Integrative bioinformatics and in vitro exploration of EVI2A expression:unraveling its immunological and prognostic implications in kidney renal clear cell carcinoma

EVI2A has emerged as a significant biomarker in various diseases;however,its biological role and mechanism in kidney renal clear cell carcinoma(KIRC)remains unexplored.We used TCGA and GEO databases to analyze EVI2A gene expression comprehensively and performed pan-cancer assessments.Clinical relevance was evaluated through Kaplan-Meier analysis and ROC curves.The gene’s immune relevance was explored through analyses of the tumor microenvironment(TME),Tumor Immune Single-cell Hub(TISCH),immune checkpoints,and immunotherapy sensitivity.Our results indicate that EVI2A expression is upregulated in KIRC,showing correlations with tumor grade and T/N/M stage.EVI2A demonstrates high diagnostic accuracy(AUC=0.906)and predicts poor overall and progression-free survival in KIRC patients.Furthermore,EVI2A expression exhibits significant associations with immunity,including TME scores and specific immune cell types such as Tfh cells,CD4 memory T cells,and CD8+T cells.Elevated EVI2A expression suggests increased sensitivity to PD-1/CTLA-4 and tyrosine kinase inhibitors.In vitro assays confirmed the impact of EVI2A on KIRC behavior,with its knockdown resulting in reduced cell proliferation and migration.In conclusion,our comprehensive analysis identifies EVI2A as a promising biomarker and a novel therapeutic target for intervening in KIRC.These findings hold significant implications for further research and potential clinical applications.

The Relationship of Expression of bcl-2, p53, and Proliferating Cell Nuclear Antigen (PCNA) to Cell Proliferation and Apoptosis in Renal Cell Carcinoma

To investigate the relationship of bcl-2, p53, proliferating cell nuclear antigen (PCNA) to cell proliferation, apoptosis and pathological parameters, the patterns of cell growth and turnover in renal cell carcinoma (RCC), formalin-fixed and paraffin-embedded tissue blocks from 34 patients with RCC were examined. Cell proliferation activity was detected by PCNA immunostaining and the proliferation index (PI) was expressed as a percentage of the PCNA-positive cells in the tumor cells. Apoptosis was detected by terminal deoxy- nucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL), and the apoptotic index (AI) was expressed as a percentage of the TUNEL-positive cells in the tumor cells. Expressions of bcl-2 and p53 were assessed immunohistochemically. Our results showed that the PI ranged from 6.0 % to 24.0 % (median 12.3 %) and the AI from 2.0 % to 8.0 % (median 5.4 %) in RCC. The expression of the bcl-2 protein was demonstrated in 15 cases (44.1 %); the expression of the p53 protein, however, was seen in only 3 case. bcl-2 positivity was not associated with PI or AI or any pathological parameters. There were close associations between PI and tumor grade and stage, and a significant relationship between AI and the tumor grade of RCC. Our study suggests that bcl-2 positivity was not associated with PI or AI or any pathological parameters. There are close associations between PI and AI and tumor grade and stage of RCC. Active cell proliferation may be accompanied by frequent apoptosis in RCC.

Nobiletin downregulates the SKP2-p21/p27-CDK2 axis to inhibit tumor progression and shows synergistic effects with palbociclib on renal cell carcinoma

Objective:Natural extracts,including nobiletin,have been reported to enhance the efficacy and sensitivity of chemotherapeutic drugs.However,whether and how nobiletin affects tumor growth and progression in renal cell carcinoma(RCC)are still unclear.Methods:Cell proliferation,cell cycle and apoptosis analyses,colony-formation assays,immunoblotting analysis,and q RT-PCR analysis were performed to investigate how nobiletin affected RCC cell proliferation in vitro.The nude mouse model was used to test the efficacy of nobiletin alone or in combination with palbociclib.Results:Nobiletin inhibited cell proliferation by inducing G1 cell cycle arrest and cell apoptosis in RCC cells.Mechanistically,nobiletin decreased SKP2 protein expression by reducing its transcriptional level.The downregulated SKP2 caused accumulation of its substrates,p27 and p21,which further inhibited the activity of the G1 phase-related protein,CDK2,leading to inhibition of cell proliferation and tumor formation.A higher SKP2 protein level indicated less sensitivity to the CDK4/6 inhibitor,palbociclib.A combination of nobiletin and palbociclib showed a synergistic tumor inhibition in vitro and in an in vivo model.Conclusions:Nobiletin downregulated the SKP2-p21/p27-CDK2 axis to inhibit tumor progression and showed synergistic tumor inhibition effects with the CDK4/6 inhibitor,palbociclib,on RCC,which indicates a potential new therapeutic strategy.

Role of MR-DWI and MR-PWI in the radiotherapy of implanted pulmonary VX-2 carcinoma in rabbits

Objective： To detect the activity of tumor cells and tumor blood flow before and after the radiotherapy of implanted pulmonary VX-2 carcinoma in rabbit models by using magnetic resonance diffusion-weighted imaging（MR-DWI） and magnetic resonance perfusion weighted imaging（MR-PWI）, and to evaluate the effectiveness and safety of the radiotherapy based on the changes in the MR-DWI and MR-PWI parameters at different treatment stages.Methods： A total of 56 rabbit models with implanted pulmonary VX-2 carcinoma were established, and then equally divided into treatment group and control group. MR-DWI and MR-PWI were separately performed using a Philips Acheiva 1.5T MRI machine（Philips, Netherland）. MRI image processing was performed using special perfusion software and the WORKSPACE advanced workstation for MRI. MRDWI was applied for the observation of tumor signals and the measurement of apparent diffusion coefficient（ADC） values; whereas MR-PWI was used for the measurement of wash in rate（WIR）, wash out rate（WOR）, and maximum enhancement rate（MER）. The radiation treatment was performed using Siemens PRIMUS linear accelerator. In the treatment group, the radiotherapy was performed 21 days later on a once weekly dosage of 1,000 c Gy to yield a total dosage of 5,000 c Gy.Results： The ADC parameters in the region of interest on DWI were as follows： on the treatment day for the implanted pulmonary VX-2 carcinoma, the t values at the center and the edge of the lesions were 1.352 and 1.461 in the treatment group and control group（P〉0.05）. During weeks 0-1 after treatment, the t values at the center and the edge of the lesions were 1.336 and 1.137（P〉0.05）. During weeks 1-2, the t values were 1.731 and 1.736（P〈0.05）. During weeks 2-3, the t values were 1.742 and 1.749（P〈0.05）. During weeks 3-4, the t values were 2.050 and 2.127（P〈0.05）. During weeks 4-5, the t values were 2.764 and 2.985（P〈0.05）. The ADC values in the treatment group were significantly higher than in the control group. After the radiotherapy（5,000 c Gy）, the tumors remarkably shrank, along with low signal on DWI, decreased signal on ADC map, and remarkably increased ADC values. As shown on PWI, on the treatment day for the implanted pulmonary VX-2 carcinoma, the t values of the WIR, WOR, and MER at the center of the lesions were 1.05, 1.31, and 1.33 in the treatment group and control group（P〉0.05）; in addition, the t values of the WIR, WOR, and MER at the edge of the lesions were 1.35, 1.07, and 1.51（P〉0.05）. During weeks 0-1 after treatment, the t values of the WIR, WOR, and MER at the center of the lesions were 1.821, 1.856, and 1.931（P〈0.05）; in addition, the t values of the WIR, WOR, and MER at the edge of the lesions were 1.799, 2.016, and 2.137（P〈0.05）. During weeks 1-1 after treatment, the t values of the WIR, WOR, and MER at the center of the lesions were 2.574, 2.156, and 2.059（P〈0.05） and the t values of the WIR, WOR, and MER at the edge of the lesions were 1.869, 2.058, and 2.057（P〈0.05）. During weeks 2-3 after treatment, the t values of the WIR, WOR, and MER at the center of the lesions were 2.461, 2.098, and 2.739（P〈0.05） and the t values of the WIR, WOR, and MER at the edge of the lesions were 2.951, 2.625, and 2.154（P〈0.05）. During weeks 3-4 after treatment, the t values of the WIR, WOR, and MER at the center of the lesions were 2.584, 2.107, and 2.869（P〈0.05） and the t values of the WIR, WOR, and MER at the edge of the lesions were 2.057, 2.637, and 2.951（P〈0.05）. During weeks 4-5 after treatment, the t values of the WIR, WOR, and MER at the center of the lesions were 2.894, 2.827, and 3.285（P〈0.05） and the t values of the WIR, WOR, andMER at the edge of the lesions were 3.45, 3.246, and 3.614（P〈0.05）. After the radiotherapy（500 c Gy）, the tumors shrank on the T1 WI, WIR, WOR, and MER; meanwhile, the PWI parameter gradually decreased and reached its minimum value.Conclusions： MR-DWI and MR-PWI can accurately and directly reflect the inactivation of tumor cells and the tumor hemodynamics in rabbit models with implanted pulmonary VX-2 carcinoma, and thus provide theoretical evidences for judging the clinical effectiveness of radiotherapy for the squamous cell carcinoma of the lung.

Curcumin induces the expression of NF-κB and Bcl-2/Bax in human renal cell carcinoma cell line ACHN

Objective： To explore the in vitro effects of curcumin on the proliferation and apoptosis of the human renal cell carcinoma cell line ACHN, and to investigate its mechanisms of action. Methods： The human renal cell carcinoma cell line ACHN was treated with different concentrations of curcumin for 24 h. The MTT assay was used to evaluate the cytotoxic effects of curcumin and flow cytometry was utilized to observe and detect the apoptosis of ACHN cells induced by curcumin. The expression levels of Bcl-2, Bax and NF-κBP65 mRNA were evaluated by Reverse Transcription-Polymerase Chain Reaction （RT-PCR）, while the expression of Bcl- 2, Bax, NF-κBP65 and IκB proteins was evaluated by Western blot. Results： The concentrations of curcumin used significantly inhibited the proliferation of ACHN human renal cell carcinoma cells in vitro in a dose and time-dependent manner （Ftime=5.55, P 〈 0.05; Fdose=110.05, P 〈 0.05）. Obvious apoptosis of cells treated with different concentrations of curcumin could be observed by FCM. Compared with the control group, the apoptosis rates of curcumin-treated cells were markedly increased （F=96.35, P 〈 0.05）. Lower dose of curcumin significantly induced the apoptosis of ACHN cells. With intervention of different concentrations of curcumin （0, 10, 20 and 40 μmol/L） for 24 h, the expression levels of Bcl-2 and NF-κBP65 mRNA in ACHN cells were decreased while the expression level of Bax mRNA was increased （P 〈 0.05）, and Bcl-2, and NF-κBP65 protein decreased, while Bax and IκB protein increased compared with those in the untreated group. Conclusion： Curcumin inhibited proliferation and increased apoptosis of the human renal cell carcinoma cell line ACHN. These curcumin effects appear to involve up-regulating IκB, down-regulating NF-κB, and regulating the expression of the apoptosis genes Bcl-2/Bax.

Eosinophilic solid and cystic renal cell carcinoma with aggressive behavior:Two case reports

BACKGROUND Eosinophilic solid and cystic(ESC)renal cell carcinoma(RCC),a unique and emerging subtype of RCC,has an indolent nature;in some rare instances,it may exhibit metastatic potential.Current cases are inadequate to precisely predict the clinical outcome of ESC RCC and determine treatment choices.CASE SUMMARY Herein,we report two patients with ESC RCC.Patient 1 was a young woman with classical pathological characteristics.Patient 2 was a 52-year-old man with multifocal metastases,involving the pulmonary hilar and mediastinal lymph nodes,liver,brain,mesosternum,vertebra,rib,femur,and symphysis pubis.Awareness of ESC RCC,along with its characteristic architecture and immunophenotype,would contribute to making a definitive diagnosis,even on core biopsy samples.CONCLUSION The discovery of ESC RCC molecular signatures may provide new therapeutic strategies in the future.

Aryl hydrocarbon receptor nuclear translocator 2 as a prognostic biomarker and immunotherapeutic indicator for clear cell renal cell carcinoma

Background:In many cancer types,aryl hydrocarbon receptor nuclear translocator 2(ARNT2)has been found to be associated with tumor cell proliferation and prognosis.However,the role of ARNT2 in clear cell renal cell carcinoma(ccRCC)has not been completely elucidated.In this study,the potential role of ARNT2 in ccRCC development was characterized.Methods:A pan-cancer dataset(TCGA-TARGET-GTEx)was accessed from UCSC Xena Data Browser.ARNT2 expression in normal and tumor samples was compared.Univariate Cox regression was performed to evaluate the prognostic value of ARNT2.Single sample gene set enrichment analysis(ssGSEA)was used to estimate the enrichment of functional pathways and gene signatures.CIBERSORT and ESTIMATE methods evaluated the immune infiltration.The ARNT2 expression was determined in ccRCC tissue and cell lines using RT-qPCR and Western blot.Results:ARNT2 expression was significantly dysregulated in 23 out of 30 cancer types.Pan-cancer data revealed a strong correlation between ARNT2 expression and immune modulators,immune cell infiltration,and genomic alternations.In ccRCC patients,the low-ARNT2 expression group had higher immune infiltration,CD8 T cells,and programmed cell death ligand 1 expression,as well as higher enrichment score of immunotherapeutic predictors than those in the high-ARNT2 expression group.Low-ARNT2 expression group was more responsive to immunotherapy.Moreover,low ARNT2 expression was observed in ccRCC tissue and cell lines.Conclusions:Dysregulated ARNT2 expression is involved in cancer development and the modulation of the immune microenvironment.ARNT2 can be potentially used as a prognostic indicator and an immunotherapeutic indicator for ccRCC.

Macrophage-derived exosomal miR-342-3p promotes the progression of renal cell carcinoma through the NEDD4L/CEP55 axis

Due to its difficulty in early diagnosis and lack of sensitivity to chemotherapy and radiotherapy,renal cell carcinoma(RCC)remains to be a frequent cause of cancer-related death.Here,we probed into new targets for its early diagnosis and treatment for RCC.microRNA(miRNA)data of M2-EVs and RCC were searched on the Gene Expression Omnibus database,followed by the prediction of the potential downstream target.Expression of target genes was measured via RT-qPCR and Western blot,respectively.M2 macrophage was obtained viaflow cytometry with M2-EVs extracted.The binding ability of miR-342-3p to NEDD4L and to CEP55 ubiquitination was studied with their roles in the physical abilities of RCC cells assayed.Subcutaneous tumor-bearing mouse models and lung metastasis models were prepared to observe in vivo role of target genes.M2-EVs induced RCC growth and metastasis.miR-342-3p showed high expression in both M2-EVs and RCC cells.M2-EVs carrying miR-342-3p promoted RCC cell abilities to proliferate,invade and migrate.In RCC cells,M2-EV-derived miR-342-3p could specifically bind to NEDD4L and consequently elevate CEP55 protein expression via suppressing NEDD4L,thereby exerting tumor-promoting effects.CEP55 could be degraded by ubiquitination under the function of NEDD4L,and miR-342-3p delivered by M2-EVs facilitated the RCC occurrence and development by activating the PI3K/AKT/mTOR signaling pathway.In conclusion,M2-EVs promote RCC growth and metastasis by delivering miR-342-3p to suppress NEDD4L and subsequently inhibit CEP55 ubiquitination and degradation via activation of the PI3K/AKT/mTOR signaling pathway,strongly driving the proliferative,migratory and invasive of RCC cells.

Highly expression of MYBL2 is correlated with a poor prognosis and immune infiltration in clear cell renal carcinoma

Background:Clear cell renal carcinoma(ccRCC)is notorious for its highly unfavorable prognosis,closely related to immune cell infiltration(ICI).MYB Proto-Oncogene Like 2(MYBL2)is elevated in multiple types of human cancer and is recognized as a crucial role in tumorigenesis.In the present study,we aimed to determine the roles of MYBL2 in the prognostic outcomes of ccRCC.Methods:We analyzed the GSE100666 dataset from the Gene Expression Omnibus(GEO)database and found that the expression of MYBL2 was significantly higher in ccRCC subjects than in normal controls.Next,RNA sequencing data related to ccRCC were retrieved from The Cancer Genome Atlas(TCGA)database and the levels of MYBL2 were compared between tumor and peri-tumor tissues.The correlation between MYBL2 and clinicopathological parameters was assessed by logistic analysis.The Kaplan-Meier method,Cox-regression analysis,and nomograms,were applied to investigate the potential clinical benefits of MYBL2 in ccRCC.We also evaluated the correlation between MYBL2 and immune cell infiltration with a single-sample gene set enrichment analysis(ssGSEA).The association between MYBL2 and immune checkpoints was determined via the TIMER and TISIDB databases.Finally,correlation analysis was conducted to predict upstream non-coding RNAs(ncRNAs)regulating MYBL2,and a completing endogenous RNA(ceRNA)network was constructed to visualize the long non-coding RNAs(lncRNAs)-microRNAs(miRNAs)-MYBL2 axis in ccRCC.Finally,further analysis of upstream lncRNAs was carried out to validate the accuracy of the network.Results:MYBL2 was significantly over-expressed in ccRCC(P<0.001).High levels of MYBL2 expression in ccRCC correlated with a worse T stage,a more advanced N stage,a higher M stage,a more deleterious pathological stage,and higher histological grades.MYBL2 was identified as a risk factor for disease-specific survival(hazard ratio(HR)=2.73,P<0.001),overall survival(HR=1.91,P<0.001),and progression-free interval(HR=2.03,P<0.001).MYBL2 also positively associated with multiple types of immune cells and checkpoints.Finally,two ceRNA axes,PVT1-miR-30e-5p-MYBL2 and LINC00511-miR-29c-3p-MYBL2 were detected as the most promising upstream ncRNAs regulating MYBL2 in ccRCC,and we also validated the expression of MYBL2 and PVT1 by launching qRT-PCR.We found that the expression of MYBL2 was significantly higher in 786-O than in human kidney-2 cell line HK-2(P<0.001)and the expression of PVT1 was significantly higher in Caki-1 than in HK-2(P<0.001).Conclusion:Our study revealed that ncRNAs might upregulated the expression of MYBL2 in ccRCC and that this was associated with an unfavorable prognosis and immune infiltration.

手术标本YAP1、POU2F2、Cath-D表达与局限性肾癌术后复发的相关性及预测意义

目的研究手术标本Yes相关蛋白1(YAP1)、POU2家族同源框2(POU2F2)和组织蛋白酶D(Cath-D)表达与局限性肾癌术后复发的相关性及预测意义。方法回顾性分析2019年1月至2022年3月新乡医学院第一附属医院收治的282例局限性肾癌手术患者的临床资料,根据术后2年随访期内(2例失访)复发情况分为复发组42例和未复发组238例。比较两组患者的基线资料以及手术标本YAP1、POU2F2、Cath-D表达水平,采用多因素Logistic回归分析局限性肾癌术后复发的影响因素,采用受试者工作特征(ROC)曲线分析手术标本YAP1、POU2F2和Cath-D表达单一及联合预测局限性肾癌术后复发价值,采用Pearson相关分析法分析手术标本YAP1、POU2F2和Cath-D表达与复发时间的相关性。结果复发组患者的2017AJCCTNM分期T2期、Fuhrman分级Ⅳ级患者占比分别为80.95%、40.48%,明显高于未复发组患者的62.31%、21.85%,差异均有统计学意义(P<0.05);复发组患者的YAP1阳性率、POU2F2 mRNA和Cath-D阳性率分别为78.57%、1.70±0.36和83.33%,明显高于未复发组患者的47.90%、1.48±0.41、50.00%,差异均有统计学意义(P<0.05);校正前多因素Logistic回归分析结果显示,2017AJCCTNM分期T2期、Fuhrman分级>Ⅱ级、YAP1阳性、POU2F2mRNA、Cath-D阳性均与局限性肾癌术后复发相关(P<0.05),校正后YAP1阳性、POU2F2 mRNA和Cath-D阳性仍是局限性肾癌术后复发的独立相关危险因素(P<0.05);ROC分析结果显示,三者联合预测局限性肾癌术后复发的AUC为0.915,敏感度为80.95%,特异度为89.00%,明显高于各指标单独预测(P<0.05);Pearson相关性分析结果显示,手术标本YAP1、POU2F2、Cath-D表达与复发时间呈负相关(r=-0.802、-0.769、-0.834,P<0.05)。结论局限性肾癌患者手术标本YAP1、POU2F2和Cath-D表达水平与术后复发密切相关,其联合预测局限性肾癌术后复发具有良好参考价值。

Unusual gastric and pancreatic metastatic renal cell carcinoma presentation 10 years after surgery and immunotherapy: A case report and a review of literature

Renal cell carcinoma （RCC） is the most common renal tumor, accounting for 2%-3% of all malignancies. Though RCC is known to spread hematogenously, isolated RCC metastasis to the stomach is a rare event. In this article, we describe the clinical course of a patient who developed a pancreatic recurrence of RCC and 1 year later a gastric recurrence of RCC treated 10 years ago with a resection and interleukin-2 （IL-2）. Accumulating evidence indicates that metastatic involvement of the pancreas and stomach should be suspected in any patient with a history of RCC who presents with gastrointestinal symptoms even 10 years after RCC resection and immunotherapy.

基于TCGA数据库分析DTX2在肾透明细胞癌组织中表达的临床意义及其对肾癌细胞增殖、迁移与侵袭的影响

目的:基于TCGA数据库分析Deltex E3泛素连接酶2(DTX2)在肾透明细胞癌(ccRCC)组织中的表达水平及临床意义,探讨DTX2对ccRCC细胞增殖、迁移和侵袭的影响。方法:利用TIMER数据库分析DTX2在泛癌组织中的表达水平,通过UALCAN数据库进一步验证ccRCC组织和癌旁组织中DTX2 mRNA和蛋白表达差异。使用UALCAN数据库中的TCGAccRCC队列数据集,分析ccRCC中DTX2表达与患者临床病理特征的相关性。通过K-M plot数据库分析DTX2表达与ccRCC患者预后的相关性。利用DAVID数据库对DTX2相关基因进行GO和KEGG通路富集分析。通过qPCR法检测DTX2基因在人胚肾293(HEK293)细胞和ccRCC细胞A498、Caki-1中的表达水平。利用siRNA技术分别将DTX2 siRNA及其阴性对照质粒转入A498、Caki-1细胞,采用CCK-8法、平板克隆实验、划痕实验及Transwell侵袭实验分别检测敲低DTX2对细胞增殖、迁移和侵袭的影响。结果:TCGA数据库分析结果表明,与癌旁组织相比,ccRCC组织中DTX2 mRNA和蛋白均呈高表达(均P<0.01)。DTX2表达水平与ccRCC患者的病理分期、临床分级、不同亚型和淋巴结转移相关联(均P<0.01),DTX2高表达与患者的不良预后具有相关性(均P<0.01)。GO功能和KEGG通路富集分析结果显示,DTX2表达相关基因主要参与蛋白酶体介导的泛素依赖性蛋白质分解代谢等生物学过程,并主要富集到了mTOR信号通路等与肿瘤的相关信号通路中(均P<0.05)。体外细胞实验结果表明,A498和Caki-1细胞中DTX2表达水平高于HEK293细胞;敲低DTX2表达可显著降低A498和Caki-1细胞的增殖、迁移及侵袭能力(均P<0.01)。结论:DTX2在ccRCC组织和细胞中呈高表达,其高表达患者的预后较差。敲低DTX2表达可抑制ccRCC细胞增殖、迁移和侵袭,DTX2有望成为ccRCC新的生物标志物和治疗靶点。

TDERS,an exosome RNA-derived signature predicts prognosis and immunotherapeutic response in clear cell renal cell cancer:a multicohort study

Background:Tumor-derived exosomes are involved in tumor progression and immune invasion and might func-tion as promising noninvasive approaches for clinical management.However,there are few reports on exosom-based markers for predicting the progression and adjuvant therapy response rate among patients with clear cell renal cell carcinoma(ccRCC).Methods:The signatures differentially expressed in exosomes from tumor and normal tissues from ccRCC pa-tients were correspondingly deregulated in ccRCC tissues.We adopted a two-step strategy,including Lasso and bootstrapping,to construct a novel risk stratification system termed the TDERS(Tumor-Derived Exosome-Related Risk Score).During the testing and validation phases,we leveraged multiple external datasets containing over 2000 RCC cases from eight cohorts and one inhouse cohort to evaluate the accuracy of the TDERS.In addition,enrichment analysis,immune infiltration signatures,mutation landscape and therapy sensitivity between the high and low TDERS groups were compared.Finally,the impact of TDERS on the tumor microenvironment(TME)was also analysed in our single-cell datasets.Results:TDERS consisted of 12 mRNAs deregulated in both exosomes and tissues from patients with ccRCC.TDERS achieved satisfactory performance in both prognosis and immune checkpoint inhibitor(ICI)response across all ccRCC cohorts and other pathological types,since the average area under the curve(AUC)to predict 5-year overall survival(OS)was larger than 0.8 across the four cohorts.Patients in the TDERS high group were resistant to ICIs,while mercaptopurine might function as a promising agent for those patients.Patients with a high TDERS were characterized by coagulation and hypoxia,which induced hampered tumor antigen presentation and relative resistance to ICIs.In addition,single cells from 12 advanced samples validated this phenomenon since the interaction between dendritic cells and macrophages was limited.Finally,PLOD2,which is highly expressed in fibro-and epi-tissue,could be a potential therapeutic target for ccRCC patients since inhibiting PLOD2 altered the malignant phenotype of ccRCC in vitro.Conclusion:As a novel,non-invasive,and repeatable monitoring tool,the TDERS could work as a robust risk stratification system for patients with ccRCC and precisely inform treatment decisions about ICI therapy.

重组人新型白介素-2治疗晚期肿瘤Ⅱ期临床研究

目的 :通过多中心前瞻性Ⅱ期临床试验观察重组人新型白细胞介素 2 (12 5Ser rhIL 2 )的疗效和不良反应。方法 :分别采用皮下和胸、腹腔内注射治疗实体瘤和癌性胸 /腹腔积液。结果 :176例患者中可评价近期疗效者 172例。其中癌性胸/腹腔积液和实体瘤患者分别为 141和 31例 ,有效率分别为 80 .14%和 2 5 .81%。治疗后大部分病人生活质量、免疫功能有一定程度提高。不良反应主要为发热、寒战、局部皮肤红肿及消化道反应。未发现低血压和毛细血管渗漏综合征发生。结论 :12 5Ser rhIL 2对晚期肾癌、恶性黑色素瘤、癌性胸 /腹腔积液具有客观抗肿瘤作用 ,不良反应较轻。

放射治疗荷肾癌小鼠肿瘤生长抑制与脾细胞及肿瘤组织IL-2,IFN-γ和IL-10的关系

目的:观察放射治疗对BALB/c小鼠肾癌移植瘤的抑瘤作用与细胞因子IL-2,IFN-γ和IL-10表达分泌的关系.方法:建立BALB/c小鼠的Renca肾癌细胞移植瘤放射治疗的模型;采用ELISA试剂盒检测小鼠脾淋巴细胞的细胞因子IL-2,IL-10和IFN-γ分泌水平.RT-PCR法检测肿瘤组织IL-2,IL-10和IFN-γ基因的表达水平.结果:治疗组小鼠肾癌移植瘤生长速度较肿瘤对照组明显减慢.放疗组小鼠脾细胞分泌IL-2,IFN-γ及肿瘤组织IL-2,IFN-γ的表达较肿瘤对照组明显升高,IL-10较肿瘤对照组降低.结论:经放射治疗后,小鼠肿瘤生长受到明显抑制,与放疗引发小鼠脾细胞分泌IL-2,IFN-γ和肿瘤组织IL-2,IFN-γ表达分泌增强,IL-10细胞因子降低有关.

HIF-1α和HIF-2α在人肾透明细胞癌中的表达及意义

目的探讨低氧诱导因子HIF-1α和HIF-2α在人肾透明细胞癌组织中的表达及其临床意义。方法应用RT-PCR的方法从转录水平检测了56例原发性散发肾细胞癌和52例正常肾组织中HIF-1αmRNA及HIF-2αmRNA的表达情况,应用Western-Blot方法从蛋白质水平检测了HIF-1α和HIF-2α的表达情况。结果HIF-1αmRNA在肾透明细胞癌标本组织中的表达率为87.5%,较对照组织中增高,差异有统计学意义(P<0.05);HIF-2αmRNA在肾透明细胞癌标本组织中的表达率为94.6%,较对照组织中增高,差异有统计学意义(P<0.05)。56例CCRCC组织标本中52例表达HIF-1α蛋白,阳性率为92.9%,较对照组织中增高,差异有统计学意义(P<0.05)。56例CCRCC组织标本中54例表达HIF-2α蛋白,阳性率为96.4%,较对照组织中增高,差异有统计学意义(P<0.05)。结论HIF-1α和HIF-2α的表达可能对肾透明细胞癌的发生和发展有重要作用。

HIF-2α、VEGF、COX-2、MMP-9表达及其与肾细胞癌血管生成的关系分析

目的探讨HIF-2α(缺氧诱导因子-2α)、VEGF(血管内皮生长因子)、COX-2(环氧化酶-2)、MMP-9(金属基质酶-9)表达及其与肾细胞癌血管生成的关系。方法应用免疫组化方法,检测79例肾细胞癌手术切除标本的HIF-2α、VEGF、COX-2、MMP-9表达情况,并与MVD(微血管密度)表达进行关联性分析。结果肾癌组织MMP-9、VEGF的表达均显著高于正常肾组织(P<0.05);不同临床分期肾癌组织中的MMP-9、VEGF表达有明显差异(P<0.05)。MVD与VEGF、MMP-9蛋白表达呈显著正相关(r=0.381、0.375,P<0.05);MVD与COX-2表达有关,COX-Z表达0级和4级MVD值最低,与1、2、3级之间比较差异有统计学意义(P<0.05),0级与4级之间比较差异无统计学意义(P>0.05),1、2、3级之间差别无统计学意义(P>0.05)。肾细胞癌中HIF-2α阳性组的MVD值高于HIF-2α阴性组中MVD值,差异有统计学意义(t=4.374,P<0.05);Spearman等级相关分析发现,HIF-2α的表达与MVD间存在正相关关系(r=0.545,P<0.01)。结论 HIF-2α、VEGF、COX-2、MMP-9表达及其与肾细胞癌血管生成之间有明显相关性,在临床上可以根据相关基因表达情况而采取相应的干预措施。

肾细胞癌COX-2及MMP-2的免疫组化研究

目的探讨COX-2在肾癌组织中的表达及其与肿瘤侵袭转移的关系。方法采用SP法检测45例肾细胞癌中COX-2和MMP-2的表达情况。结果COX-2主要为癌组织的表达,而在癌旁正常组织中无表达或弱表达,COX-2高表达与肿瘤分级、分期和分型有统计学差异(P<0.01);MMP-2在正常肾组织均为阴性,肾癌组织中的表达与肿瘤的分级及分型有统计学差异(P<0.01),而与分期则无统计学差异(P>0.05);COX-2与MMP-2阳性表达率无统计学差异(P=1.000),且两者的吻合度较强(κ=0.867)。结论肾癌中COX-2的高表达与肾癌的分级、分期、分型及肿瘤侵袭转移有关,提示COX-2选择性抑制剂是防治肾癌的可行途径之一。

姜黄素对人肾癌Caki-2细胞生长和凋亡的影响及其机制

目的:观察姜黄素对体外培养的人肾癌Caki-2细胞的生长抑制作用和凋亡诱导作用,并探讨其可能的作用机制。方法:应用不同浓度的姜黄素分别作用于人肾癌Caki-2细胞12、24、36、48、72、96 h,采用MTT法评价姜黄素对Caki-2细胞的生长抑制作用;应用不同浓度的姜黄素分别作用于人肾癌Caki-2细胞36、48、72、96 h,采用Annexin V-FITC/PI凋亡试剂盒评价姜黄素对Caki-2细胞的凋亡诱导作用;Western blot检测姜黄素对Caki-2细胞H-Ras、p-Raf-B、p-MEK1/2、p-ERK1/2、ERK1/2、Bcl-2、Bax蛋白表达的影响,β-actin作为内参蛋白。结果:不同浓度的姜黄素能显著抑制Caki-2细胞生长,36、48、72、96 h呈剂量、时间依赖关系;不同浓度的姜黄素能显著诱导Caki-2细胞凋亡,48、72、96 h呈剂量、时间依赖关系;姜黄素作用后,Caki-2细胞中H-Ras、p-Raf-B、p-MEK1/2、p-ERK1/2、Bcl-2蛋白表达明显减少,Bax蛋白表达显著增加,ERK1/2、β-actin蛋白表达与空白组相比无统计学差异。结论:姜黄素对体外培养的人肾癌Caki-2细胞有显著的生长抑制作用,其机制可能与通过抑制H-Ras蛋白表达、直接或间接下调ERK信号通路蛋白表达相关;同时,姜黄素对Caki-2细胞有显著的凋亡诱导作用,其机制可能与上调促凋亡蛋白Bax表达、下调抗凋亡蛋白Bcl-2表达相关。

大剂量IL-2活化的HLA半相合异基因造血干细胞治疗10例晚期难治性肾癌的疗效观察

目的:传统的免疫治疗对晚期难治性肾癌的疗效非常有限,因为肿瘤自身产生了免疫耐受,本研究的目的是探讨大剂量IL-2活化的HLA半相合异基因造血干细胞治疗晚期难治性肾癌的临床疗效。方法:10例晚期肾癌患者以及作为供者的其HLA半相合的亲属入组。所有患音均接受1个疗程的haplo-PBSCs治疗,评估临床疗效和免疫学反应。结果:经IL-2活化后获得的HLA半相合的haplo-PBSCs总数为(2.3～5.5)×10^(10)。活化后,NK细胞和活化淋巴细胞亚群(CD69^+和CD25^+)比例明显升高,而且对肾癌细胞的杀伤活性也明显增强。治疗后,2例部分缓解(PR),6例疾病稳定(SD),2例疾病进展(PD),中位无进展生存期(mPFS)为5.5个月(3～14个月)。结论:传统的免疫治疗无效的晚期难治性肾癌患者,采用IL-2活化的HLA半相合异基因造血干细胞治疗可以产生明显的抗肿瘤效应,并且有良好的耐受性。