Abstract
Kidney cancer is one of the deadliest malignancies due to frequent late diagnosis (33 % or renal cell carcinoma are metastatic at diagnosis) and poor treatment options. There are two major subtypes of kidney cancer: renal cell carcinoma (RCC) and renal pelvis carcinoma. The risk factors for RCC, accounting for more than 90 % of all kidney cancers, are smoking, obesity, hypertension, misuse of pain medication, and some genetic diseases. The most common molecular markers of kidney cancer include mutations and epigenetic inactivation of von Hippel-Lindau (VHL) gene, genes of vascular endothelial growth factor (VEGF) pathway, and carbonic anhydrase IX (CIAX). The role of epigenetic pathways, including DNA methylation and chromatin structure remodeling, was also demonstrated. Immunologic properties of RCC enable this type of tumor to escape immune response effectively. An important role in this process is played by tumor-associated macrophages that demonstrate mixed M1/M2 phenotype. In this review, we discuss molecular and cellular aspects for RCC development and current state of knowledge allowing personalized approaches for diagnostics and prognostic prediction of this disease. A set of macrophage markers is suggested for the analysis of the association of macrophage phenotype and disease prognosis.
Highlights
Kidney cancer is one of the most common and deadly malignancies, with approximately 58,000 new cases and 13,000 deaths estimated to have occurred in the USA in 2010
Patients with baseline levels of sVEGFR-3 were associated with a better prognosis, suggesting that these factors can be used as predictive markers in this type of therapy [11]
Higher number of CD163 cells was associated with higher density of capillaries as defined by CD31 staining. These findings suggest the functional impact of tumor-associated macrophages (TAMs) on the prognosis of papillary renal cell carcinoma (RCC) type II [46]
Summary
Kidney cancer is one of the most common and deadly malignancies, with approximately 58,000 new cases and 13,000 deaths estimated to have occurred in the USA in 2010 (http://www.cancer.gov/cancertopics/types/kidney). There are two main types of kidney cancer, which includes renal cell carcinoma (RCC) and renal pelvis carcinoma. In a study by Yao et al, it was shown that the presence of VHL alterations is associated with better outcomes for patients with stages I–III clear cell RCC treated by nephrectomy [9].
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