肾癌误诊为肾良性肿瘤六例分析

目的 探讨肾癌(RCC)的临床特点、误诊为肾良性肿瘤的原因.方法 回顾性分析6例误诊为肾良性肿瘤的肾癌患者的临床资料.结果 6例术前全部误诊,均行手术治疗;术中行冰冻病理检查,结果都提示为肾细胞癌,遂行患肾根治切除术.手术均成功,预后良好.结论 肾细胞癌系恶性疾病,临床表现与肾良性肿瘤相似,临床医师应重视此病,结合病史、体检、影像学检查以及其他检查以明诊断.     

Genome-wide gene expression profiles of clear cell renal cell carcinoma: identification of molecular targets for treatment of renal cell carcinoma

In order to clarify the molecular mechanism involved in renal carcinogenesis, and to identify molecular targets for diagnosis and treatment, we analyzed genome-wide gene expression profiles of 15 surgical specimens of clear cell renal cell carcinoma (RCC), compared to normal renal cortex, using a combination of laser microbeam microdissection (LMM) with a cDNA microarray representing 27,648 genes. We identified 257 genes that were commonly up-regulated and 721 genes that were down-regulated in RCCs. None of top 24 up-regulated genes that showed most significant differences in informative RCC-cases were included in previous reports describing expression profiles of RCC using RNAs isolated from bulk tissues. These findings suggest that it is important to purify as much as possible the populations of cancerous and normal epithelial cells obtained from surgical specimens. Among the significantly-transactivated genes, we focused on Semaphorin 5B (SEMA5B) and knocked-down its expression in RCC cells by small-interfering RNA (siRNA). Effective down-regulation of its expression levels in RCC cells significantly attenuated RCC cell viability. In conclusion, our data should be helpful for a better understanding of the tumorigenesis of RCC and should contribute to the development of diagnostic tumor markers and molecular-targeting therapy for patients with RCC.     

肾嗜酸细胞瘤螺旋CT特征及鉴别要点分析

目的：观察肾嗜酸细胞瘤的平扫及动态增强扫描特征,并与肾嫌色细胞癌进行比较。方法选择20例肾嗜酸细胞瘤患者为研究对象,另选择30例肾嫌色细胞癌患者为对照组,观察肾嗜酸细胞瘤CT表现,比较肾嗜酸细胞瘤与肾嫌色细胞癌病变形态学特征,病灶强化百分比及肿瘤-肾皮质强化指数。结果肾嗜酸细胞瘤密度于皮髓质期、实质期及排泄期均低于肾脏皮质,差异均有统计学意义（P﹤0.05）;肾嗜酸细胞瘤密度于皮髓质期、肾实质期及排泄期高于肾脏髓质,差异具有统计学意义（P﹤0.05）;肾嗜酸细胞瘤较肾嫌色细胞癌体积小,密度均匀的比例高,存在星芒状瘢痕的比例高,差异均具有统计学意义（P﹤0.05）。动态增强扫描,肾嗜酸细胞瘤与肾嫌色细胞癌强化程度间比较显示,肾嗜酸细胞瘤在皮髓质期、实质期的病灶强化百分比和肿瘤-肾皮质强化指数,均高于肾嫌色细胞癌,差异均具有统计学意义（P﹤0.05）。结论肾嗜酸细胞瘤的CT表现具有一定的特征,形态学特征及动态增强表现有助于鉴别诊断。     

MSCT多期扫描在肾脏乏脂肪血管平滑肌脂肪瘤与透明细胞癌鉴别诊断中的应用价值

目的 探讨肾脏乏脂肪血管平滑肌脂肪瘤(fpAML)和透明细胞癌(ccRCC)多排螺旋CT(MSCT)平扫及多期增强扫描表现,提高诊断准确率.方法 选取2015年1月至2019年12月江苏省中医院经手术病理确诊的fpAML和ccRCC患者各20例,测量肿瘤的短径和长径、CT平扫及多期增强的肿瘤CT值及邻近肾皮质的CT值,...     

Hsa-miR-34a作为肾癌早期诊断指标的临床探讨

目的:探讨hsa-miR-34a作为肾癌早期诊断分子指标的可行性.方法:选择27例肾细胞癌患者的肿瘤组织及相匹配的正常组织进行高通量的real-time PCR检测鉴定,数据采用SPSS17.0作统计学处理,分析hsa-miR-34a在肾癌组织与相匹配的正常组织的表达差异性.并结合临床数据进行分析.结果:hsa-miR-34a在肾细胞癌组织中表达显著上调(P＜0.05).hsa-miR-34a的表达与肾癌患者的病理核分级及临床分期呈显著正相关.结论:hsa-miR-34a的表达异常可能与肿瘤侵袭性有关,提示hsa-miR-34a可能可以作为肾癌的早期诊断的重要分子指标.     

Increased expression of human ribosomal phosphoprotein P0 messenger RNA in hepatocellular carcinoma and colon carcinoma.

To search for differentially expressed gene products in selected cancers of endodermal origin, cDNA libraries derived from mRNA in human hepatocellular carcinoma and adjacent grossly normal tissue were generated. From these parent libraries, subtracted cDNA libraries of tumor minus normal and normal minus tumor tissues were constructed. After screening these subtracted libraries by +/- hybridization, a cDNA clone that is overexpressed in hepatocellular carcinoma and encodes the human acidic ribosomal phosphoprotein P0 (P0) was identified. We then evaluated the expression of this phosphoprotein P0 in human colon carcinoma samples. Surgical specimens of primary tumors and liver metastases were examined by Northern hybridization of total RNA with one of 2 32P-labeled P0 probes. The mRNA level of the P0 was greater in primary colon carcinoma than in paired adjacent normal colonic epithelium in 36 of 38 cases; the mean tumor/normal ratio was 2.7 (range, up to 13). The tumor/normal ratio, when plotted against the Dukes' stage of disease, gave evidence for increasing P0 expression with increasing stage of colon carcinoma (P = 0.02). In all 8 cases of paired colon carcinoma metastatic to liver and 2 cases of paired primary hepatocellular carcinoma, the P0 mRNA level was greater in tumor than in adjacent normal liver tissue. The mean tumor/normal ratio was 4.0 (range, up to 11) for the colon cancers metastatic to liver and 4.2 for the primary hepatocellular carcinoma samples. These findings support a common increased expression of selected gene products in different tumors of endodermal origin and suggest that increased P0 expression, in line with certain other ribosomal proteins, may be associated with human colorectal cancer progression and biological aggressiveness.     

肾癌环状RNA表达谱和调控通路分析

目的 检测肾癌环状RNA(circRNA)表达谱并预测其调控通路.方法 对3例肾癌患者的肾癌组织及癌旁正常肾组织标本进行高通量测序,结合生物信息学的方法预测差异表达的circRNA在肾癌中的调控通路.结果 共鉴定出4661个circRNA,其中1963个为新发现的circRNA,89.89％(4190/4661)cir...     

Prognostic factors and molecular markers for renal cell carcinoma

Renal cell carcinoma is the most common cancer in the kidney, affecting nearly 30,000 Americans every year and is associated with over 12,000 deaths annually. If detected early, renal cell carcinomas can be cured surgically. However, once metastatic disease develops the prognosis for long-term survival is poor. Unfortunately, one-third of patients have metastatic disease at the time of diagnosis and approximately 50% of the patients undergoing surgical resection for less advanced disease eventually relapse. This review examines the clinical and molecular prognostic tools currently available or under investigation for kidney cancer.     

Prognostic factors and molecular markers for renal cell carcinoma

Renal cell carcinoma is the most common cancer in the kidney, affecting nearly 30,000 Americans every year and is associated with over 12,000 deaths annually. If detected early, renal cell carcinomas can be cured surgically. However, once metastatic disease develops the prognosis for long-term survival is poor. Unfortunately, one-third of patients have metastatic disease at the time of diagnosis and approximately 50% of the patients undergoing surgical resection for less advanced disease eventually relapse. This review examines the clinical and molecular prognostic tools currently available or under investigation for kidney cancer.     

小肾细胞癌的超声诊断

目的 分析小肾癌的超声声像图表现及特征,评价超声诊断的临床应用价值。方法收集我院1987年1月～2002年4月超声诊断并经手术病理证实的79例肾细胞癌患者的临床资料。结果 79例小肾癌(≤3 cm)瘤体内回声相对比较均匀,表现为混合性回声、或伴有钙化形成者较少。彩色多普勒检查显示瘤内血流信号分布差异较大,大部分血流信号丰富。结论 超声诊断可较全面评估小肾癌的部位、大小、病变性质,对周围组织的侵犯,有无静脉、淋巴结转移及远处转移灶。     

Alteration of frizzled expression in renal cell carcinoma.

To evaluate the involvement of frizzled receptors (Fzds) in oncogenesis, we investigated mRNA expression levels of several human Fzds in more than 30 different human tumor samples and their corresponding (matched) normal tissue samples, using real-time quantitative PCR. We observed that the mRNA level of Fzd5 was markedly increased in 8 of 11 renal carcinoma samples whilst Fzd8 mRNA was increased in 7 of 11 renal carcinoma samples. Western blot analysis of crude membrane fractions revealed that Fzd5 protein expression in the matched tumor/normal kidney samples correlated with the observed mRNA level. Wnt/beta-catenin signaling pathway activation was confirmed by the increased expression of a set of target genes. Using a kidney tumor tissue array, Fzd5 protein expression was investigated in a broader panel of kidney tumor samples. Fzd5 membrane staining was detected in 30% of clear cell carcinomas, and there was a strong correlation with nuclear cyclin D1 staining in the samples. Our data suggested that altered expression of certain members of the Fzd family, and their downstream targets, could provide alternative mechanisms leading to activation of the Wnt signaling pathway in renal carcinogenesis. Fzd family members may have a role as a biomarker.     

Differences in messenger RNA expression of carcinoembryonic antigen in surgical specimens of colorectal carcinoma.

Carcinoembryonic antigen (CEA) is the most widely used tumor marker for colorectal cancer. Plasma CEA levels have been variably associated with prognosis. Since plasma CEA level is multifactorial, CEA gene expression in tumors may provide one precise mechanism to evaluate its functional role. This study evaluated CEA expression at the messenger RNA (mRNA) level in 22 human colorectal carcinomas and their adjacent normal mucosae by Northern blot hybridization using a 32P-labeled CEA probe (a loop-domain specific cDNA, LV7). Both tumor and normal mucosa displayed three mRNA species of 4.0, 3.6, and 3.0 kb in length. The expression of 3.6-kb mRNA which encodes for CEA was dominant and it was correlated with another 4.0-kb CEA mRNA expression. The expression of 3.0-kb mRNA which encodes for nonspecific cross-reacting antigen was weak and not detectable in 8 of 22 colon tumors and 12 of 22 normal colon mucosae. In only one tumor, a 4.5-kb mRNA (which might encode for a new family member of CEA) was expressed. A two- to fourfold higher expression of CEA mRNA (3.6 kb) was observed in 11 of 22 colorectal tumors (2 of 9 proximal colon tumors and 9 of 14 rectosigmoid tumors) when compared with morphologically normal adjacent mucosae. Preoperative plasma CEA levels and Dukes' staging had no correlation with this CEA mRNA expression. CEA mRNA did not appear to correlate with metastasis because its expression in the primary colon cancers with metastases (Dukes' stage D tumor) was not always increased. These data also imply that factors other than mRNA expression in tumor might be important in regulating plasma CEA levels.