Circulating RNA in Kidney Cancer: What We Know and What We Still Suppose.

Alessandra Cinque,Francesco Trevisani,Riccardo Vago

doi:10.3390/genes12060835

Alessandra Cinque, Francesco Trevisani + Show 1 more

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https://doi.org/10.3390/genes12060835

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Abstract

Renal cancer represents the 7th most common tumor worldwide, affecting 400,000 people annually. This malignancy, which is the third most frequent cancer among urological diseases, displays a completely different prognosis if the tumor is detected in the early stages or advance phases. Unfortunately, more than 50% of renal cancers are discovered incidentally, with a consistent percentage of cases where the tumor remains clinically silent till the metastatic process is established. In day-to-day clinical practice, no available predictive biomarkers exist, and the existent imaging diagnostic techniques harbor several gaps in terms of diagnosis and prognosis. In the last decade, many efforts have been reported to detect new predictive molecular biomarkers using liquid biopsies, which are less invasive in comparison to renal biopsy. However, until now, there has been no clear evidence that a liquid biopsy biomarker could be relevant to the creation of a precise and tailored medical management in these oncological patients, even though circulating RNA biomarkers remain among the most promising. Given the idea that liquid biopsies will play a future key role in the management of these patients, in the present review, we summarize the current state of circulating RNA (miRNA, lncRNAs, and circRNAs) as possible biomarkers of renal cancer presence and aggressiveness in patients.

Highlights

Renal cell carcinoma (RCC) in adults comprises a heterogeneous group of tumors derived from renal tubular epithelial cells and accounts for 3% of all malignancy scenarios [1], with over 400,000 new cases of RCC worldwide annually [2]
The gold standard treatment for RCC is represented by radical and partial nephrectomy, whereas active surveillance is suggested in the case of small and localized tumors affecting patients with multiple comorbidities [5–7]
Only a computed tomography (CT) scan and MRI allow for an accurate diagnosis of RCC, they have some limitations in terms of distinguishing between benign and malignant neoplasms [11]

Summary

Introduction

Renal cell carcinoma (RCC) in adults comprises a heterogeneous group of tumors derived from renal tubular epithelial cells and accounts for 3% of all malignancy scenarios [1], with over 400,000 new cases of RCC worldwide annually [2]. If the 5-year disease-specific survival rate for a localized and low-risk RCC (N0, M0 according to TNM classification) achieves more than 90%, a metastatic high-risk (N2, M0/M1) neoplasm may be fatal rapidly, despite surgical and oncological treatments [9,10]. For these reasons, the diagnostic process remains one of the most important clinical steps in the management of RCC patients. RCC is characterized by the presence of nonspecific symptoms (blood hypertension, anemia, and weight loss) during its development in the human body, from the early stages to the advanced ones [11] For this reason, the majority of renal tumors are diagnosed incidentally by an abdominal ultrasound or computed tomography (CT) scan performed for other medical purposes. Only a CT scan and MRI allow for an accurate diagnosis of RCC, they have some limitations in terms of distinguishing between benign and malignant neoplasms [11]

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