renal cell cancer

肾细胞癌
  • 文章类型: Journal Article
    胃癌(GC)是全球第四大致命癌症。在几种类型的癌症中,adducin1(ADD1)蛋白参与致癌信号转导途径,和rs4961变体(c.1378G>T,ADD1基因的p.Gly460Trp)与盐敏感性高血压有关,肾细胞癌和乳腺癌易感性;然而,它尚未在GC中进行调查。本研究的目的是评估rs4961变体与墨西哥西部人群中GC和肿瘤前胃病变(PGL)的发展之间的关系。总共对225名接受内窥镜检查的人进行了评估,其中71例患者有组织病理学诊断为GC,53例患者有PGLs,101名患者作为对照。通过使用PCR和DNA测序对rs4961变体进行基因分型。rs4961变体的突变纯合基因型(TT)的频率在三个评估组中<10%,在GC中次要等位基因(T)的频率<21%,PGL和对照组。基因型和等位基因频率在所有研究组中分布相似(P>0.05)。总之,在研究人群中,rs4961变体与GC风险无关;然而,它在其他人群和其他类型癌症中的作用值得未来研究。
    Gastric cancer (GC) is the fourth most deadly cancer globally. The adducin 1 (ADD1) protein is involved in oncogenic signal transduction pathways in several types of cancer, and the rs4961 variant (c.1378 G>T, p.Gly460Trp) of the ADD1 gene is associated with salt-sensitive hypertension, renal cell cancer and breast cancer susceptibility; however, it has not been investigated in GC. The aim of the present study was to evaluate the association between the rs4961 variant and the development of GC and preneoplastic gastric lesions (PGLs) in a population from western Mexico. A total of 225 individuals who underwent an endoscopy were evaluated, of which 71 patients had histopathologically diagnosed GC and 53 patients had PGLs, with 101 patients used as controls. The rs4961 variant was genotyped by using PCR and DNA sequencing. The frequency of the mutated homozygous genotype (TT) of the rs4961 variant was <10% in the three evaluated groups, and the frequency of the minor allele (T) was <21% in the GC, PGL and control groups. Genotypic and allelic frequencies were similarly distributed in all of the studied groups (P>0.05). In summary, in the study population, the rs4961 variant was not associated with GC risk; however, its role in other populations and in other types of cancer is worthy of future research.
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  • 文章类型: Journal Article
    用全身药物治疗肾细胞癌(RCC)后患者的反应,其中包括各种药物类别,通常是贫穷和不可预测的。在这种情况下,理想的药物管理包括预测疾病对治疗的敏感性的工具。本研究旨在系统总结甲基化状态在肾癌全身治疗中的预测价值。本综述仅包括有关启动子甲基化与患者或细胞系对全身性药物的反应相关的原始文章。我们将PRISMA建议应用于本次系统评价的结构和方法。我们的文献检索总结了31篇关于RCC细胞系和患者组织的文章。大多数研究证明了对全身性药物的甲基化依赖性反应。这种相关性表明,甲基化模式可用作各种全身性药物治疗RCC的预测工具。然而,尽管甲基化生物标志物显示出预测反应的前景,这种相关性的证据仍然薄弱。需要更多研究全身治疗患者的基因甲基化模式及其与不同反应程度的相关性。
    Patient response after treatment of renal cell cancer (RCC) with systemic agents, which include various drug categories, is generally poor and unpredictable. In this context, the ideal drug administration includes tools to predict the sensitivity of the disease to therapy. The aim of this study was to systematically summarize the reports on the predictive value of the methylation status in the systemic therapy of RCC. Only original articles reporting on the association of promoter methylation with the response of patients or cell lines to systemic agents were included in this review. We applied PRISMA recommendations to the structure and methodology of this systematic review. Our literature search concluded with 31 articles conducted on RCC cell lines and patient tissues. The majority of the studies demonstrated a methylation-dependent response to systemic agents. This correlation suggests that the methylation pattern can be used as a predictive tool in the management of RCC with various classes of systemic agents. However, although methylation biomarkers show promise for predicting response, the evidence of such correlation is still weak. More studies on the gene methylation pattern in patients under systemic therapy and its correlation with different degrees of response are needed.
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  • 文章类型: Journal Article
    背景:膀胱癌(BC)和肾细胞癌(RCC)是男女最常见的泌尿生殖道癌症,每年全球发病率约为50万。BC和RCC都与糖尿病有关。血糖控制不良(低血糖)是糖尿病的严重后果,也是BC和RCC中使用的全身治疗的可能后果。这项研究的目的是调查BC或RCC患者的糖尿病患病率和基于医院的血糖管理。
    方法:这项瑞典基于人群的回顾性登记研究使用国家健康数据登记来获取15年癌症发病率的纵向数据,使用以医院为基础的医疗保健,并填写了门诊药物的处方。研究终点包括BC/RCC个体中糖尿病的共同患病率,由于血糖不良而导致的医疗保健资源利用,使用全身性皮质类固醇,以及合并2型糖尿病患者的糖尿病管理变化。
    结果:我们确定了36,620和15,581名诊断为BC和RCC的个体,分别,2006年至2019年。在BC中,糖尿病患者的比例为24%,在RCC中为23%。发现BC/RCC与血糖控制不良之间存在关联,尽管医院护理中的血糖不良事件数量很少(糖尿病患者和BC/RCC患者中分别有65/59例,至少有1起事件).与2型糖尿病但没有癌症的匹配个体相比,在BC/RCC中观察到更早地转换为基于胰岛素的糖尿病管理。结果还表明类固醇治疗与血糖控制不良之间存在关联,与糖尿病对照组相比,全身性皮质类固醇在BC/RCC患者中更常见。
    结论:在这项大型国家研究中观察到的糖尿病的高患病率和全身性皮质类固醇治疗的增加,突出了对特定临床管理的需求。风险评估,并监测BC/RCC和糖尿病患者。
    BACKGROUND: Bladder cancer (BC) and Renal cell carcinoma (RCC) are the most common urogenital cancers among both sexes, with a yearly global incidence of around 500 000 each. Both BC and RCC have been linked to diabetes. Poor glycemic control (malglycemia) is a serious consequence of diabetes and a possible consequence of systemic treatments used in BC and RCC. The objective of this study was to investigate the prevalence of diabetes and use of hospital-based care for malglycemia in people with BC or RCC.
    METHODS: This Swedish retrospective population-based register study used national health-data registers for longitudinal data on cancer incidence covering 15 years, use of hospital-based health care, and filled prescriptions of outpatient medications. Study endpoints included co-prevalence of diabetes in individuals with BC/RCC, healthcare resource utilization due to malglycemia, use of systemic corticosteroids, and changes in diabetes management for people with concomitant type 2 diabetes.
    RESULTS: We identified 36,620 and 15,581 individuals diagnosed with BC and RCC, respectively, between 2006 and 2019. The proportion of individuals registered with diabetes was 24% in BC and 23% in RCC. An association between BC/RCC and poor glycemic control was found, although the number of malglycemic events in hospital-based care were few (65/59 per 1000 individuals with diabetes and BC/RCC respectively with at least one event). An earlier switch to insulin-based diabetes management was observed in BC/RCC compared to matched individuals with type 2 diabetes but no cancer. The results also indicated an association between steroid treatment and poor glycemic control, and that systemic corticosteroids were more common among people with BC/RCC compared to diabetes controls.
    CONCLUSIONS: The high prevalence of diabetes and increased use of systemic corticosteroid treatment observed in this large national study highlights the need for specific clinical management, risk-assessment, and monitoring of individuals with BC/RCC and diabetes.
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  • 文章类型: Journal Article
    背景肾癌转移到口腔区域非常罕见。许多研究人员已经发表了分析口腔转移性肿瘤病例的研究。迄今为止,很少进行研究来分析肾癌转移作为口腔软组织的唯一主要来源。这项研究的目的是检查1911年至2022年作为唯一主要来源的肾细胞癌口腔软组织转移的已发表病例。材料和方法在PubMed/Medline中对已发表文献进行了电子搜索,没有出版年份限制,Scopus,谷歌学者,WebofScience,科学直接,Embase,和研究门数据库,使用网格关键字,如(“肾癌,\"或\"肾癌\"或\"肾细胞癌\"或\"肾细胞癌\"),和(“转移”或“转移”),和(“口腔软组织”或“舌头”或“腭”或“扁桃体”或“颊粘膜”或“唾液腺”)。我们还手动搜索了相关期刊和参考文献列表。结果我们的研究共揭示了226篇相关文章,共250例患者。腮腺和舌是最常见的转移部位。23%的患者死亡,生存时间为10天至4年。结论肾细胞癌口腔软组织转移预后不良。需要发布更多病例,以提高对这些病变的认识。
    Background  Renal cancer metastasis to oral region is very rare. Studies have been published analyzing the cases of metastatic tumors to the oral cavity by many researchers. Very few research studies have been conducted till date to analyze the renal cancer metastasis as the sole primary source to the oral soft tissues. The goal of this study was to examine the published cases of oral soft tissue metastasis from renal cell carcinoma as the only primary source from 1911 to 2022. Materials and Methods  An electronic search of the published literature was performed without publication year limitation in PubMed/Medline, Scopus, Google Scholar, Web of Science, Science Direct, Embase, and Research Gate databases, using mesh keywords like (\"Renal cancer,\" or \"Renal carcinoma\" or \"Renal cell cancer\" or \"Renal cell carcinoma\"), and (\"Metastasis\" or \"Metastases\"), and (\"Oral soft tissues\" or \"Tongue\" or \"Palate\" or \"Tonsil\" or \"Buccal mucosa\" or \"Salivary glands\"). We also searched related journals manually and the reference lists. Results  Our research revealed a total of 226 relevant articles with 250 patients. Parotid glands and tongue were the most common sites of metastasis. 23% patients died with a survival time of 10 days to 4 years. Conclusions  Oral soft tissue metastasis from renal cell carcinoma has a bad prognosis. More cases need to be published in order to raise awareness of these lesions.
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  • 文章类型: Case Reports
    对于免疫组织化学等“旧”诊断工具,遗传性皮肤肿瘤的诊断很困难。全外显子组测序分析作为一种“新的”诊断工具,使我们能够在过去未知的遗传性疾病的情况下做出最终诊断。遗传性平滑肌瘤和肾细胞癌是以子宫肌瘤为特征的常染色体显性遗传性癌症综合征。皮肤平滑肌瘤,和侵袭性肾细胞癌。该综合征与富马酸水合酶基因的致病性种系变异有关。在这里,我们在一名患有多发性皮肤平滑肌瘤的60岁女性中证明了富马酸水合酶基因的致病性种系变异,导致遗传性平滑肌瘤病和肾细胞癌的诊断。使用从外周血白细胞中提取的基因组DNA进行的全外显子组测序分析显示,1号染色体上的FH基因中有一个种系变异(c.290G>A,p.Gly97Asp)。她因子宫肌瘤接受了全子宫切除术,这强烈支持了诊断。计算机断层扫描和超声检查未在她的肾脏中检测到肿瘤。富马酸水合酶基因突变的遗传检查对于达到正确诊断并在早期检测肾癌很重要。
    The diagnosis of hereditary skin tumors is difficult for \"old\" diagnostic tools such as immunohistochemistry. Whole-exome sequencing analysis as a \"new\" diagnostic tool enables us to make a final diagnosis in spite of unknown hereditary diseases in the past. Hereditary leiomyomatosis and renal cell cancer are autosomal dominant hereditary cancer syndromes characterized by uterine myomas, cutaneous leiomyomas, and aggressive renal cell cancer. The syndrome is associated with pathogenic germline variants in the fumarate hydratase gene. Herein, we demonstrate a pathogenic germline variant of the fumarate hydratase gene in a 60-year-old woman with multiple cutaneous leiomyomas, leading to the diagnosis of hereditary leiomyomatosis and renal cell cancer. Whole-exome sequencing analysis using genomic DNA extracted from peripheral blood leukocytes revealed one germline variant in the FH gene on chromosome 1 (c.290G>A, p.Gly97Asp). She received total hysterectomy due to uterine myoma, which strongly supported the diagnosis. No tumor was detected in her kidney by computed tomography and ultrasound examination. Genetic examination for the mutation of the fumarate hydratase gene is important in order to reach the correct diagnosis and to detect renal cancer at its early stage.
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  • 文章类型: Journal Article
    目的:肾细胞癌(RCC)的发病率正在增加,目前有多种治疗选择。这篇综述的目的是概述患者的选择和技术方法,并介绍T1b(4.1-7cm)RCC经皮消融的最新文献。
    结果:越来越多的回顾性研究和荟萃分析评估了经皮消融治疗T1bRCC的应用。总的来说,这些研究倾向于表明,经皮消融在这一患者人群中是可行的。然而,T1b型RCC经皮消融术后的主要不良事件和局部复发率均高于较小肿瘤的消融术.因此,一个多学科,需要以患者为中心的方法。由于这方面的文献越来越多,最新的国家综合癌症网络(NCCN)指南将经皮消融作为T1bRCC非手术患者的一种选择.
    OBJECTIVE: There is increasing incidence of renal cell carcinoma (RCC) with multiple treatment options currently available. The purpose of this review is to outline patient selection and technical approaches and present the current literature for percutaneous ablation of T1b (4.1-7 cm) RCC.
    RESULTS: An increasing number of retrospective studies and meta-analyses have evaluated the use of percutaneous ablation for T1b RCC. Overall, these studies tend to show that percutaneous ablation in this patient population is feasible. However, rates of major adverse events and local recurrence after percutaneous ablation for T1b RCC are both higher than when ablation is used for smaller tumors. As such, a multi-disciplinary, patient-centered approach is required. Due to the increasing literature in this area, the most recent National Comprehensive Cancer Network (NCCN) guidelines include percutaneous ablation as an option for non-surgical patients with T1b RCC.
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  • 文章类型: Journal Article
    在我们最近的研究中,我们探讨了三维(3D)测量肿瘤体积在预测肾细胞癌(RCC)患者生活质量(QoL)改善中的功效,接受阿西替尼和抗PD-L1抗体治疗的患者。这项研究包括18例RCC患者,包括10名男性和8名女性,平均年龄56.83±9.94岁。通过利用3D切片器软件,我们分析了治疗前后的CT扫描,以评估肿瘤体积的变化.通过FKSI-DRS问卷评估患者的QoL。我们的研究结果表明,所有患者的3D模型都被成功创建,基于RECIST1.1标准的治疗应答分类与体积分析之间存在中度一致性(kappa=0.556,p=0.001).值得注意的是,9例患者报告治疗后QoL有临床意义的改善.有趣的是,与CT测量的直径变化相比,3D模型显示的肿瘤体积变化在预测QoL改善方面显示出更高的曲线下面积,尽管这种差异没有统计学意义(z=0.593,p=0.553).此外,一项多变量分析将基于3D模型的肿瘤体积变化确定为QoL改善的独立预测因子(比值比=1.073,95%CI1.002-1.149,p=0.045).总之,我们的研究表明,与传统的基于CT的直径测量相比,通过3D模型测量的肿瘤体积变化可能更有效地预测RCC患者的症状改善.这提供了一种评估治疗反应和患者健康状况的新方法,在RCC治疗领域取得了重大进展。
    In our recent study, we explored the efficacy of three-dimensional (3D) measurement of tumor volume in predicting the improvement of quality of life (QoL) in patients suffering from renal cell cancer (RCC), who were treated with axitinib and anti-PD-L1 antibodies. This study encompassed 18 RCC patients, including 10 men and 8 women, with an average age of 56.83 ± 9.94 years. By utilizing 3D Slicer software, we analyzed pre- and post-treatment CT scans to assess changes in tumor volume. Patients\' QoL was evaluated through the FKSI-DRS questionnaire. Our findings revealed that 3D models for all patients were successfully created, and there was a moderate agreement between treatment response classifications based on RECIST 1.1 criteria and volumetric analysis (kappa = 0.556, p = 0.001). Notably, nine patients reported a clinically meaningful improvement in QoL following the treatment. Interestingly, the change in tumor volume as indicated by the 3D model showed a higher area under the curve in predicting QoL improvement compared to the change in diameter measured by CT, although this difference was not statistically significant (z = 0.593, p = 0.553). Furthermore, a multivariable analysis identified the change in tumor volume based on the 3D model as an independent predictor of QoL improvement (odds ratio = 1.073, 95% CI 1.002-1.149, p = 0.045).In conclusion, our study suggests that the change in tumor volume measured by a 3D model may be a more effective predictor of symptom improvement in RCC patients than traditional CT-based diameter measurements. This offers a novel approach for assessing treatment response and patient well-being, presenting a significant advancement in the field of RCC treatment.
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  • 文章类型: Journal Article
    脑转移(BM)的诊断显着影响转移性肾细胞癌(mRCC)患者的生活质量。尽管全身治疗在mRCC中显示出疗效,主动监测(AS)仍然是临床实践中常用的方法。在这项单中心队列研究中,我们评估了转移性肾癌(mRCC)不同初始治疗策略对BM发展的影响。2011年至2022年期间诊断为mRCC的所有连续患者都被包括在伊拉斯谟MC癌症研究所,荷兰,并选择BM患者亚组。总的来说,381例mRCC患者(ECM,BM,或两者)被识别。46例患者患有BM,其中39例患有异时BM(ECM后诊断≥1个月)。在这39例异时性BM患者中,有25例(64.1%)接受了先前的ECM全身治疗,而14例(35.9%)患者在BM诊断时初治。与未接受治疗的患者(6.8[IQR1.0-7.0]个月)相比,先前接受治疗的患者(29.0[IQR12.6-57.0]个月)自ECM诊断以来的中位无BM生存期显着更长(p=.02)。总之,与未接受治疗的患者相比,在BM诊断前接受ECM系统治疗的mRCC患者的无BM生存期更长.这些结果强调需要仔细评估治疗策略,尤其是AS,对于mRCC患者。
    A diagnosis of brain metastasis (BM) significantly affects quality of life in patients with metastatic renal cell cancer (mRCC). Although systemic treatments have shown efficacy in mRCC, active surveillance (AS) is still commonly used in clinical practice. In this single-center cohort study, we assessed the impact of different initial treatment strategies for metastatic RCC (mRCC) on the development of BM. All consecutive patients diagnosed with mRCC between 2011 and 2022 were included at the Erasmus MC Cancer Institute, the Netherlands, and a subgroup of patients with BM was selected. In total, 381 patients with mRCC (ECM, BM, or both) were identified. Forty-six patients had BM of whom 39 had metachronous BM (diagnosed ≥1 month after ECM). Twenty-five (64.1%) of these 39 patients with metachronous BM had received prior systemic treatment for ECM and 14 (35.9%) patients were treatment naive at BM diagnosis. The median BM-free survival since ECM diagnosis was significantly longer (p = .02) in previously treated patients (29.0 [IQR 12.6-57.0] months) compared to treatment naive patients (6.8 [IQR 1.0-7.0] months). In conclusion, patients with mRCC who received systemic treatment for ECM prior to BM diagnosis had a longer BM-free survival as compared to treatment naïve patients. These results emphasize the need for careful evaluation of treatment strategies, and especially AS, for patients with mRCC.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:本研究旨在探讨术前身体成分参数的相关性,通过计算机断层扫描在接受肾细胞癌手术的患者中测量,并探讨其分期与术后住院时间和生存率的关系。
    方法:人口统计数据,病理结果,癌症阶段,回顾性分析了2019年至2023年因肾癌在泌尿外科诊所接受手术的104例患者的住院时间。在诊断期间获得的计算机断层扫描扫描中,内脏脂肪组织,皮下脂肪组织,总脂肪组织,测量骨骼肌面积。计算身体成分参数的比率。
    结果:当分析死亡患者的生存时间与身体成分之间的相关性时,骨骼肌面积值与总脂肪组织/骨骼肌面积比之间存在中等但显著的相关性(r=0.630,p=0.001;r=0.598,p=0.002).在总脂肪组织值和存活率之间观察到显著且强的相关性(r=0.704,p<0.001)。发现皮下脂肪组织/骨骼肌面积是与死亡率相关的独立危险因素。0.98或更低的比率增加了约16倍的死亡风险.
    结论:计算机断层扫描测量的身体成分参数之间的关系,这可以很容易地评估预处理,和死亡率,可以评估术后恢复和住院时间,让临床医生了解患者在治疗过程中可能遇到的潜在困难。为此,皮下脂肪组织/骨骼肌面积比是可以使用的最有用的参数。

    This study aims to investigate the association of preoperative body composition parameters, measured by computed tomography in patients undergoing surgery for renal cell carcinoma, with its stage and to survey the relationship with postoperative hospitalization duration and survival.
    Demographic data, pathology results, cancer stages, and hospitalization duration of 104 patients undergoing surgery at the urology clinic due to renal cell carcinoma between 2019 and 2023 were analyzed retrospectively. On computed tomography scans acquired during diagnosis, visceral adipose tissue, subcutaneous adipose tissue, total adipose tissue, and skeletal muscle area were measured. The ratios of body composition parameters were computed.
    When the correlation between survival time and body composition in deceased patients was analysed, a moderate but significant correlation was observed between skeletal muscle area value and total adipose tissue / skeletal muscle area ratio (r=0.630, p=0.001; r=0.598, p=0.002). A significant and strong correlation was observed between total adipose tissue value and survival (r=0.704, p<0.001). Subcutaneous adipose tissue / skeletal muscle area was found to be an independent risk factor associated with mortality, and a ratio of 0.98 or less increased the mortality risk approximately 16-fold.
    The relationship between body composition parameters measured by computed tomography, which can be easily evaluated pre-treatment, and mortality, postoperative recovery and length of hospital stay can be evaluated, giving clinicians an idea about the potential difficulties that patients may encounter during the treatment process. For this purpose, the subcutaneous adipose tissue / skeletal muscle area ratio is the most helpful parameter that can be used.

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