RESUMO
The aim of the study was to assess the capabilities of mRNA genes encoding CD16a (FCGR3A) and CD16b (FCGR3B) in tumor samples from patients with renal cancer, and characterize the tumor process in relation to clinical and morphological factors. Materials and Methods: We used 125 tumor samples from patients with a histologically confirmed diagnosis of renal cancer T1-4N0-1M0-1. A method described by Chomczynski and Sacchi was used to isolate nucleic acids. The mRNA levels were determined using a reverse transcription polymerase chain reaction and calculated according to ΔΔCt formula, taking into account the reaction efficiency. Results: mRNA of the FCGR3A gene was detected in all tumor tissue samples under study; in contrast, mRNA of the FCGR3B gene was found only in 92.0% (115/125) of cases. In tumors classified as pT1, the mRNA content of the FCGR3A gene was significantly lower than that in tumor samples of pT3 size. There was the significant increase in the mRNA content of both genes with an increase in tumor grade, as well as in the cases with distant metastases. The presence of a tumor thrombus in the inferior vena cava system was accompanied by a significant increase in the mRNA content of the FCGR3A gene. Conclusion: In tumor tissue samples from patients with clear cell renal cancer, the predominant production of the FCGR3A mRNA was observed in comparison with the FCGR3B mRNA. The revealed relationship of an increased amount of the FCGR3A mRNA and, in some cases, the FCGR3B mRNA with a number of clinical and morphological factors enables to consider the mRNA level of the genes as new monitoring biomarkers.
Assuntos
Carcinoma de Células Renais , Predisposição Genética para Doença , Humanos , Projetos Piloto , Carcinoma de Células Renais/genética , Receptores de IgG/genética , Proteínas Ligadas por GPI/genéticaRESUMO
The aim of the study was to assess the possibility of using plasma levels of tumor M2-pyruvate kinase (Tu M2-PK), matrix carbonic anhydrase IX (CA9), and matrix metalloproteinase 9 (MMP9) in patients with renal cell cancer as predictors of the disease course and the response to treatment. MATERIALS AND METHODS: Samples of blood plasma or serum of 46 patients with clear cell renal cancer T1-4N0-1M0-1 obtained before surgery and 8-9 days after surgery were tested. The control group consisted of 20 practically healthy individuals, comparable in age with the examined patients. Quantitative determination of Tu M2-PK in EDTA-added blood plasma was performed by enzyme-linked immunosorbent assay using a ScheBo Tumor M2-PK test (Germany). Determination of CA9 by ELISA was performed using a Human Carbonic Anhydrase IX Quantikine ELISA Kit (USA) and MMP9 - using a Quantikine ELISA Kit (USA). RESULTS: In patients with renal cell carcinoma, a statistically significant increase in the level of Tu M2-PK, CA9 and a statistically significant decrease in MMP9 in comparison with the control group were found. The level of Tu M2-PK in patients with localized kidney cancer was significantly lower than in patients with disseminated cancer. An increase in size of the primary tumor and a decrease in the degree of its differentiation correlated with an increase in Tu M2-PK, and decrease in CA9 and MMP9 in the blood serum. Performing surgery equivalent to nephrectomy did not change the Tu M2-PK levels in the early postoperative period, but caused a decrease in the levels of CA9 and MMP9. CONCLUSION: The results indicate a potential significance of Tu M2-PK, CA9, and MMP9 as biological markers for predicting the disease course in patients with renal cell carcinoma.
RESUMO
Results of treatment of 32 patients after nephrectomy with thrombectomy for renal cell carci-noma complicated by tumor thrombosis of the inferior vena cava were analyzed. The study in-cluded patients only with II - IV clot levels: 26 patients with T3b - the length of the thrombus 5.1 +/- 1.75 cm, 6 patients with T3c - the length of a thrombus - 14.8 +/- 0.98 cm. One patient (3.1%) died due to pulmonary artery thromboembolia in immediate postoperative period. 1-2 degrees Clavier Complications were observed in 11 patients, 3-4 degree - in two (6.2%) patients. 90.4% of patients had metastases in distant organs and (or) in the regional lymph nodes, which nega-tively affected the survival rates of patients - 5-year survival rate was 36%. The presence of lymphogenous metastases, MSKCC criteria were factors affecting survival rate. Survival rates of patients with T3b and T3C levels were not statistically different. The results of postoperative systemic targeted therapy were significantly statistically better than the results of immunotherapy.