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Annals of Urologic Oncology最新文献

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Asian Medical Press Limited Crossmark Policy 亚洲医学出版社有限公司
Pub Date : 2018-11-20 DOI: 10.32948/ampl.crossmark.policy
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引用次数: 0
Renal cell carcinoma 肾细胞癌
Pub Date : 2018-11-15 DOI: 10.32948/AUO.2018.11.1
Peng Zhang, J. Ro
The global incidence of cases of kidney cancer has increased rapidly, and a relatively high incidence of kidney cancer has been reported in developed countries such as Northern and Eastern Europe. Various factors can affect the incidence and mortality of kidney cancer, including demographic risk factors, lifestyle factors, iatrogenic risk factors, nutritional factors and diet, occupation, and genetic factors. Renal cell carcinoma (RCC) refers to a tumor group with heterogeneity derived from renal tubular cells, which form almost all kidney cancer types. Clear cell RCC (ccRCC) is the most frequent renal tumor subtype, accounting for 75% of renal cancer, followed by papillar RCC(pRCC) making up approximately 10% of RCC. Hematoxylin-eosin staining shows a clear, eosinophilic cytoplasm in ccRCC cells. Epithelial cells forming the papillae and tubules have pRCC histological characteristics. Traditionally, genetic mutations of VHL and MET are the genetic features in ccRCC and pRCC, respectively. Recently, a new concept supports the contribution of mutations in some chromatin-modifier genes, including polybromo 1 (PBRM1), SET domain containing 2 (SETD2), BRCA1-associated protein-1 (BAP1), and lysine (K)-specific demethylase 5C (KDM5C). The metabolic disease concept in renal cancer is noted by researchers worldwide. The PD-1 pathway has been valued by researchers of kidney cancer in recent years, and new agents, such as anti-PD-1 monoclonal antibodies (nivolumab and pembrolizumab) and CTLA4 inhibitors (Ipilimumab), have been approved to treat advanced RCC. Partial nephrectomy (PN) and radical nephrectomy (RN) remain the standard management option for local RCC with a stage of T1 and T2, respectively. PN can also be selected for T2 stage RCC in suitable cases. Even though targeted therapy consisting of mainly the anti-VEGF and anti-mTOR pathways is recommended as the first-line and second-line treatment for RCC, the effectiveness and side effect of these therapies should be improved in future research.
全球肾癌病例的发病率迅速增加,在北欧和东欧等发达国家,肾癌的发病率相对较高。影响肾癌发病率和死亡率的因素多种多样,包括人口危险因素、生活方式因素、医源性危险因素、营养因素和饮食、职业、遗传因素等。肾细胞癌(Renal cell carcinoma, RCC)是指起源于肾小管细胞的具有异质性的肿瘤组,几乎构成了所有类型的肾癌。透明细胞RCC(ccRCC)是最常见的肾脏肿瘤亚型,占肾癌的75%,其次是乳头状RCC(pRCC),约占RCC的10%。苏木精-伊红染色显示ccRCC细胞内有清晰的嗜伊红细胞质。形成乳头和小管的上皮细胞具有pRCC的组织学特征。传统上,VHL和MET基因突变分别是ccRCC和pRCC的遗传特征。最近,一个新的概念支持一些染色质修饰基因突变的贡献,包括多溴化1 (PBRM1)、SET结构域2 (SETD2)、brca1相关蛋白-1 (BAP1)和赖氨酸(K)特异性去甲基化酶5C (KDM5C)。肾癌的代谢性疾病概念受到世界各国研究者的关注。近年来,PD-1通路受到肾癌研究人员的重视,抗PD-1单克隆抗体(nivolumab和pembrolizumab)和CTLA4抑制剂(Ipilimumab)等新药物已被批准用于治疗晚期RCC。部分肾切除术(PN)和根治性肾切除术(RN)仍然是T1期和T2期局部肾细胞癌的标准治疗选择。在合适的情况下,T2期RCC也可以选择PN。尽管目前推荐以抗vegf和抗mtor途径为主的靶向治疗作为RCC的一线和二线治疗,但在未来的研究中,这些治疗方法的有效性和副作用还有待进一步提高。
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引用次数: 0
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Annals of Urologic Oncology
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