Metastatic clear-cell renal carcinoma: an exceptional cause of ileocolonic intussusception in adults

Introduction: Intussusceptions in adults are rare, representing 1% to 5% of intestinal obstructions in this age group. This condition can be caused by benign and malignant lesions acting as lead points, the latter being the most frequent. Furthermore, the diagnosis is challenging due to the non-specific symptoms with variable duration. Case Presentation: A 43-year-old man, with a history of localized clear-cell renal carcinoma (ccRCC) treated 9 years earlier with a right radical nephrectomy, presented with bowel obstruction symptoms. An abdominal computed tomography scan showed an ileocolonic intussusception. Hence, the patient required a right hemicolectomy with ileotransverse anastomosis. The histopathological analysis showed a metastatic ccRC to the terminal ileum causing the intussusception. Discussion: Adult intussusceptions are rare. However, they should be considered in the differential diagnosis of patients with abdominal pain and symptoms of bowel obstruction. Metastases of renal cancer to the small bowel are uncommon and even more so in the form of intussusception. Definitive treatment must be tailored to the patient's condition and underlying cause. (AU)

Influence of SOX7 gene methylation on the proliferation, migration and invasion of renal cancer cells and its clinical value / 国际生物医学工程杂志

Objective:To study the clinical value of SRY-Box transcription factor 7 ( SOX7) gene methylation in renal cancer and its effect on the biological behavior of renal cancer cells. Methods:80 patients with renal cancer (the kidney cancer group) and 50 patients with benign renal disease (the control group) were selected as the research subjects. Synthetic oligonucleotide sequences (MON, UMON, and CON) were designed and transfected into A498 renal carcinoma cells. Methyl-specific PCR was used to detect the methylation status of the SOX7 gene in the tumor and adjacent tissue of the kidney cancer group as well as in the renal tissue of the control group. The relationship between SOX7 gene methylation and clinicopathological factors was analyzed. The migration and invasion of A498 renal cancer cells in the MON group, UMON group, and CON group were detected by the Transwell chamber. Results:The SOX7 gene methylation rate in tumor tissue of the kidney cancer group was significantly higher than that of the control group and the adjacent tissue, and the difference was statistically significant (χ 2 = 67.522, P < 0.05). The SOX7 gene is methylated in renal cancer cell lines such as Caki-1, 786-O, 769-P, while it is unmethylated in A498 renal cancer cells. There were no statistical differences in the SOX7 gene methylation rate in the tumor tissue of the renal cancer group in terms of gender, age, or pathological type (all P > 0.05). There were statistical differences in the degree of differentiation, maximum tumor diameter, lymph node metastasis, tumor number, and TNM staging in the renal cancer group in terms of tumor tissue SOX7 gene methylation rate (all P < 0.05). After transfection with MON, the SOX7 gene methylation of A498 renal cancer cells could be successfully induced, and the day-1 to day-7 cell viability, cell migration, and invasion numbers of A498 renal cancer cells in the MON group were significantly higher than those in the UMON group and the CON group ( P < 0.05). Conclusions:Hypermethylation of the SOX7 gene can promote the proliferation, migration, and invasion of renal cancer cells and has important clinical value in the evaluation of the disease and prognosis of renal cancer.

Prognostic differences between type Ⅰ and type Ⅱ renal papillary cell carcinoma / 现代泌尿外科杂志

【Objective】 To analyze the clinical characteristics and prognostic differences between type Ⅰ and type Ⅱ papillary renal cell carcinoma (PRCC), and identify the prognosis-related independent predictors. 【Methods】 A total of 143 PRCC patients treated during Jan.2012 and Dec.2019 were involved, including 91 type Ⅰ patients and 52 type Ⅱ patients. The prognostic factors were analyzed with univariate and multivariate Cox regression analysis. The differences in cancer-specific survival (CSS) between the two groups were analyzed with Kaplan-Meier method and log-rank test. 【Results】 The patients’ age was 53.41±13.50 years. After a mean follow-up of 63.27±26.20 months, 14 patients died, and the overall CSS was 90.2%. The prognosis of type Ⅰ patients was better than type Ⅱ patients (94.5% vs. 82.7%, P=0.020). Cox regression suggested that PRCC subtype and stage were significantly associated with prognosis. There was no difference in prognosis between type Ⅰ and type Ⅱ patients in T1/T2 subgroup (P>0.05). However, in T3/T4 subgroup, type Ⅰ patients had a significant better prognosis than type Ⅱ patients (P=0.023), while the above trends were not observed in G1/G2 and G3/G4 subgroups (P>0.05). 【Conclusion】 PRCC subtype and stage are independent prognostic predictors. The impact of PRCC subtype on prognosis is mainly manifested in the subgroup of patients with T3 or higher stage.

Management of vena cava tumor thrombus dislodgement in robot-assisted laparoscopic surgery / 现代泌尿外科杂志

Renal cancer complicated with inferior vena cava tumor thrombus has been difficult to manage in urological surgery, because it has a complex anatomical relationship and involves vascular blockage of vital organs such as kidney, liver and heart, as well as the blockage and reconstruction of inferior vena cava. In addition, tumor thrombus dislodgement may occur intraoperatively, leading to acute pulmonary embolism, which makes the surgery extremely difficult and risky. In this paper, we report the successful treatment of thrombus dislodgement in a case of right kidney tumor with inferior vena cava thrombus during robot-assisted laparoscopic surgery and explore the treatment methods, aiming to avoid lethal pulmonary embolism caused by tumor thrombus dislodgement.

Experiencia en Nefrectomía Parcial y Enucleación de Tumor Renal Laparoscópico "Zero Isquemia", en Cochabamba, Bolivia

Resumen El manejo quirúrgico de los tumores renales pequeños es la cirugía conservadora de nefronas, este tipo de manejo se reservaba para pacientes seleccionados, con riñón solitario, enfermedad renal crónica o tumores bilaterales. La evidencia sugiere que la nefrectomía parcial laparoscópica es equivalente en términos de resultados oncológicos y superior en las mediciones de calidad de vida comparada al abordaje abierto. Objetivos: determinar los resultados oncológicos en cuanto a bordes libres del tumor y complicaciones quirúrgicas en pacientes sometidos a nefrectomía parcial y enucleación de tumor renal laparoscópico "Zero isquemia". Metodología: estudio retrospectivo, observacional, y comparativo, universo pacientes de la Clínica privada Los Ángeles y de la Caja Nacional de Salud, Hospital Obrero Nº2, Cochabamba, Bolivia, que fueron sometidos a nefrectomía parcial laparoscópica, se agruparon en dos grupos: Grupo I: nefrectomía parcial y Grupo II: enucleación, se analizaron: tamaño y localización del tumor, RENAL score, tiempo quirúrgico, sangrado, días de estancia, complicaciones y reporte histopatológico. Se utilizó el SPSS versión 20 (IBM, Chicago, IL). Resultados: se evaluaron 17 pacientes, 3 fueron excluidos por terminar en cirugía radical, 6 parciales (Grupo I) y 8 enucleaciones (Grupo II). Edad promedio de 45,7 (± 8,6) vs 51,2 (± 6,3) años. Tamaño del tumor 7,8 (2,5-10) vs 3,2 (1-5,7) cm, El RENAL score en global de todos los pacientes fue de baja a moderada, se realizó un análisis por separado, en el grupo I, la distribución fue complejidad baja n=2 (33,3%), moderada n= 1 (16,7%) y alta n= 3 (50%), en el grupo II, baja complejidad n=5 (62,5%), moderada n=2 (25%), alta complejidad n= 1 (12,5%). Hubo diferencias a favor del grupo II (enucleación) en cuanto a tiempo quirúrgico y sangrado transoperatorio, presentando solo 1 caso con fuga urinaria, resuelta con colocación de catéter JJ, se evidencia iguales tiempos de estancia intrahospitalaria, en cuanto a los bordes quirúrgicos, se tuvo 2 (14,2%) casos con bordes positivos 1 para cada abordaje, los cuales se mantienen en vigilancia estrecha. Conclusiones: el abordaje laparoscópico es una opción equiparable al abierto, se obtuvieron iguales resultados en cuanto a control oncológico en relación a bordes libres y con menos complicaciones, aunque se requiere experiencia en cirugía laparoscópica y aumentar el seguimiento en tiempo y mayor número de casos.

Abstract Surgical management of small renal tumors involves nephron-sparing surgery, which used to be reserved for selected patients with a solitary kidney, chronic kidney disease or bilateral tumors. Evidence suggests that laparoscopic partial nephrectomy is equivalent to the open approach in terms of oncologic outcomes and superior in quality of life measures. Objectives: to determine oncologic outcomes regarding tumor free edges and surgical complications in patients undergoing laparoscopic "Zero ischemia" partial nephrectomy and enucleation of renal tumor. Methodology: retrospective, observational, and comparative study, with a universe of patients from Los Angeles private clinic and Caja Nacional de Salud, Hospital Obrero Nº2, Cochabamba, Bolivia, who underwent laparoscopic partial nephrectomy, were grouped in two groups: Group I: partial nephrectomy and Group II: enucleation. The following were analyzed: tumor size and location, RENAL score, surgical time, bleeding, days of stay, complications and histopathological report. SPSS version 20 (IBM, Chicago, IL) was used for statistical analysis. Results: seventeen patients were evaluated, 3 were excluded due to completion of radical surgery, 6 partial nephrectomies (Group I) and 8 enucleations (Group II). Mean age 45.7 (± 8.6) vs 51.2 (± 6.3) years. Tumor size 7.8 (2.5-10) vs 3.2 (1-5.7) cm, The overall RENAL score of all patients was low to moderate, a separate analysis was performed, in group I, the distribution was low complexity 2 (33.3%), moderate n=1 (16.7%) and high n=3 (50%), in group II, low complexity n=5 (62.5%), moderate n=2 (25%), high complexity n=1 (12.5%). There were differences in favor of group II (enucleation) in terms of surgical time and transoperative bleeding, presenting only 1 case with urinary leakage, resolved with placement of a JJ catheter. In terms of surgical edges, there were 2 (14.2%) cases with positive edges, 1 for each approach, which are kept under close surveillance. Conclusions: laparoscopic approach is an option comparable to the open one, equal results were obtained with respect to oncologic control in relation to free edges and with fewer complications, although experience in laparoscopic surgery is required, as well as an increase in follow-up time and a greater number of cases.

Crioablación percutánea de tumores renales cT1 como alternativa al tratamiento quirúrgico / Percutaneous cryoablation of cT1 kidney tumors as alternative to surgical treatment

Resumen El cáncer renal representa el 3 al 4% de todas las lesiones malignas y su detección incidental es cada vez más frecuente. Para los tumores renales cT1a la cirugía es el tratamiento de elección. No todos los pacientes son candidatos a este tipo de tratamiento por elevado riesgo quirúrgico debido a comorbi lidades asociadas o antecedentes de cirugía en dicho órgano. Las guías de la Asociación Americana de Urología recomiendan la termoablación como alternativa a la cirugía en tumores menores a 3 cm. La experiencia con crioablación percutánea en tumores renales es escasa en Latinoamérica y hay pocas publicaciones al respecto en esta región. El objetivo de este trabajo fue describir la efectividad y seguridad de la crioablación percutánea en una cohorte de pacientes adultos con cáncer renal cT1 (menores a 5 cm) como alternativa al tratamiento quirúrgico. Los procedimientos fueron realizados con guía de tomografía computarizada o con un angiógrafo, en condiciones estériles y bajo anestesia general. Los pacientes fueron tratados en condiciones ambulatorias. El seguimiento se realizó con estudios por imágenes, análisis de laboratorio y consulta clínica. Todos tuvieron una respuesta completa constatada por imágenes en los controles evolutivos. El 61% no tuvo complicaciones y en el resto se observaron complicaciones grado 1 como hematuria, retención urinaria y hematoma perirrenal. Se concluyó que la crioablación percutánea es segura y efectiva como alternativa a la cirugía en pacientes con tumores renales.

Abstract Renal cancer represents 3-4% of all malignancies. Its incidental detection is becoming more frequent. Surgery is the gold standard treatment for T1 renal cancer. Still, surgery is not suitable for every patient due to comorbidities or previous kidney surgery. Guidelines provided by The American Urological Association recommend thermoablation therapies as an alternative to surgery in tumors under 3 cm. Experience regarding percutaneous cryoablation in renal tumors is scarce in Latin America and there are only a handful of publications in this region regarding this subject. The objective of this study was to assess the effectiveness and security of percutaneous cryoablation in a cohort of adult patients with cT1 renal cancer (smaller than 5 cm) as an alternative to surgery. The procedures were performed with CT or Cone Beam CT guidance and under general anesthesia in sterile conditions. Cryoablation was carried out on an outpatient basis. Follow up was done with imaging studies, blood test and clinical consultation. All patients had complete response in imaging studies. There were no complications in 61% of all of them, the remaining patients suffered grade-1 complications such as hematuria, urinary reten tion and perirenal hematoma. In conclusion, percutaneous cryoablation for renal tumors is a safe and effective alternative to surgery.

Increased systemic IL-6 levels point to inflammation as a determinant of renal cell carcinoma development

Introduction: Renal cell carcinoma (RCC) is one of the most prevalent kidney tumors. Inflammation is believed to be a key factor in its progression and spread since inflammatory markers are generally associated with poor prognosis in RCC patients. Cytokines are cell communication molecules involved in both healthy and pathological processes, including tumor growth and progression. Recent findings suggest that cytokine level measurements could be used for cancer monitoring and prognosis. Methods: This study characterized and compared the levels of different cytokines associated with the classical Th1, Th2, and Th17 immune responses in plasma samples from RCC patients (n = 25) and healthy controls (n = 29). Cytokine levels (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, and IL-17A) were evaluated by flow cytometry using a BD Cytometric Bead Array (CBA) kit. Results: No statistical differences in systemic IL-2, IL-4, IL-10, IL-17A, TNF, and INF-γ levels were observed between RCC patients and controls (p > 0.05). However, higher systemic IL-6 levels were observed in RCC patients (p = 0.0034). Conclusions: This study highlights the importance of assessing the impact of IL-6 on RCC pathogenesis and its potential role as a biomarker of disease progression. (AU)

Hereditary leiomyomatosis and renal cell carcinoma syndrome-associated renal cell carcinoma: Morphological appraisal with a comprehensive review of differential diagnoses

Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is an autosomal dominant syndrome wherein affected individuals are at risk for the development of cutaneous leiomyomas, early-onset multiple uterine leiomyomas, and an aggressive subtype of renal cell cancer. HLRCC is caused by germline mutations in the fumarate hydratase (FH) gene, which inactivates the enzyme and alters the function of the tricarboxylic acid/Krebs cycle. This article reviews the hitherto described morphologic features of HLRCC-associated renal cell carcinoma (RCC) and outlines the differential diagnosis and ancillary use of immunohistochemistry and molecular diagnostics for these tumors. The morphologic spectrum of HLRCC-associated RCC is wide and histologic features, including tumor cells with prominent nucleoli, perinucleolar halos, and multiple architectural patterns within the same tumor, which are suggestive of this diagnosis. FH immunohistochemistry in conjunction with genetic counseling and germline FH testing are the important parameters for detection of this entity. These kidney tumors warrant prompt treatment as even smaller sized lesions can demonstrate aggressive behavior and systemic oncologic treatment in metastatic disease should, if possible, be part of a clinical trial. Screening procedures in HLRCC families should preferably be evaluated in large cohorts.

Metástasis bilateral de húmero, en paciente con cáncer renal, tratado con inmunoterapia y cirugía: reporte de un caso / Bilateral Humeral metastases, in a patient with renal cancer, treated with immunotherapy and surgery: case report

El carcinoma de células renales es el 7mo cáncer en frecuencia a nivel mundial con más de 300.000 casos nuevos al año y es la 3era malignidad genitourinaria más frecuente. El sitio más común de metástasis es el pulmón mientras que el esqueleto ocupa el segundo lugar con una frecuencia que varía entre un 20% a un 35%. Se ha reportado una sobrevida de 12 meses en promedio luego de la aparición de metástasis óseas. Reporte del caso de un paciente con diagnóstico de cáncer renal de células claras y metástasis óseas (en columna, pelvis y ambos húmeros), que evoluciona con fractura de ambos brazos. El paciente es aceptado en un ensayo clínico de tratamiento con inmunoterapia y además se somete a una reducción y osteosíntesis bilateral de húmero con clavo endomedular, logrando la consolidación de ambas fracturas y, por ende, la regresión de la enfermedad.

Renal cell carcinoma is ranked 7th in frequent cancer worldwide with more than 3000.000 new cases per year, as well as it's ranked 3rd in frequent genitourinary malignancy. The most common area of metastases is lung followed by skeleton in second place. The frequency of skeleton metastases varies from 20% to 35%. A survival average time of 12 months is generally observed after the appearance of bone metastases. This case report is about a patient diagnosed with clear cell renal cancer and bone metastases (in the spine, pelvis and both humerus) that evolves with fracture of both arms. The patient undergoes a clinical trial with immunotherapy and also a reduction and osteosynthesis of both arms with intramedullary nail, achieving consolidation of both fractures and regression of the disease.

Effect of small interfering RNA-mediated BIRC6 silencing on apoptosis and autophagy of renal cancer 786-O cells / 南方医科大学学报

OBJECTIVE@#To study the expression of BIRC6 in renal cancer tissues and investigate the effect of BIRC6 silencing on apoptosis and autophagy of 786-O cells.@*METHODS@#Twenty surgical specimens of renal cancer tissues and adjacent renal tissues were collected from Meizhou People's Hospital between February, 2016 and December, 2018 for detection of BIRC6 protein expression using immunohistochemistry. Renal cancer 786-O cells were transfected with a control small interfering RNA (siRNA) or BIRC6 siRNA @*RESULTS@#The expression of BIRC6 protein was significantly higher in renal cancer tissues than in the adjacent renal tissues. Western blotting showed that siRNA-mediated silencing of BIRC6 significantly lowered the expression of BIRC6 in 786-O cells. In the cells with BIRC6 silencing, treatment with 12.5, 25, 50, 100 and 200 μg/mL 5-FU resulted in significantly higher proliferation inhibition rates than in the cells transfected with the control siRNA (@*CONCLUSIONS@#Interference of BIRC6 mediated by siRNA can inhibit autophagy and promote 5-FU-induced apoptosis to enhance the sensitivity of 786-O cells to 5-FU.

Expression and biological function of human-derived RUNX1 gene in renal cancer / 医学研究生学报

ObjectiveIt remains an open question of whether the human-derived RUNX-related transcription factor 1 (RUNX1) influences the development of renal cell carcinoma. This study aims to investigate the expression and biological function of the RUNX1 gene in renal cell carcinoma.MethodsBioinformatics technique of gene chip was used to identify the expression of RUNX1 in renal cancer. The expression level of RUNX1 in renal cancer tissue was determined by real-time polymerase chain reaction (RT-PCR). Twenty samples of cancer tissue were collected from the Department of Urology, Affiliated Hospital of Nantong University between January 2015 and June 2019. Accordingly, the adjacent normal tissue of the tumor was as well collected. The 786-O cell line was transfected using small interfering RNA, and was subsequently divided into three groups by knocking down the RUNX1 gene: siRNA1 group (siRNA1 sequence transfected with si-RUNX1), siRNA2 group (siRNA2 sequence transfected with si-RUNX1), siRNA3 Group (siRNA3 sequence transfected with si-RUNX1), control group (control sequence empty vector siRNA transfection). Cell clone formation experiment was used to count the number of cell clone formation; MTT assay was used to detect 786-O cell proliferation activity; the Transwell tumor cell invasion experiment was used to analyze the amount of cell migration; Western blot was used to detect changes in protein levels.Results The expression of RUNX1 in renal tumor tissue was significantly higher than that in adjacent normal tissue. The expression of RUNX1 in renal tumor tissues was increased with the escalation of the malignant degree of the pathological stage. The prognosis of patients with high expression of RUNX1 was significantly poor than that of the patients with low expression of RUNX1. The results of cell colony formation assay and MTT assay showed that the cell viability and proliferation of si-RUNX1 groups were significantly inhibited compared to the control group (P<0.01 for both). Transwell assay showed that the number of 786-O cells passing through the membrane in the si-RUNX1 group (98.67±3.53/field) was significantly lower than that of the control group (143.3±8.74/field) (P<0.01).ConclusionThe expression of RUNX1 is correlated with the proliferation and migration ability of renal cancer cells. Knockdown of RUNX1 expression can significantly inhibit the proliferation and migration of renal cancer cells, suggesting that RUNX1 plays an important role in the proliferation and metastasis of melanoma. Hence, the RUNX1 gene can be used as a potential clinical diagnosis and treatment target and prognostic marker for renal cancer.

Expression changes of S100 family proteins and their functional significances in renal cancer / 中国药科大学学报

@#Renal cell carcinoma is a common type malignant tumor of the urinary system. The global incidence of renal cancer is 2. 2%. S100 proteins are involved in the regulations of proliferation, differentiation, apoptosis, and Ca2+ homeostasis, etc. S100 proteins are often closely associated with tumor progression. This review lists the expression changes of S100s and their functional significances in renal cancers, providing a new direction for the researches and treatments of renal cancer. The interpretation of S100 in the regulation of VHL/HIF signaling pathways should be a future direction.

Anticancer and Molecular Docking Studies of 1-(5-substituted phenyl) isoxazol-3-yl)-5-phenyl-1H-tetrazoles

Cancer a leading cause of human mortality worldwide is characterised by the unseemly growth of cellular mass and signalled through the enlargement of stress. Management of cancer treatment is still buried andhas been recently alerting the need to discover a drug molecule with lesser side effects. The objective of the present study is to explore the anticancer activity and docking studies of 1-(5-substituted phenyl) isoxazol-3-yl)-5-phenyl-1H-tetrazole derivatives. The compounds were evaluated for in-vitroanticancer activity under the drug discovery program of National Cancer Institute (NCI), USA. Only seven compounds were selected and screened for anticancer activity at a single high dose (10-5M) using NCI 60 cancer cell lines. Among all the selected compounds, 4band 4iexhibited significant anticancer activity against Leukemia cell lines. Molecular docking studies for the 5-phenyl-1-(5-substituted phenylisoxazol-3-yl)-1H-tetrazole analogues was done by Schrodinger software. Docking results stated that the compounds 4band 4ihas good dock score among the other derivatives which shows good binding efficiency towards receptor

Tumores renales pediátricos y su posible asociación con poblaciones endogámicas en el centro de Argentina / Pediatric renal tumors and their possible relation with endogamous populations in central Argentina

Introducción: Existen pocas investigaciones sobre factores de riesgo de tumores renales pediátricos. Objetivo: Caracterizar en detalle regiones geográficas de alta incidencia de tumores renales pediátricos en el centro de Argentina y su posible vinculación con factores de riesgo genéticos. Métodos: El área de estudio comprendió la provincia de Córdoba (Argentina). Se generó una base de datos de incidencia del cáncer renal infantil con información del Registro Provincial de Tumores. Se realizaron análisis de conglomerados espaciotemporales. En localidades dentro de los conglomerados, se llevaron a cabo entrevistas en profundidad a informantes claves. Resultados: Se registraron 56 casos de tumores renales pediátricos en el Registro en el periodo 2004-2013. Se detectó un conglomerado espacial significativo que abarca siete departamentos de la provincia. En esa región se concretaron seis entrevistas en profundidad a informantes claves. Los entrevistados resaltaron la mayor frecuencia de enfermedad genética de Sandhoff y las prácticas de endogamia (corroboradas en numerosos resultados científicos). A partir de estos datos se determinaron zonas de superposición de tumores renales y de la enfermedad de Sandhoff. Conclusiones: Se detectó una región particular de la provincia con alta frecuencia de tumores renales pediátricos y de la enfermedad de Sandhoff. Numerosos estudios científicos determinan que la endogamia es el factor de riesgo que aumenta la frecuencia de esta enfermedad en esta región. En futuras investigaciones se deberá corroborar si la endogamia también actúa aumentando la incidencia de tumores renales infantiles(AU)

Introduction: There is little research on risk factors of pediatric renal tumors. Objective: To characterize in detail the geographic regions of greatest incidence of pediatric renal tumors in central Argentina and exploring their possible link to genetic risk factors. Methods: The study area comprised the province of Córdoba (Argentina), and a database of pediatric renal tumors incidence was generated with information from the Provincial Tumor Registry. Analyses of spatio-temporal clusters were performed. In-depth interviews with key informants were carried out at localities within the conglomerates. Results: 56 cases of pediatric renal tumors were registered in the Provincial Registry of Tumors between 2004 and 2013. A significant spatial conglomerate was detected, covering seven districts of the province. In that region, six in-depth interviews were conducted with key informants. Interviewees highlighted the increased frequency of Sandhoff genetic disease and endogamous practices (corroborated in numerous scientific results). From these data, zones of overlap of renal tumors and of Sandhoff disease were determined. Conclusions: A particular region of the province was detected with high frequency of pediatric renal tumors and Sandhoff disease. Numerous scientific studies have determined that endogamy is the risk factor that increases the frequency of Sandhoff disease in this region. In future research, it should be confirmed whether it also acts by increasing the incidence of renal tumors in children(AU)

Metástasis inusuales en carcinoma de células renales / Unusual Metastases in Renal Cell Carcinoma

Introducción y Objetivos El carcinoma renal de células claras (CCR), es la neoplasia renal más frecuente. Hasta el 30% de los casos presentan enfermedad sistémica, siendo las más usuales: pulmón, ganglios, hígado y cerebro. El objetivo de este trabajo es informar casos poco frecuentes de metástasis por CCR y establecer posibles factores relacionados con las metástasis. Métodos y Materiales revisión retrospectiva de historias clínicas en el instituto nacional de cancerología de los pacientes con carcinoma de células renales metastásico entre los años 2013 a 2017. Se identificaron 6 casos con sitios de metástasis inusuales en pacientes del servicio de urología oncológica del instituto nacional de cancerología, destacando histopatología e inmunohistoquímica de los especímenes quirúrgicos tanto del primario como de la metástasis, reportando marcadores específicos y clasificaciones según corresponda. Resultados Caso 1 Metástasis a duodeno, Caso 2 metástasis a ovario, caso 3 metástasis a testículo, caso 4 metástasis a piel, caso 5 metástasis a glándula tiroides, caso 6 metástasis a mama y piel. Se evaluaron diferentes variables y se analizaron con base en la literatura. Conclusiones Consideramos que la edad, el tabaquismo, el grado histológico, la invasión de la vena renal, el tamaño tumoral y el estadio pueden ser factores predisponentes para ese comportamiento.

Introduction and Objectives Clear cell renal carcinoma (CRC) is the most frequent renal neoplasm. Up to 30% of cases present systemic disease, being the most common: lung, lymph, liver and brain. The objective of this work is to report rare cases of CRC metastasis and to establish possible factors related to metastasis. Methods and Materials Retrospective review of medical records in the national institute of cancerology of patients with metastatic renal cell carcinoma between the years 2013 to 2017. Six cases with sites of unusual metastases were identified in patients of the oncology urology service of the national institute of cancerology, highlighting histopathology and immunhistochemistry of the surgical specimens of both the primary and metastasis, reporting specific markers and classifications as appropriate. Results Case 1 Metastasis to duodenum, Case 2 metastasis to ovary, case 3 metastasis to testis, case 4 metastasis to skin, case 5 metastasis to thyroid gland, case 6 metastasis to breast and skin. Different variables were evaluated and analyzed based on the literature. Conclusions We consider that age, smoking, histological grade, invasion of the renal vein, tumor size and stage may be predisposing factors to this behavior.

Clinical, pathological features and prognosis of renal carcinoma: A single-center analysis of 4167 cases / 解放军医学杂志

Objective: To analyze the clinical characteristics, pathological features and prognosis of 4167 patients with renal carcinoma. Methods: The clinical data of 4167 patients with renal carcinoma were retrospectively studied who were admitted and received renal cancer surgery in the First Medical Center of Chinese PLA General Hospital from Jan. 2008 to Sep. 2016. All the cases were followed up for 40(2-99) months. The general data, pathological features, tumor-node-metastasis (TNM) stage, tumor diameter, surgical and postoperative clinical indicators, postoperative metastasis of renal carcinoma, and postoperative mortality and survival of patients were analyzed. Results: The male-female ratio of the 4167 cases was 72.2%(3010 cases) and 27.8%(1157 cases) (2.6:1), age of ill onset was 0.3-86(52.4 ± 12.4) years old, high incidence age was 45-65 years old. Case load diagnosed with and without symptom was 20.7% (863 cases) and 79.3% (3304 cases), respectively. In pathological diagnosis, 3670 cases of suprarenal epithelioma accounted for 88.1% in all cases. Minimally invasive surgery was 3821 cases (91.7%), nephron sparing surgery (NSS) was 1698 cases (40.7%), radical nephrectomy (RN) was 2466 cases (59.2%), open surgery was 346 cases (8.3%), transperitoneal approach rate was 16.9% (705 cases) and retroperitoneal approach rate was 83.1% (3462 cases). The overall survival rate at 1, 3 and 5 year post-operation was 98.1%, 94.8% and 92.0%, respectively. Cancer specific survival rate (1, 3, 5 year) was 98.6%, 96.2% and 94.6%, respectively. Tumor-free survival rate was 96.4%, 92.8% and 90.7%, respectively. Conclusions: The high incidence age of renal cancer is about 50 years old, the prevalence rate of men is 2.6 times higher than that of women. The main pathological type of renal cancer is suprarenal epithelioma. The rate of asymptomatic consultation rate has increased significantly. Minimally invasive surgery is the main treatment method for kidney cancer. The 5-year overall survival rate of renal cell carcinoma has exceeded 91%, and the long-term prognosis is better.

Inhibition of proliferation and invasion of renal cancer cells by miR-125a-5p targeting STAT3 and its possible mechanism / 中国肿瘤生物治疗杂志

@# Objective: To investigate the effects of miR-125a-5p targeting signal transducer and activator of transcription-3 (STAT3) on proliferation and invasion of renal cancer cells, and to preliminarily analyze the action mechanism. Methods: During the period from March 2017 to February 2018, 48 pairs of cancer tissues and corresponding normal adjacent tissues (more than 3 cm away from the tumor margin) resected from patients underwent renal cancer surgery at the Department of Urology, the Air Force Hospital of the Northern War Zone were collected for this study. Normal renal HK-2 cells and renal cancer cells (A498, GRC-1, 786-O and ACHN) were cultured in vitro. The expression of miR-125a-5p in above mentioned tissues and cells was detected by qPCR. miR-125a-5p-NC, miR-125a-5p-mimics, pLV-STAT3 and pLV-STAT3 with miR-125a-5p mimics were transfected intoA498 cells, namely NC group (negative control group), miR-125a-5p-mimics group, pLV-STAT3 group and pLV-STAT3+mimics group. The normally cultured A498 cells were used as blank control (Ctrl group). qPCR was performed to detect them RNA expressions of miR-125a-5p and STAT3 in cells of all groups. The bioinformatics prediction software and Dual luciferase assay were performed to analyze the targeting relationship between miR-125a-5p and STAT3. CCK-8, Flow cytometry, Transwell chamber assay were performed to detect cell proliferation activity, apoptosisand invasion, respectively. The expressions of STAT3, Bcl-2, BAX, cleaved cysteinyl aspartate specific proteinase 3 (cl-caspase-3), tumor suppressor gene p21, N-cadherin, E-cadherin, VEGF and HIF-1 in the cells were detected by WB. Results: The expression of miR-125a-5p in renal cancer tissues and cells was significantly lower than that in adjacent normal tissues and normal renal cells (all P<0.05). Compared with NC group, expression of miR-125a-5p in A498 cells transfected with miR-125a-5p-mimics was significantly increased, while expression of STAT3 mRNA was significantly decreased (all P<0.05). STAT3 was the target gene of miR-125a5p. Compared with NC group, cell viability, number of invasive cells, expressions of Bcl-2, N-cadherin, VEGF, HIF-1, and STAT3 as well as its phosphorylation level in miR-125a-5p mimics group were significantly decreased (all P<0.05), while cell apoptosis and expressions of BAX, p21, cl-caspase-3 and E-cadherin were significantly increased (all P<0.05); the cell viability, number of invasive cells, expressions of Bcl-2, N-cadherin, VEGF, HIF-1 and STAT3 as well as its phosphorylation level in pLV-STAT3 group were significantly increased (all P<0.05), while cell apoptosis and expressions of BAX, p21, cl-caspase-3 and E-cadherin were significantly decreased (all P<0.05). Compared with pLV-STAT3 group, cell viability, number of invasive cells, expressions of Bcl-2, N-cadherin, VEGF, HIF-1, and STAT3 as well asits phosphorylation level were significantly decreased in pLV-STAT3 mimics group (all P<0.05), while cell apoptosis, expressions of BAX, p21, cl-caspase-3 and E-cadherin were significantly increased (all P<0.05). Conclusion: miR125a-5p shows low expression in renal cancer tissues and cells, which can inhibit proliferation and invasion of A498 cells and promote cell apoptosis by down-regulating its target gene STAT3.

Anti-tumor activity and mechanisms of isorhamnetin in combination with sorafenib for renal cancer / 药学学报

This study aimed to explore the anti-tumor activity and mechanisms of action of isorhamnetin, a compound isolated from Astragalus membranaceus, in combination with sorafenib for treatment of renal cell carcinoma (RCC). The anti-tumor activity of isorhamnetin in combination with sorafenib was detected by MTT assay with cells in culture or Renca xenograft model in mice. Western blot was used to study the mechanisms of isorhamnetin in combination with sorafenib. Lymphocyte proliferation assay was also used to investigate the effects of the two drugs in combination. The results indicated that isorhamnetin inhibited the proliferation of RCC cells, with IC50 for A498, 786-O and Renca cell lines with being 31.7, 28.8 and 106.0 μmol·L-1, respectively. Isorhamnetin in combination with sorafenib improved the anti-lymphocyte proliferation activity of sorafenib with the IC50 down to 12.0 μmol·L-1. Isorhamnetin inhibited the growth of RCC in mice slightly with the inhibition efficiency at 26.9%. With 50.0 mg·kg-1 isorhamnetin in combination with 20.0 mg·kg-1 sorafenib, the anti-tumor activity of sorafenib was enhanced, with inhibition of growth rate increased to 60.7%. Meanwhile, isorhamnetin in combination with sorafenib could promote the lymphocytes proliferation in Renca xenograft model. Western blot results showed that combination of isorhamnetin and sorafenib could inhibit c-Raf/MEK/ERK and AKT/mTOR signaling pathways. In conclusion, the combination of isorhamnetin with sorafenib could increase the anti-tumor activity of sorafenib in RCC in vitro and in vivo. The mechanisms may be related to the inhibition of c-Raf/MEK/ERK and AKT/mTOR signaling pathways. Procedures for animal study were performed with approval of the Animal Care and Use Committee of the Chinese Academy of Medical Sciences and Peking Union Medical College.

Relationship between occupational sunlight exposure and the incidence of renal cancer

BACKGROUND: The risk factors for renal cancer include smoking, obesity, hypertension, and exposure to trichloroethylene. Recent studies have shown that low sunlight exposure increases the risk of developing a range of cancers, including renal cancer. Given that most of the daytime is spent at work, a lack of occupational sunlight exposure can be a risk factor for renal cancer. Therefore, this study examined the relationship between occupational sunlight exposure and the incidence of renal cancer. METHODS: This was a university hospital-based case-control study on renal cancer. Of the 706 newly diagnosed patients with renal cell carcinoma (RCC), 633 cases were selected; 73 who had no occupational history were excluded. In addition, 633 controls were selected from the general population after 1:1 matching with respect to sex, age (within 5 years), and residential area (constituency-level). Information on sunlight exposure by the occupational group was referred to data from France. To estimate the association between occupational sunlight exposure and the RCC risk, the odds ratios (ORs) were calculated using conditional logistic regression analysis. RESULTS: Sunlight exposure was divided into quartiles and the risk of RCC was analyzed. The adjusted OR of RCC (OR: 0.664, 95% confidence interval: 0.449–0.983) was significantly lower for the Q4 group than Q1 group but the Q2 and Q3 groups did not show significant results. The risk of RCC tended to decrease with increasing exposure to sunlight (p for trend < 0.028). CONCLUSIONS: Higher occupational sunlight exposure reduces the risk of RCC.

Modelo de simulación inanimado para experiencia física de entrenamiento (S. I. M. P. L. E.) En nefrectomia parcial asistida por robot usando tecnología de impresión 3d / Inanimate simulation model for physical training experience (S. I. M. P. L. E.) in robot-assisted partial nephrectomy using 3D printing technology

INTRODUCCIÓN: Pese a que la exposición a pacientes reales sigue estando a la vanguardia de la educación médica, la implementación de simuladores en el entrenamiento y docencia está en uso creciente a nivel global. Muchos de ellos, sin embargo, no entregan una experiencia quirúrgica completa. En este video presentamos un modelo de simulación inanimado de alta fidelidad y bajo costo para el entrenamiento en Nefrectomía parcial asistida por Robot (RAPN). MATERIAL Y MÉTODOS: Utilizando tecnología de impresión 3D se crearon modelos anatómicamente correctos del riñón humano y estructuras relevantes. Estos se consiguieron a través de polimerización gradual de un hidrogel, mediante ciclos de congelación/descongelación, dando distintas características de consistencia y apariencia a los órganos y estructuras, similares a las esperadas durante la cirugía en vivo. Se simularon todas las etapas de RAPN. 3 expertos con >250 casos robóticos fueron asignados al grupo 1; 3 novatos con <50 casos fueron asignados al grupo 2; y 3 estudiantes de medicina que completaron un programa básico de simulación robótica fueron asignados al grupo 3. Se midió validez por expertos, de contenido y de constructo, mediante encuestas y la comparación de las métricas de procedimiento (tiempo de isquemia, la pérdida de sangre, márgenes positivos y la pérdida de sangre estimada) entre los tres grupos. RESULTADOS: El modelo mostró una excelente validación de expertos y de contenido con una puntuación media de 3/5 y 4/5, respectivamente. El tiempo de isquemia medio fue de <15 minutos, entre 20 a 30 minutos y >40 minutos en los grupos 1, 2 y 3, respectivamente. Hubo diferencia estadísticamente significativa en el tiempo operatorio, tiempo de isquemia, márgenes quirúrgicos positivos y la pérdida de sangre estimada (p <0,01), obteniendo una buena validez de constructo. CONCLUSIONES: Este modelo proporciona un modelo realista, de bajo costo y alta fidelidad que ofrece un entrenamiento exhaustivo para RAPN. Esta forma de simulación puede ser una herramienta de enseñanza quirúrgica útil, permitiendo la evaluación objetiva del aprendiz, y entregando a los alumnos una exposición adecuada a un entorno real simulado, para así dominar las habilidades necesarias antes de una experiencia quirúrgica en vivo.(AU)

INTRODUCTION: Although exposure to real patients continues to be at the forefront of medical education, the implementation of simulators in training and teaching is in increasing use, globally. Many of them, however, do not deliver a complete surgical experience. In this video, we present an inanimate simulation model of high fidelity and low cost for training in Robotic-assisted partial nephrectomy (RAPN). MATERIAL AND METHODS: Using 3D printing technology, anatomically correct models of the human kidney and relevant structures were created. These were achieved through the gradual polymerization of a hydrogel, by means of freezing / thawing cycles, giving different characteristics of consistency and appearance to organs and structures, similar to those expected during real surgery. All RAPN stages were simulated. Three experts with> 250 robotic cases were assigned to group 1; three beginners with <50 cases were assigned to group 2; and three medical students who had completed a basic robotic simulation program were assigned to group 3. Validity was measured by experts, content and construct, by means of surveys and comparison of the procedure metrics (ischemia time, blood loss, positive margins and estimated blood loss) among the three groups. RESULTS: The model showed excellent expert and content validation with an average score of 3/5 and 4/5 respectively. The mean ischemia time was <15 minutes, between 20 to 30 minutes and > 40 minutes in groups 1, 2 and 3, respectively. There was statistically significant difference in surgery time, ischemia time, positive surgical margins and estimated blood loss (p <0.01), obtaining good construct validity. CONCLUSIONS: This model provides a realistic, low cost and high fidelity model that offers comprehensive training for RAPN. This type of simulation can be a useful surgical teaching tool, allowing objective evaluation of the apprentice, and giving the students an adequate exposure to a simulated real environment, in order to master the necessary skills before a live surgical experience.(AU)