-1 and PAR-3, but mRNA encoding PAR-4 could not be found in human RCC cells. The expression of PAR-1 and PAR-3 on protein level was investigated with confocal laser fluorescence and freeze-fracture electron microscopy. Both thrombin receptor types were localized on the cell membrane but were also found on intracellular compartments of RCC cells. On the outer cell membrane, clustering of PAR-1 and PAR-3 molecules was partly observed. This is the first study demonstrating presence of both PAR-1 and PAR-3 in human carcinoma cells.
UI - 11780196
AU - Zang T; Zhuang L; Zhang Z; Xin D; Guo Y
TI - Expression of beta-catenin in renal cell carcinoma.
SO - Chin Med J (Engl) 2001 Feb;114(2):152-4
AD - Department of Urology, First Hospital, Beijing Medical University, Institute of Urology, Beijing 100034, China.
OBJECTIVE: To investigate the expression of beta-catenin and its mRNA in renal cell carcinoma. METHODS: Twenty-six cases with renal cell carcinoma (RCC) were studied by immunohistochemistry, Western blot and RT-PCR. RESULTS: We found the expression of beta-catenis is higher in cancer tissues than in normal kidney tissues and the level of beta-catenin is associated with the tumor stage. Its expression in tumor of pT3 and pT4 is obviously higher than pT1 and pT2 (P < 0.01). That is to say, there was an overexpression of beta-catenin protein in RCC and its level was related to the tumor stage, but the expression of beta-catenin mRNA had no difference between tumor tissue and normal tissue. CONCLUSION: beta-catenin may be related to the occurrence and progress of RCC.
UI - 11772233
AU - Fishman M; Seigne J; Antonia S
TI - Novel therapies for renal cell carcinoma.
SO - Expert Opin Investig Drugs 2001 Jun;10(6):1033-44
AD - H Lee Moffitt Cancer Center & Research Institute, University of South Florida, Interdisciplinary Oncology Program, 12902 Magnolia Dr., Tampa, FL 33612, USA.
Metastatic renal cell cancer remains a disease which is difficult to treat medically. Prognosis often depends more on intrinsic disease features than on treatment choices. In this review, we examine novel therapies and scientific directions surrounding the RCC treatment problem. Reports relating chromosomal aberrations and of comparative gene expression analyses relating to RCC, are reviewed briefly. The central role of the von Hippel Lindau protein in clear cell RCC pathogenesis is evident. The limited contribution of conventional cytotoxic chemotherapy is mentioned. Some clinically applied agents whose clinical results are highlighted include 5-FU, retinoids, thalidomide, razoxane and IL-12. Features of the pathophysiology of von Hippel Lindau protein are described, with attention to potential novel therapies targeting HIF-1alpha, VEGF, TGF-beta1 and TGF-alpha pathways. Immunotherapy is being explored in many angles. Most basic are cytokine therapies incorporating new IL-2 and IFN-alpha schedules. Newer cytokine-based drugs include pegylated forms and IL-12. Allogeneic mini-transplantation has generated much interest. Tumour-associated antigens are being used to direct therapy using both identified and non-identified epitopes. A variety of tumour-cell vaccine and dendritic-cell vaccine clinical approaches are discussed. Finally, nephrectomy for known metastatic disease has been demonstrated to be helpful in retrospective and now prospective trials. Resection of metastases is also discussed. We are optimistic that the further clinical development among these novel therapies will improve the outlook for metastatic RCC.
UI - 11690558
AU - Murakami Y; Kanda K; Yokota K; Kanayama H; Kagawa S
TI - Prognostic significance of immuno-proteosome subunit expression in patients with renal-cell carcinoma: a preliminary study.
SO - Mol Urol 2001 Autumn;5(3):113-9
AD - Department of Urology, School of Medicine, The University of Tokushima, Tokushima, Japan. firstname.lastname@example.org
Our purpose was to elucidate the clinical roles of the "immuno-proteosome," which is involved in the accelerated pathway of the major histocompatibility complex (MHC) class I-restricted antigen presentation system, in renal cell carcinoma (RCC). The relative expression of six proteosome subunits (existing subunits X, Y, and Z and immunoproteosome subunits LMP7, LMP2, and MECL1) in 54 RCCs was investigated using RT-PCR analysis and was compared with clinicopathological measures, including patient outcome. Expression of the LMP7 and LMP2 genes was significantly low in high-grade tumors, and that of the LMP7 and MECL1 genes was significantly low in high-stage tumors. Low levels of LMP7, LMP2, and MECL1 expression were strongly associated with shortened survival (LMP7: P = 0.0002, LMP2: P < 0.0001, MECL1: P < 0.0047). The levels of subunits X, Y, and Z had no significant correlation with those measures. These findings suggest that RCCs with low level of immuno-proteosome subunit expression have a disorder in their antigen-presentation system. As a consequence, they may escape from immune surveillance and worsen patient outcome.
UI - 11756220
AU - Kamiya Y; Puzianowska-Kuznicka M; McPhie P; Nauman J; Cheng SY; Nauman A
TI - Expression of mutant thyroid hormone nuclear receptors is associated with human renal clear cell carcinoma.
SO - Carcinogenesis 2002 Jan;23(1):25-33
AD - Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, 37 Convent Drive MSC 4255, Bethesda, MD 20892-4255, USA.
Thyroid hormone (T(3)) regulates proliferation and differentiation of cells, via its nuclear receptors (TRs). These processes have been shown to be abnormally regulated during carcinogenesis. We have previously found aberrant expression of TRalpha and TRbeta mRNAs in renal clear cell carcinoma (RCCC), suggesting possible involvement of TRs in the carcinogenesis of RCCC. To understand the molecular actions of TRs in RCCC, cDNAs for TRbeta1 and TRalpha1 were cloned from 22 RCCC tissues and 20 surrounding normal tissues. Mutations were found in seven TRbeta1 and three TRalpha1 cDNAs. Two TRbeta1 cDNAs had a single mutation, while five TRbeta1 and three TRalpha1 had two or three mutations. Most of the mutations were localized in the hormone-binding domain. Using the TRs prepared by in vitro transcription/translation, we found that these mutations led to a loss of T(3) binding activity and/or impairment in binding to thyroid hormone response elements (TREs). Furthermore, nuclear extracts from RCCC tissues also exhibited impairment in binding to TREs. These results indicate that the normal functions of TRs in RCCC tissues were impaired. Together with the aberrant expression patterns, these mutated TRs could contribute to the carcinogenesis of RCCC.
UI - 11809699
AU - Falk CS; Noessner E; Weiss EH; Schendel DJ
TI - Retaliation against tumor cells showing aberrant HLA expression using lymphokine activated killer-derived T cells.
SO - Cancer Res 2002 Jan 15;62(2):480-7
AD - Institute of Molecular Immunology, GSF National Research Center for the Environment and Health, 81377 Munich, Germany.
Lymphokine activated killer (LAK) cells represent mixtures of natural killer (NK) and non-MHC-restricted CTLs that have the capacity to lyse a variety of tumor cells and MHC class I-negative target cells. Although it is clear that NK cells are negatively regulated by interactions with MHC class Ia or class Ib molecules, the regulation of LAK-derived T cells has not been clarified to date. In the studies presented here, we demonstrate that IFN-gamma treatment of tumor cells can induce their resistance to LAK-derived T cells in a manner similar to that seen for NK cells. The IFN-gamma-mediated suppression of LAK activity correlates with increased MHC class I expression by the tumor cells, and the inhibition of LAK-mediated cytotoxicity can be reversed in the presence of class I-specific antibody. Furthermore, the expression of MHC class Ia or class Ib molecules in class I-negative cell lines can reduce their susceptibility to LAK-mediated cytotoxicity. This principle of negative regulation by MHC class I molecules applies to LAK-derived T cells generated from peripheral blood lymphocytes of renal cell carcinoma patients and healthy, control donors. Although LAK-derived T cells can be inhibited in their lytic activity through interactions with MHC class Ia and class Ib molecules, they do not express the known inhibitory receptors specific for these ligands that are found on NK cells. Apparently, LAK-derived T cells are negatively regulated by as yet undefined inhibitory receptors.
UI - 11823974
AU - Kraus S; Abel PD; Nachtmann C; Linsenmann HJ; Weidner W; Stamp GW;
TI - Chaudhary KS; Mitchell SE; Franke FE; Lalani el-N MUC1 mucin and trefoil factor 1 protein expression in renal cell carcinoma: correlation with prognosis.
SO - Hum Pathol 2002 Jan;33(1):60-7
AD - Department of Urology, Justus-Liebig-University, Giessen, Germany.
This study examines the coexpression of MUC1 mucin and trefoil factor 1 (TFF1) and their relationship to progression of renal cell carcinoma (RCC). Immunohistochemistry was performed on tumor and adjacent normal tissue from clear-cell RCC (n = 60) and tissues from normal controls (n = 5) using a set of well-characterized monoclonal antibodies recognizing different epitopes of MUC1 and TFF1. Results of immunohistochemistry were compared with clinical parameters, including tumor grade, tumor size, presence of metastasis, and progression-free survival of patients after surgery. In normal tissue, MUC1 and TFF1 were absent from the normal proximal tubular epithelium but were identified in distal and collecting tubular epithelium. In RCC, increased MUC1 expression positively correlated to tumor progression. MUC1 recognized by HMFG1 was associated with large tumor size (P < .05), distant metastasis (P < .05), and invasion of large veins (P < .05). Expression of the under-glycosylated form of MUC1 recognized by SM3 was found to correlate to time to progression (recurrence, metastasis, or death of patient; P < .001). Expression of TFF1 did not significantly correlate with any prognostic parameters. However, there was a significant correlation (P < .01) between TFF1 and MUC1 expression (HMFG2 epitope) in RCCs. These results are consistent with the following conclusions: (1) MUC1 may be an independent prognostic marker in RCC; (2) TFF1 is frequently coexpressed with MUC1 and may act synergistically; and (3) RCC may originate from distal tubular epithelium. Copyright 2002 by W.B. Saunders Company
UI - 11823975
AU - Krishnan B; Truong LD
TI - Renal epithelial neoplasms: the diagnostic implications of electron microscopic study in 55 cases.
SO - Hum Pathol 2002 Jan;33(1):68-79
AD - Department of Pathology, Veterans Affairs Medical Center, Houston, TX 77030, USA.
Several unsettled histogenetic, nosologic and diagnostic considerations for renal epithelial tumors may have ultrastructural ramifications. Yet, a comprehensive electron microscopic study of renal epithelial neoplasms, in light of the recent classification, is not available. The ultrastructural findings from fifty-five renal epithelial neoplasms [31 clear cell renal cell carcinomas (RCC), 11 papillary RCC, 5 chromophobe RCC, 3 sarcomatoid RCC and 5 oncocytomas] were correlated with their light microscopic appearance. Clear cell RCC showed long microvilli similar to the brush border of the normal proximal tubules, with abundant cytoplasmic lipid and glycogen. Papillary RCC showed variably sized microvilli, and small amounts of cytoplasmic lipid, but no glycogen. Chromophobe RCC showed many cytoplasmic vesicles and abnormal mitochondria, with rare short and stubby microvilli. Renal oncocytoma showed many mitochondria with a few vesicles in the apical portion of the cytoplasm and rare short and stubby microvilli. The eosinophilic cell variants of clear cell RCC, papillary RCC and chromophobe RCC showed ultrastructural features similar to those of their respective prototypes, except for an increased numbers of mitochondria in the cytoplasm. One sarcomatoid clear cell RCC showed skeletal muscle differentiation. Two types of cytoplasmic inclusions, i.e. hyaline globules and granules similar to those in the Paneth cells (PC-like granules) were identified only in clear cell RCC, which displayed distinctive ultrastructural features. The current EM study demonstrates distinctive ultrastructural features of renal epithelial neoplasms. The findings lend additional support to the current classification of the pertinent tumor types, facilitate the differential diagnoses, and provide insights into the possible histogenesis of renal epithelial neoplasms. Copyright 2002 by W.B. Saunders Company
UI - 11834387
AU - Shekarriz B; Upadhyay J; Shekarriz H; Goes A; Bianco FJ; Tiguert R;
TI - Gheiler E; Wood DP Jr Comparison of costs and complications of radical and partial nephrectomy for treatment of localized renal cell carcinoma.
SO - Urology 2002 Feb;59(2):211-5
AD - Department of Urology, Wayne State University and Barbara Ann Karmanos Cancer Institute, Detroit, Michigan 48201, USA.
OBJECTIVES: To compare the complications and costs of radical and partial nephrectomy (PN) and to investigate the impact of increasing experience on costs and complications during a 7-year period. Nephron-sparing surgery has found increasing applications in the past decade. PN has achieved similar long-term results in localized renal cell carcinoma with respect to cancer control compared with radical nephrectomy (RN). However, data are limited on the direct comparison of complications and hospital costs between these two modalities. METHODS: A retrospective case-matched study was performed comparing 60 RNs and 60 PNs during a 7-year period with respect to complications and hospital costs. A longitudinal comparison was also performed between the various periods to assess the impact of surgical experience on these parameters. RESULTS: The mean length of stay was 6.4 +/- 3 days in the RN group and 6.4 +/- 3.3 days in the PN group. The hospital costs were comparable between the two procedures during the observed interval. The mean operative time was 176.6 +/- 51.6 minutes for RN and 220.1 +/- 59.6 minutes for PN (P = 0.0001). This difference was accentuated during the observed period. No differences were found in the blood loss and transfusion rates between the groups. The complication rate was 3.3% and 10% for RN and PN, respectively (P = 0.2). CONCLUSIONS: Our data suggest that RN and PN can be performed with a similar rate of complications and comparable hospital costs. This is of practical importance when comparing these modalities as treatment options for localized renal cell carcinoma.
UI - 11842961
AU - Mancini GJ; McQuay LA; Klein FA; Mancini ML
TI - Hand-assisted laparoscopic radical nephrectomy: comparison with transabdominal radical nephrectomy.
SO - Am Surg 2002 Feb;68(2):151-3
AD - Graduate School of Medicine, University of Tennessee, Knoxville, USA.
The purpose of this study was to investigate whether hand-assisted laparoscopic radical nephrectomy (HALN) has benefits over the traditional transabdominal radical nephrectomy. More specifically we focused on the use of the hand-assisted technique as a definitive oncologic procedure for renal cancers. This study is a retrospective nonrandomized study comparing 12 hand-assisted laparoscopic radical nephrectomies with 12 transabdominal radical nephrectomies. All patients included in the study had the preoperative diagnosis of renal mass. HALN population averaged 1.83 +/- 1.64 (mean +/- standard deviation) major comorbidities versus 1.08 +/- 0.8 open (P = 0.032). The HALN OR time averaged 103 +/- 32.8 versus 57 +/- 18.3 minutes open (P = 0.001). The estimated blood loss mean for HALN was 83 versus 318 cm3 open (P = 0.001). Length of stay for HALN was 4.9 +/- 2.2 versus 5.9 +/- 2.9 days (P = 0.35). Days to regular diet was 2.9 +/- 2.3 in HALN versus 3.5 +/- 2.11 open (P = 0.52). Days of intravenous pain medications were 1.8 +/- 0.72 HALN versus 3.0 +/- 1.28 open (P = 0.016). Postoperative complication rates for the two groups were identical: two of 12 (ileus and post-operative bleeding). Tumor size mean was 6.8 +/- 2.99 cm for HALN versus 4.2 +/- 1.29 cm open (P = 0.012). Tumor margins were negative for 12 of 12 in HALN versus 11 of 12 open. Selection bias (selecting ailing patients to the HALN cohort) diminished the statistical significance of our postoperative recovery data. It is likely that a prospectively randomized study with a larger population may prove the hand-assisted approach equal if not superior to the open technique. The use of HALN in patients with renal tumors is an effective alternative to traditional transabdominal radical nephrectomy.
UI - 11783059
AU - Yu L; Tang D; Ding Y
TI - [Microsatellite instability in renal cell carcinoma and its mechanisms]
SO - Zhonghua Zhong Liu Za Zhi 2001 Jan;23(1):11-3
AD - Department of Urology, First Hospital, Institute of Urology, Beijing Medical University, Beijing 100034, China.
OBJECTIVE: To study the expression of microsatellite instability (MSI) in renal cell carcinoma (RCC) and its relationship with gene mutation. METHODS: Tumor samples from 34 patients with RCC were analyzed for MSI by PCR. RT-PCR was used to evaluate the expression of mRNA of 5 human mismatch repair (MMR) genes in RCC and RCC cell lines. Mutation of hMLH1 gene coding regions was detected by PCR-SSCP. PCR was used to check the mutations of TGF-beta R II gene and BAX gene in 15 MSI-positive samples of RCC. RESULTS: Microsatellite changes were detected in 15 of 34 patients with RCC (44.1%). It might be associated with the progression of this disease. There were 3 of 15 MSI-positive RCC cases without expression of MMR gene hMLH1, and in 3 of 15 cases its expression was decreased. All 5 MMR genes were expressed in normal and RCC 949 cell line. There were three mutations in 15 MSI-positive cases. Frame shift mutation of TGF beta R II gene and BAX gene was found in 6 and 4 of the 15 cases with MSI, respectively, but it was not found in MSI-negative RCC and normal tissue. CONCLUSION: MSI and expression of MMR genes are associated events in RCC. The effect of gene mutation on tumorgenerasis may be related to MSI.
UI - 11804895
AU - Herts BR; Coll DM; Novick AC; Obuchowski N; Linnell G; Wirth SL; Baker
TI - ME Enhancement characteristics of papillary renal neoplasms revealed on triphasic helical CT of the kidneys.
SO - AJR Am J Roentgenol 2002 Feb;178(2):367-72
AD - Department of Radiology-H66, The Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, USA.
OBJECTIVE: The purpose of this study was to determine whether renal tumor enhancement or heterogeneity on triphasic helical CT scans is predictive of the papillary cell subtype or nuclear grade of renal cell carcinoma. MATERIALS AND METHODS: We reviewed the CT scans of 90 consecutive patients with renal masses who had undergone triphasic renal helical CT before a complete or partial nephrectomy (12 with papillary renal cell carcinomas, 66 with nonpapillary renal cell carcinomas, and 12 with benign lesions). Three radiologists who were unaware of the patients' diagnoses retrospectively and independently measured the attenuation of each patient's tumor, abdominal aorta, and normal renal parenchyma on the scans obtained during all three phases. Ratios of tumor-to-aorta enhancement and tumor-to-normal renal parenchyma enhancement were calculated for both of the phases performed after contrast material had been administered. Tumor heterogeneity was calculated as the difference between the highest and lowest attenuation values divided by the value of the enhancement of the aorta. Values were correlated with cell type and nuclear grade found at surgical pathology. RESULTS: Low tumor-to-aorta enhancement and low tumor-to-normal renal parenchyma enhancement ratios on the vascular phase scans significantly correlated (p < 0.001) with papillary renal cell type carcinoma. Homogeneity and tumor-to-parenchyma enhancement ratios on the parenchymal phase scans also significantly correlated (p < 0.001) with papillary renal cell type carcinoma. Heterogeneity and tumor enhancement ratios did not correlate with the nuclear grade of the carcinoma. CONCLUSION: Papillary renal cell carcinomas are typically hypovascular and homogeneous. A high tumor-to-parenchyma enhancement ratio (> or = 25%) essentially excludes the possibility of a tumor being papillary renal cell carcinoma. A low tumor-to-aorta enhancement ratio or tumor-to-normal renal parenchyma enhancement ratio is more likely to indicate papillary renal cell carcinoma.
UI - 11783026
AU - Kong X; Zeng L; Mi P
TI - [Carcinoma of kidney collecting duct: an analysis of 10 cases]
SO - Zhonghua Zhong Liu Za Zhi 2001 Mar;23(2):162-4
AD - Institute of Urology, Beijing University, Beijing 100034, China.
OBJECTIVE: To study the clinicopathologic characteristics of renal collecting duct carcinoma (CDC). METHODS: A retrospective study was done in 10 cases of CDC. RESULTS: Among 466 cases of renal cell carcinoma 10(2.1%) cases of CDC were identified. Seven presented with gross hematuria and 3 with abdominal pain. Radical nephrectomy was done in 9 patients, enucleation of tumor in one. The primary tumor was located predominantly in the renal medulla. Histologic examination showed prominent tubular or tubulopapillary structures. Sarcomatoid carcinoma, cystadenocarcinoma, nests and cords of tumor cells in desmoplastic stroma were identified in some cases. High molecular weight cytokeratin 34 beta E12 was positive in 8 cases and peanut agglutinin in 7 cases. According to Fuhrman's nuclear grade, one was in G2, 4 were in G3 and 5 in G4. Six patients died of metastases within 3 to 23 months (mean 13.3 months), one died of heart disease with tumor free after 19 months, two survived with tumor free for 14