Chinese quality control indices for standardized diagnosis and treatment of renal cancer(2022 edition)

Renal cancer is one of the most common malignancies of the urinary system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of renal cancer is challenging due to the great differences in the diagnosis and treatment of renal cancer in different regions.The Renal Cancer Expert Committee of the National Cancer Quality Control Center(NCQCC)identified a lack of authoritative quality control standards as an opportunity to utilize its multidisciplinary membership to improve the standardized diagnosis and treatment of renal cancer.The Renal Cancer Expert Committee of the NCQCC aims to promote quality control and national standardization,uniformity,and normalization of renal cancer diagnosis and treatment,which ultimately improved the survival rate and quality of life of renal cancer patients.A panel of experts with renal cancer surgery,renal cancer medicine,medical imaging,pathology and radiotherapy were drawn together and determined the quality control standards for the standardized diagnosis and treatment of renal cancer.The Indices includes 20 items that cover all key areas in the diagnosis and treatment of renal cancer,such as standard diagnosis,surgery treatment,systemic treatment,and prognostic evaluation.

Influence of Osteopontin Short Hairpin RNA on the Proliferation and Invasion of Human Renal Cancer Cells

The influence of short hairpin RNA(shRNA)-mediated osteopontin(OPN)gene silencing on the proliferation and invasion of human renal cancer ACHN cells was investigated.Four types of OPN shRNA recombinant plasmids were constructed and RT-PCR assays were used to screen the most highly functional shRNA recombinant plasmids,which were transferred into the cultured ACHN cells by LipofectamineTM 2000.The cells transfected by shRNA expression vectors(ACHN/OPN)were visualized under an inverted microscope and screened...

Application of Circulating Tumor Cells in Peripheral Blood in Judging the Prognosis of Patients with Renal Cancer and Related Indexes of Blood Coagulation

Objective: To investigate the value of the number of circulating tumor cells (CTC) in peripheral blood in the prognosis and coagulation-related indicators of patients with renal cancer. Methods: 65 patients with renal cell carcinoma (RCC) confirmed pathologically were divided into CTC positive group and CTC negative group according to the CTC count (5 pcs/3.5 ml). Compare the age, gender, tumor location, TNM (clinical stage), pathological grade, tissue type, lymph node metastasis, distant metastasis, prognosis and prothrombin time (PT), fibrinogen (FIB), partial coagulation of the two groups of patients The correlation between the results of zymogen time (APTT) and D-dimer (DD) and the number of CTC. Results: There were significant differences in TNM, lymph node metastasis, and distant metastasis between the two groups (P < 0.05). The number of CTC in patients was correlated with FIB and D-D levels (P < 0.05). Conclusion: The number of CTC in patients with renal cell carcinoma is correlated with some clinical phenotypes (TNM, lymph node metastasis, distant metastasis) and some coagulation indexes (FIB, D-D), and can jointly predict the prognosis of renal cancer.

Feasibility of similarity coefficient map for improving morphological evaluation of T_2* weighted MRI for renal cancer

The purpose of this paper is to investigate the feasibility of using a similarity coefficient map（SCM） in improving the morphological evaluation of T2＊ weighted（T2＊W） magnatic resonance imaging（MRI） for renal cancer.Simulation studies and in vivo 12-echo T2＊W experiments for renal cancers were performed for this purpose.The results of the first simulation study suggest that an SCM can reveal small structures which are hard to distinguish from the background tissue in T2＊W images and the corresponding T2＊ map.The capability of improving the morphological evaluation is likely due to the improvement in the signal-to-noise ratio（SNR） and the carrier-to-noise ratio（CNR） by using the SCM technique.Compared with T2＊ W images,an SCM can improve the SNR by a factor ranging from 1.87 to 2.47.Compared with T2＊ maps,an SCM can improve the SNR by a factor ranging from 3.85 to 33.31.Compared with T2＊W images,an SCM can improve the CNR by a factor ranging from 2.09 to 2.43.Compared with T2＊ maps,an SCM can improve the CNR by a factor ranging from 1.94 to 8.14.For a given noise level,the improvements of the SNR and the CNR depend mainly on the original SNRs and CNRs in T2＊W images,respectively.In vivo experiments confirmed the results of the first simulation study.The results of the second simulation study suggest that more echoes are used to generate the SCM,and higher SNRs and CNRs can be achieved in SCMs.In conclusion,an SCM can provide improved morphological evaluation of T2＊W MR images for renal cancer by unveiling fine structures which are ambiguous or invisible in the corresponding T2＊W MR images and T2＊ maps.Furthermore,in practical applications,for a fixed total sampling time,one should increase the number of echoes as much as possible to achieve SCMs with better SNRs and CNRs.

Computational docking and in vitro analysis identifies novel arylidene analogue FPMXY-14 against renal cancer cells by attenuating Akt

Targeted therapies are gaining global attention to tackle Renal Cancer(RC).This study aims to screen FPMXY-14(novel arylidene analogue)for Akt inhibition by computational and in vitro methods.FPMXY-14 was subjected to proton NMR analysis and Mass spectrum analysis.Vero,HEK-293,Caki-1,and A498 cell lines were used.Akt enzyme inhibition was studied with the fluorescent-based kit assay.Modeller 9.19,Schrodinger 2018-1,LigPrep module,and Glide docking were used in computational analysis.The nuclear status was assessed by PI/Hoechst-333258 staining,cell cycle,and apoptosis assays were performed using flow cytometry.Scratch wound and migrations assays were performed.Western blotting was applied to study key signalling proteins.FPMXY-14 selectively inhibited kidney cancer cell proliferation with GI50 values of 77.5 nM and 101.40 nM in Caki-1 cells and A-498 cells,respectively.The compound dose-dependently inhibited Akt enzyme with an IC50 value of 148.5 nM and bound efficiently at the allosteric pocking of the Akt when computationally analyzed.FPMXY-14 caused nuclear condensation/fragmentation,increased the sub G_(0)/G_(1),G_(2)M populations,and induced early,late phase apoptosis in both cells when compared to controls.Treatment of the compound inhibited wound healing and migration of tumor cells,while proteins like Bcl-2,Bax,and caspase 3 were also altered.FPMXY-14 effectively inhibited the phosphorylation of Akt in these cancer cells,while total Akt was unaltered.FPMXY-14 exhibited anti-proliferative and anti-metastatic activities in kidney cancer cells by attenuating the Akt enzyme.Further pre-clinical research on animals with a detailed pathway elucidation is recommended.

Group Decision-Making Model of Renal Cancer Surgery Options Using Entropy Fuzzy Element Aczel-Alsina Weighted Aggregation Operators under the Environment of Fuzzy Multi-Sets

Since existing selection methods of surgical treatment schemes of renal cancer patients mainly depend on physicians’clinical experience and judgments,the surgical treatment options of renal cancer patients lack their scientifical and reasonable information expression and group decision-making model for renal cancer patients.Fuzzy multi-sets(FMSs)have a number of properties,which make them suitable for expressing the uncertain information of medical diagnoses and treatments in group decision-making(GDM)problems.To choose the most appropriate surgical treatment scheme for a patient with localized renal cell carcinoma(RCC)(T1 stage kidney tumor),this article needs to develop an effective GDM model based on the fuzzy multivalued evaluation information of the renal cancer patients.First,we propose a conversionmethod of transforming FMSs into entropy fuzzy sets(EFSs)based on the mean and Shannon entropy of a fuzzy sequence in FMS to reasonably simplify the information expression and operations of FMSs and define the score function of an entropy fuzzy element(EFE)for ranking EFEs.Second,we present the Aczel-Alsina t-norm and t-conorm operations of EFEs and the EFE Aczel-Alsina weighted arithmetic averaging(EFEAAWAA)and EFE Aczel-Alsina weighted geometric averaging(EFEAAWGA)operators.Third,we develop a multicriteria GDM model of renal cancer surgery options in the setting of FMSs.Finally,the proposed GDM model is applied to two clinical cases of renal cancer patients to choose the best surgical treatment scheme for a renal cancer patient in the setting of FMSs.The selected results of two clinical cases verify the efficiency and rationality of the proposed GDM model in the setting of FMSs.

RESPONSE OF HUMAN RENAL CANCER TO UFT IN NUDE MICE

A primary human renal cell carcinoma was developed as a xenograft (NT-25) and maintained by serial transplantation in nude mice. The effect of UFT on this neogrowth was tested and evaluated as well its distribution in the animal tissues. The concentration of UFT was higher in tumor tissues than that in other tissues and in the animal experimentation UFT was found to be effective on human renal cell carcinoma.

Partial Nephrectomy Allowed By Anti CD_(20) Antibody Treatment for Renal Cancer Associated with Acquired Haemophilia A

The case of a forty-five year old woman is presented who consulted for spontaneous haematomas of the thighs. The diagnosis of acquired haemophilia A associated to renal cancer was retained. She received anti CD20 monoclonal antibody treatment allowing her to undergo partial nephrectomy 4 months later without major complication. One year after surgery there is no sign of tumour recurrence.

Application of Dual-Energy CT Non-Linear Fusion Technology in Improving CTA Image Quality of Renal Cancer

Objective: To explore the significance of dual-energy CT non-linear fusion technique in improving the quality of CTA image of renal cancer. Methods: The CTA images of 100 patients who had been confirmed by pathology as renal cancer were collected and were randomly divided into experimental group and control group with 50 cases respectively. The two groups of patients were treated with iodine concentration of 300 mg/ml and 350 mg/ml non-ionic contrast agent, with a dosage of 1.5 ml/kg and an injection rate of 4 ml/s. The contrast agent intelligently tracking method was adopted bolus. The control group used the conventional CTA scanning, with a reference tube voltage/tube current of 100 kv/ref150 mas. The experimental group adopted the double energy scanning, with ball tube A and ball tube B. The reference tube voltage/tube current was 100 kv/ref250 mas and sn150 kv/ref125 mas respectively. The images of the experimental group were non-linear fused to obtain the Mono+ 55 kev single-energy images. The CT value, SNR contrast ratio of the abdominal aorta, renal artery and tumor tissue of the experimental group images and the 100 KV images and the Mono+ 55 kev images of the control group were compared. The objective evaluation and subjective evaluation of the image quality of the three groups of images was performed. Results: The results showed that the 100 kV images of the experimental group were statistically different from those of the control group (P05) in CT value, SNR and CNR (P 0.05). And there was no statistically significant difference between the non-linear fusion single-energy Mono+ 55 kev images and the control group images in CT value, SNR and CNR (P > 0.05). The subjective evaluation of image quality showed that there was no significant difference between Mono+ 55 kev images and control group images, and the quality of Mono+ 55 kev images was higher than that of experimental group 100 kV images. Conclusion: The dual-energy CT non-linear fusion technique can improve the quality of CTA image in patients with renal cancer, and it is possible to obtain high quality CTA images with low iodine concentration contrast agent.

A p53/CPEB2 negative feedback loop regulates renal cancer cell proliferation and migration

The tumor suppressor p53 transactivates the expression of multiple genes to exert its multifaceted functions and ultimately maintains genome stability.Thus,cancer cells develop various mechanisms to diminish p53 expression and bypass the cell cycle checkpoint.In this study,we identified the gene encoding RNAbinding protein cytoplasmic polyadenylation element-binding protein 2(CPEB2)as a p53 target.In turn,CPEB2 decreases p53 messenger RNA stability and translation to fine-tune p53 level.Specifically,we showed that CPEB2 binds the cytoplasmic polyadenylation elements in the p5330-untranslated region,and the RNA recognition motif and zinc finger(ZF)domains of CPEB2 are required for this binding.Furthermore,we found that CPEB2 was upregulated in renal cancer tissues and promotes the renal cancer cell proliferation and migration.The oncogenic effect of CPEB2 is partially dependent on negative feedback regulation of p53.Overall,we identify a novel regulatory feedback loop between p53 and CPEB2 and demonstrate that CPEB2 promotes tumor progression by inactivating p53,suggesting that CPEB2 is a potential therapeutic target in human renal cancer.

One-Pot Solvothermal Synthesis of TiO2 Nanobelt/Graphene Composites for Selective Renal Cancer Cells Destruction

Little attention has been paid to synthesis and application of TiO2 nanobelt/graphene composites （TiO2/GR）. In this work, a facile one-pot solvothermal approach to synthesize TiO2/GR was developed. In such processes, the reduction of graphene oxide （GO） nanosheets was accompanied by generation of TiO2/GR in one-step. In vitro experiments revealed that the renal cancer （RENCA） cell viability decreased sharply to 4.72% in the presence of the resulting composites in the near infrared light （NIR） window.

miR-206 Inhibits Renal Cell Cancer Growth by Targeting GAK

Renal cell cancer(RCC)remains one of the most lethal types of cancer in adults.Micro RNAs(mi RNAs)play key roles in the pathogenesis of RCC.The role of mi R-206 in RCC has not been fully understood.The purpose of this study was to examine the role of mi R-206 in the regulation of proliferation and metastasis of RCC and the possible mechanism.mi R-206 expression was detected by reverse transcription?quantitative polymerase chain reaction(RT-q PCR)in RCC cell lines(786-O and OS-RC-2 cells)and clinical samples.MTS[3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium]method,colony formation and transwell assay were used to detect the tumor-suppressing ability of mi R-206 in RCC.Luciferase assay was performed to verify the precise target of mi R-206.The results showed that the expression of mi R-206 was significantly down-regulated in RCC tissues and cells.The expression level of cyclin G-associated kinase(GAK),a master regulator of tumor proliferation and metastasis,was up-regulated with the decrease in mi R-206 in RCC tissues as well as RCC cell lines.In addition,the mi R-206 inhibitor promoted the proliferation,migration and invasion of 786-O and OS-RC-2 cells.Bioinformatics combined with luciferase and Western blot assays revealed that mi R-206 inhibited the expression of GAK.Moreover,mi R-206 regulates RCC cell growth partly through targeting GAK.Our study indicated that mi R-206 functions as a tumor suppressor in regulating the proliferation,migration and invasion of RCC by directly targeting GAK,and it holds promises as a potential therapeutic target for RCC.

Tet methylcytosine dioxygenase 2 suppresses renal cell cancer proliferation and metastasis by regulating the miR-200c-SCD axis

Tet methylcytosine dioxygenase 2(TET2)acts as an antioncogene that is investigated in different cancers.But the effects of TET2 in renal cell cancer(RCC)is still known little.Here,quantitative real-time PCR(qRT-PCR),Western blot,and immunofluorescence were performed to exam gene and protein expression.Cell proliferation was measured using Cell Counting Kit-8(CCK-8).Transwell assay was performed to detect cell metastasis viability.Flow cytometry was performed to analyze the cell cycle and cell apoptosis.The effects of TET2 on RCC growth in vivo was analyzed using a mouse xenograft model.We found that TET2 and miR-200c were decreased in RCC tissues,and hypermethylation of miR-200c promoter was found.Overexpression of TET2 promoted miR-200c expression by reducing miR-200c promoter methylation.Additionally,overexpression of TET2 or miR-200c suppressed cell growth and metastasis.Also,knockdown of miR-200c could moderate TET2 mediated cell growth inhibition.Furthermore,we found miR-200c directly regulates Stearoyl-CoA desaturase(SCD)gene expression.Moreover,in vivo experiment results confirmed that TET2 inhibited tumor growth.In conclusion,TET2 acts as an antioncogene in RCC by regulating the miR-200c-SCD axis and providing a potential target for RCC diagnosis and treatment.

Serial Pancreas,Liver and Duodenal Metastasis from Renal Clear Cell Cancer:a Case Report

Case ReportIn August 2004, a 76-year-old patient was referred to our hospital for progressive loss of appetite, accompanied with mild upper abdominal distention, pain, hiccups and dyspepsia over a recent 3 months period. Reviewing his disease history showed that 16 months before admission （April 2003）, he was diagnosed with a recurring left renal clear cell cancer （immunohistochemical staining of tumor cells were positive for CK and Vim, but negative for SMA, HMB-45 and HHF-35, Fig. 1） 10 years after a nephrectomy due to a right renal cancer. At that time, he was treated with photodynamic therapy followed by bio-immunotherapy（interleukine-2 plus lymphokine-activated killer cells）. Follow-up by an abdominal CT scan every 3 months showed significant regression of the left renal carcinoma.

Recurrent renal cell cancer presenting as gastrointestinal bleed

We present an unusual case of renal cell cancer(RCC) which relapsed with duodenal metastasis and unveiled itself by gastrointestinal(GI) bleeding.An 80-year old Caucasian gentleman with history of renal cell cancer status post nephrectomy 11 mo previously,presented with syncope and melena.Computed tomography scan of the abdomen revealed heterogeneous soft tissue mass in the right nephrectomy bed invading the duodenum.Upper GI endoscopic biopsy confirmed the presence of recurrent renal cell cancer.However,due to extensive metastatic disease,the patient was placed on palliative chemotherapy as surgical options were ruled out.Our case report reiterates the fact that renal cell carcinoma can recur with gastrointestinal manifestations and,although a rarity,it should be considered in a patient with a history of malignancy who presents with these symptoms.

Concurrence of composite adrenal pheochromocytoma-ganglioneuroma and renal pelvic cancer: A case report

Embryologically, chromaffin cells of the pheo-chromocytoma and ganglion cells of the ganglioneuroma are both derived from neural crest cells. Composite pheochromocytoma-ganglioneuroma (Pheo-GN) in a single adrenal gland is very rare. A case report of a patient with composite Pheo-GN of the adrenal gland and renal pelvic cancer is presented. Laparoscopic left adrenalectomy, nephroureterectomy and para-aortic lymphadenectomy were performed. This represents the first report of simultaneous surgical treatment for composite Pheo-GN and renal pelvic cancer.

Long Term Progression Free Survival Achieved by Maintenance “Second–Line” Polychemotherapy with Gemcitabine/Paclitaxel in Metastatic Urothelial Cancer of the Renal Pelvis—A Case Report

Moderate activity of systemic chemotherapy for advanced urothelial cancer has been reported for more than 30 years. Only with the advent of potent combination therapy clinically significant response rates as well as prolonged survival were documented. The therapeutic effect of a “second-line” polychemotherapy in metastatic upper tract urothelial cancer is largely unknown caused by the small number of cases and poor prognosis. We report an interesting case of a 59-year-old man suffering from urothelial cancer of the renal pelvis with pulmonary, lymphogenic and bone metastases who showed an unexpected response to a “second-line”chemotherapy after only 2 treatment cycles of Gemcitabine/Paclitaxel (partial remission) after 24 treatment cycles Gemcitabine / Cisplatin in “stable disease” and progression between the treatment intervals. We performed maintenance “second-line” therapy for 24 cycles and the patient showed a remarkable persisting response 54 months after operation.

Nasal metastases from renal cell carcinoma are associated with Memorial Sloan-Kettering Cancer Center poor-prognosis classification

Unusual sites of metastases are recognized in patients with renal cell carcinoma (RCC). However, the prognostic implications of these sites are not well understood. We used the Memorial Sloan-Kettering Cancer Center (MSKCC) risk classification for metastatic RCC to evaluate 912 consecutive patients with RCC managed at the Singapore General Hospital between 1990 and 2009. Among these patients, 301 had metastases either at diagnosis or during the course of illness. Nasal metastases, all arising from clear cell RCC, were identified histologically in 4 patients (1.3% of those with metastasis). All 4 patients were classified as MSKCC poor prognosis by current risk criteria. Nasal metastases were significantly associated with lung and bone metastases. The frequency of nasal metastases in patients with metastatic RCC is about 1%, occurring predominantly in patients with clear cell RCC. Nasal metastases are associated with poor prognosis as estimated by the MSKCC risk classification, with attendant implications for selection of targeted therapy, and are usually associated with multi-organ dissemination, including concurrent lung and bone involvement.

Development of Aseptic Renal Abscess in a Patient with Non-Small-Cell Lung Cancer with ALK Translocation during Crizotinib Treatment

Background: Crizotinib is a tyrosine kinase inhibitor of ALK, MET and ROS1. In a safety database trial, it was suggested an association of Crizotinib with the development of renal cyst in patients with non-small-cell lung cancer (NSCLC). Aim: To report an uncommon side effect of Crizotinib in a patient with NSLC. Case Presentation: We report the case of a 68-year-old woman with NSCLC who developed bilateral progressive aseptic renal abscesses during Crizotinib treatment. Conclusion: Further studies may be necessary to determinate the risk of renal cyst development and the management of these complications.

Multiple Primary Malignancies: Metastatic Renal with Early Breast and Endometrial Cancers: A Case Report

Double primary malignancies could be divided into two categories, depending on the interval between tumor diagnoses. A secondary malignancy could be defined as a new cancer that has occurred as a result of previous treatment with radiation or chemotherapy. Second primary malignancy can occur at any age but it’s commonly at old age. A 46 premenopausal female patient presented to our outpatient clinic complaining from a mass in her right breast, routine metastatic work-up for distant metastasis declared multiple hepatic metastases, RT renal mass, and bone metastases. Palliative radiotherapy to tender and weight bearing sites followed by 4 cycles of systemic chemotherapy FEC regimen were received. Tru-cut needle biopsy from renal mass detected renal cell carcinoma of clear cell type, the patient started sunitinib and tamoxifen with bisphosphonate (Zoledronic acid), assessment of the response revealed reduction of the size and number of HFLs, and the size of renal mass, so the patient was decided to do cytoreductive nephrectomy and then continued on TAM and sunitinib. Collectively, due to the rising incidence of multiple primary malignancies, further studies should be done not only for better clinical evaluation and treatments but also for accurate determination of possible causes, pathogenesis, effective managements and screening programs.