1
|
Wan Z, Wang Y, Li A, Li C, Zheng D. Single-cell transcription analysis reveals the tumor origin and heterogeneity of human bilateral renal clear cell carcinoma. Open Life Sci 2023; 18:20220569. [PMID: 36816799 PMCID: PMC9922059 DOI: 10.1515/biol-2022-0569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/25/2022] [Accepted: 01/14/2023] [Indexed: 02/11/2023] Open
Abstract
Bilateral renal clear cell carcinoma (BRCC) is a rare type of renal cell carcinoma (RCC) that accounts for only 1-5% of RCC cases and has a poor clinical prognosis. The origin, tumor microenvironment, cellular molecular features, and intra-tumoral heterogeneity of BRCC are still unclear. We downloaded BRCC single-cell transcriptome sequencing data from the gene expression omnibus database biochip GSE171306, containing 3,575 cells from left-sided clear cell renal cell carcinoma (ccRCC) and 3,568 cells from right-sided ccRCC, and used a series of R packages for data quality control (QC) and subsequent analysis of BRCC single-cell transcriptome data, including the use of the R packages Seurat and scCancer for cell QC, identification of major cell types, and cell annotation; R package scran for calculation of cell cycle scores; R package infercnv for malignancy scoring of tumor cells; R package ReactomeGSA for functional enrichment analysis; R package Monocle 2 for the analysis of cell differentiation trajectories; and R package CellphoneDB for the analysis of intercellular interactions. In this study, by analyzing the high-quality single-cell transcriptome data of BRCC, we identified 18 cell types and found that left- and right-sided ccRCC were approximately the same in terms of cell type and the number of each cell but differed significantly in terms of tumor cell malignancy score, tumor microenvironment, and cell stemness score. In the cell differentiation trajectory analysis of BRCC, we found that endothelial cells and macrophages play an extremely important role in its tumor progression. Further cell communication analysis was performed, and we found that it may signal through ligand-receptors, such as vascular endothelial growth factor-vascular endothelial growth factor receptor1 (VEGF-VEGFR1), MIF-(CD74-CXCR4), and growth arrest-specific protein 6-AXL, to influence the development of BRCC. The analysis of single-cell transcriptomic data of human BRCC suggests that left- and right-sided ccRCC may be of the same tumor origin, but the left-sided ccRCC is more malignant and has a better immune response.
Collapse
Affiliation(s)
- Zhengqiang Wan
- The Second Clinical Medical College of Binzhou Medical University, Shandong, China
| | - Yinglei Wang
- The Second Ward of Urology, Yantai Affiliated Hospital of Binzhou Medical University, Shandong, China
| | - Aiqun Li
- Emergency Surgery, Yantai Affiliated Hospital of Binzhou Medical University, Shandong, China
| | - Cheng Li
- The Second Clinical Medical College of Binzhou Medical University, Shandong, China
| | - Dongbing Zheng
- The Second Ward of Urology, Yantai Affiliated Hospital of Binzhou Medical University, Shandong, China
| |
Collapse
|
2
|
Ju X, Li P, Shao P, Lv Q, Wang Z, Qin C, Li J. Retroperitoneal Laparoscopic Nephrectomy Combined with Bench Surgery and Autotransplantation for Renal Cell Carcinoma in the Solitary Kidney or Tumor Involving Bilateral Kidneys: Experience at a Single Center and Technical Considerations. Urol Int 2016; 97:473-479. [DOI: 10.1159/000448594] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 07/19/2016] [Indexed: 11/19/2022]
|
3
|
Takei H, Barrios R, Monzon FA. Cytogenomics and gene expression in a case of metachronous bilateral renal cell carcinomas with drop metastasis: Resolving a diagnostic dilemma with molecular technologies. Pathol Int 2013; 63:326-32. [DOI: 10.1111/pin.12068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Accepted: 04/26/2013] [Indexed: 02/03/2023]
Affiliation(s)
- Hidehiro Takei
- Department of Pathology and Genomic Medicine; The Methodist Hospital
| | - Roberto Barrios
- Department of Pathology and Genomic Medicine; The Methodist Hospital
| | - Federico A. Monzon
- Department of Pathology and Immunology; Baylor College of Medicine; Houston; Texas; USA
| |
Collapse
|
4
|
Patel AR, Lee BH, Campbell SC, Zhou M, Fergany AF. Bilateral synchronous sporadic renal tumors: pathologic concordance and clinical implications. Urology 2011; 78:1095-9. [PMID: 21937095 DOI: 10.1016/j.urology.2011.06.051] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 05/09/2011] [Accepted: 06/04/2011] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine the pathologic concordance rates in patients with bilateral synchronous sporadic renal tumors (BSSRT) and to determine factors predictive of concordance. METHODS A retrospective chart review from 1985 to 2008 was completed with search criteria of all patients diagnosed with bilateral renal tumors. We included patients who had image-documented BSSRT or via reported history. We excluded patients with bilateral metachronous renal tumors, cystic renal masses, familial renal cell carcinoma (RCC) syndromes, urothelial cell carcinomas, and other variant histology. Univariate and multivariate analysis were conducted to assess for factors predictive of concordance. RESULTS We identified 297 patients eligible for analysis. RCC concordance was exhibited in 222 of 249 (89%) of patients. Benign tumor concordance, specifically oncocytoma, was found in 41 of 59 (71%) of patients. Factors such as age, gender, and tumor size on imaging did not have an association with concordance rates for bilateral RCC or bilateral oncocytoma. On multivariate analysis, multifocal tumors were associated with benign concordance (OR = 6.9, 95% CI = 1.6-29.2, P = .009). CONCLUSION Malignant and benign concordance rates are high for patients with BSSRT. Given the high concordance of RCC, the data support a management approach consisting of bilateral nephron-sparing surgery whenever possible. However, given the high concordance rate of oncocytoma in this population as well, less aggressive management (renal mass biopsy and surveillance) of the contralateral kidney may be considered after histologic confirmation of one side.
Collapse
Affiliation(s)
- Amit R Patel
- Section of Urology, University of Chicago Medical Center, Chicago, Illinois, USA
| | | | | | | | | |
Collapse
|
5
|
Amano H, Kondo T, Hashimoto Y, Kobayashi H, Iizuka J, Shimada K, Nakazawa H, Ito F, Tanabe K. Contralateral metachronous tumor occurrence is more frequently associated with distant metastases or postoperative intrarenal recurrence in renal cell carcinoma patients. Int J Urol 2010; 17:615-22. [DOI: 10.1111/j.1442-2042.2010.02541.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
6
|
Abstract
Complete removal of metastatic lesions can contribute to improve clinical prognosis of renal cancer. Nowadays, it is accepted that surgical extirpation of solitary metastases for patients with renal cancer is the only potential for long-term survival. Provided that the metastases could be technical and functionally resected. This review addresses the current evidence about resecable renal cancer metastases at lung, liver, bone, kidney and other organs. The criteria to consider a patient as candidate for resection of metastases are: control of primary tumor, surgical extirpation feasibility and lack of systemic disease. In patients with synchronous metastases, the surgical extirpation should be performed at the same time than nephrectomy. The clinical prognosis is worse when metastases are asynchronous. After the introduction of novel anti-angiogenic agents, surgery is also justified in patients with good responses. Although, this approach remains in the field of investigation.
Collapse
Affiliation(s)
- José L Ruiz-Cerdá
- Servicio de Urología, Hospital Universitario La Fe, Valencia, España.
| | | |
Collapse
|
7
|
Utsumi T, Suzuki H, Nakamura K, Kim W, Kamijima S, Awa Y, Araki K, Nihei N, Naya Y, Ichikawa T. Renal cell carcinoma with a huge solitary metastasis to the contralateral adrenal gland: A case report. Int J Urol 2008; 15:1077-9. [DOI: 10.1111/j.1442-2042.2008.02182.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
Ramus SJ, Elmasry K, Luo Z, Gammerman A, Lu K, Ayhan A, Singh N, McCluggage WG, Jacobs IJ, Whittaker JC, Gayther SA. Predicting Clinical Outcome in Patients Diagnosed with Synchronous Ovarian and Endometrial Cancer. Clin Cancer Res 2008; 14:5840-8. [DOI: 10.1158/1078-0432.ccr-08-0373] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Abstract
Purpose: Patients with synchronous ovarian and endometrial cancers may represent cases of a single primary tumor with metastasis (SPM) or dual primary tumors (DP). The diagnosis given will influence the patient's treatment and prognosis. Currently, a diagnosis of SPM or DP is made using histologic criteria, which are frequently unable to make a definitive diagnosis.
Experimental Design: In this study, we used genetic profiling to make a genetic diagnosis of SPM or DP in 90 patients with synchronous ovarian/endometrial cancers. We compared genetic diagnoses in these patients with the original histologic diagnoses and evaluated the clinical outcome in this series of patients based on their diagnoses.
Results: Combining genetic and histologic approaches, we were able make a diagnosis in 88 of 90 cases, whereas histology alone was able to make a diagnosis in only 64 cases. Patients diagnosed with SPM had a significantly worse survival than patients with DP (P = 0.002). Patients in which both tumors were of endometrioid histology survived longer than patients of other histologic subtypes (P = 0.025), and patients diagnosed with SPM had a worse survival if the mode of spread was from ovary to endometrium rather than from endometrium to ovary (P = 0.019).
Conclusions: Genetic analysis may represent a powerful tool for use in clinical practice for distinguishing between SPM and DP in patients with synchronous ovarian/endometrial cancer and predicting disease outcome. The data also suggest a hitherto uncharacterized level of heterogeneity in these cases, which, if accurately defined, could lead to improved treatment and survival.
Collapse
Affiliation(s)
- Susan J. Ramus
- 1Gynaecological Cancer Research Laboratory, University College London Elizabeth Garrett Anderson Institute for Women's Health, University College London
| | - Karim Elmasry
- 1Gynaecological Cancer Research Laboratory, University College London Elizabeth Garrett Anderson Institute for Women's Health, University College London
| | - Zhiyuan Luo
- 2Department Computer Science, Royal Holloway, University of London
| | - Alex Gammerman
- 2Department Computer Science, Royal Holloway, University of London
| | - Karen Lu
- 5M. D. Anderson Cancer Center, Houston, Texas
| | - Ayse Ayhan
- 6Department Pathology, Seirei Mikatahara Hospital, Hamamatsu, Japan; and
| | - Naveena Singh
- 3Department Pathology, St. Bartholomew's and The Royal London
| | | | - Ian J. Jacobs
- 1Gynaecological Cancer Research Laboratory, University College London Elizabeth Garrett Anderson Institute for Women's Health, University College London
| | - John C. Whittaker
- 4London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Simon A. Gayther
- 1Gynaecological Cancer Research Laboratory, University College London Elizabeth Garrett Anderson Institute for Women's Health, University College London
| |
Collapse
|
9
|
Patard JJ. Editorial comment on: The impact of temporal presentation on clinical and pathological outcomes for patients with sporadic bilateral renal masses. Eur Urol 2008; 54:864. [PMID: 18487008 DOI: 10.1016/j.eururo.2008.04.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
10
|
Boorjian SA, Crispen PL, Lohse CM, Leibovich BC, Blute ML. The impact of temporal presentation on clinical and pathological outcomes for patients with sporadic bilateral renal masses. Eur Urol 2008; 54:855-63. [PMID: 18487007 DOI: 10.1016/j.eururo.2008.04.079] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Accepted: 04/28/2008] [Indexed: 12/15/2022]
Abstract
BACKGROUND The origin of bilateral renal masses has not been definitively established to date. As limited studies on the genetics of bilateral tumors exist, defining the clinical behavior of these lesions remains important. OBJECTIVE To evaluate the impact of synchronous versus metachronous presentation on clinicopathological outcomes of patients with bilateral renal masses. DESIGN, SETTING, AND PARTICIPANTS We identified 310 patients who were treated at the Mayo Clinic for sporadic bilateral renal masses between 1970-2003, including 148 (47.7%) with synchronous tumors and 162 (52.3%) with metachronous lesions. INTERVENTION Patients underwent surgical resection of bilateral renal tumors. MEASUREMENTS Clinicopathological features of synchronous and metachronous tumors were compared. Survival rates for patients with synchronous (n=92) and metachronous (n=100) renal cell carcinoma (RCC) were estimated using the Kaplan-Meier method and compared with the log rank test. RESULTS AND LIMITATIONS Metachronous tumors had a greater degree of pathological concordance than synchronous lesions, with 87.7% of metachronous tumors representing bilateral RCC, compared to 69.2% of synchronous masses (p=0.002). Patients with synchronous RCC tended to have an increased incidence of papillary RCC compared to patients with metachronous RCC, who were more likely to have bilateral clear-cell RCC (p=0.076). A longer interval between tumors was inversely associated with the risk of cancer death for patients with metachronous RCC (HR 0.90, 95% CI 0.81-0.99, p=0.039). Compared to patients with metachronous RCC, patients with synchronous bilateral RCC had similar 10-yr CSS (70.5% vs. 69.4%, p=0.51) and OS (47.5% vs. 51.2%, p=0.58). We nevertheless recognize that these findings may be limited by the study's retrospective, single-institution design. CONCLUSIONS Metachronous bilateral solid renal masses have a greater degree of pathological concordance and were more likely to represent malignancy. Surgical resection may provide durable cancer control for patients with bilateral RCC, with no difference in survival noted between synchronous and metachronous cancers.
Collapse
Affiliation(s)
- Stephen A Boorjian
- Department of Urology, Mayo Medical School and Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | | | | | | | | |
Collapse
|
11
|
Pathologic concordance of sporadic synchronous bilateral renal masses. Urology 2008; 72:138-42. [PMID: 18336882 DOI: 10.1016/j.urology.2008.01.043] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Revised: 01/23/2008] [Accepted: 01/28/2008] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To review the collective experience evaluating pathologic concordance rates of sporadic bilateral synchronous renal tumors reported in the Surveillance, Epidemiology, and End Results (SEER) database and the published English literature and treated at Fox Chase Cancer Center; specifically, to analyze concordance rates of malignant versus benign disease, histologic type, tumor stage, and nuclear grade. METHODS We reviewed the SEER database, the published English language literature, and our own institutional tumor registry to identify all cases of sporadic, synchronous localized (cT1-3N0M0) bilateral renal masses. Malignant and benign concordance rates were defined as agreement of any benign or malignant tumor type bilaterally. Histologic concordance was defined as bilateral histologic agreement. Tumors with mixed histologies were discordant unless all patterns were identical bilaterally. Nuclear grades were concordant if bilateral tumors were either "high" grade or "low" grade. RESULTS The malignant concordance rate in the SEER data was 99% (273 of 274), and benign concordance was 0 (0 of 1). In the published literature and Fox Chase Cancer Center series, malignant concordance rates ranged from 84% to 95%, whereas benign concordance ranged from 39% to 67%. The SEER data revealed a histologic concordance rate of 93% (256 of 274), and nuclear grade concordance was 85% (88 of 103). CONCLUSIONS These data demonstrate that in cases of bilateral sporadic localized synchronous renal masses, a diagnosis of ipsilateral renal cell carcinoma is associated with contralateral renal cell carcinoma in the vast majority of patients, whereas ipsilateral benign pathology is associated with contralateral benign disease at a substantially lower rate. Histologic concordance is similarly high, meaning most cases of clear cell or papillary tumors ipsilaterally are concordant in the contralateral kidney. Concordance rates of nuclear grade were slightly lower. These data are important when counseling and managing patients with bilateral synchronous sporadic renal tumors.
Collapse
|
12
|
Klatte T, Patard JJ, Wunderlich H, Goel RH, Lam JS, Junker K, Schubert J, Böhm M, Allhoff EP, Kabbinavar FF, Crepel M, Cindolo L, De La Taille A, Tostain J, Mejean A, Soulie M, Bellec L, Bernhard JC, Ferriere JM, Pfister C, Albouy B, Colombel M, Zisman A, Belldegrun AS, Pantuck AJ. Metachronous Bilateral Renal Cell Carcinoma: Risk Assessment, Prognosis and Relevance of the Primary-Free Interval. J Urol 2007; 177:2081-6; discussion 2086-7. [PMID: 17509291 DOI: 10.1016/j.juro.2007.01.122] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2006] [Indexed: 11/20/2022]
Abstract
PURPOSE We evaluated the prognosis, risk factors and relevance of the primary-free interval in a large cohort with metachronous bilateral renal cell carcinoma. MATERIALS AND METHODS We studied 120 patients with metachronous, bilateral renal cell carcinoma who were treated at 12 international academic centers. Logistic regression was performed to evaluate risk factors for contralateral metachronous renal cell carcinoma during followup. Disease specific survival was evaluated with univariate and multivariate analysis. RESULTS Median age at diagnosis of the first and second renal cell carcinomas was 54 and 62 years, respectively. The most common histological subtype was bilateral clear cell renal cell carcinoma (89% of cases). Familial renal cell carcinoma was found in 14% of patients, von Hippel-Lindau disease was found in 4% and nonfamilial renal cell carcinoma was found in 81%. The 15-year disease specific survival rates for the first and second renal cell carcinomas were 66% and 44%, respectively. Logistic regression revealed von Hippel-Lindau disease, a family history of renal cell carcinoma, multifocal first renal cell carcinoma and young patient age as independent risk factors for contralateral renal cell carcinoma after surgery for unilateral renal cell carcinoma. A longer primary-free interval was associated with a better prognosis. When calculating disease specific survival from the diagnosis of the first renal cell carcinoma, the primary-free interval was an independent prognostic factor. CONCLUSIONS Long-term survival rates of metachronous, bilateral renal cell carcinoma are moderate. von Hippel-Lindau disease, a family history of renal cell carcinoma, multifocal first renal cell carcinoma and young patient age are independent risk factors for contralateral renal cell carcinoma. These risk factors support close and extended abdominal surveillance following nephrectomy for unilateral renal cell carcinoma. Patients with a longer primary-free interval have a more favorable prognosis.
Collapse
Affiliation(s)
- Tobias Klatte
- Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90025, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Klatte T, Wunderlich H, Patard JJ, Kleid MD, Lam JS, Junker K, Schubert J, Böhm M, Allhoff EP, Kabbinavar FF, Crepel M, Cindolo L, De La Taille A, Tostain J, Mejean A, Soulie M, Bellec L, Bernhard JC, Ferriere JM, Pfister C, Albouy B, Colombel M, Zisman A, Belldegrun AS, Pantuck AJ. Clinicopathological features and prognosis of synchronous bilateral renal cell carcinoma: an international multicentre experience. BJU Int 2007; 100:21-5. [PMID: 17433034 DOI: 10.1111/j.1464-410x.2007.06877.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To present a multicentre experience and the largest cohort to date of nonmetastatic (N0M0) synchronous bilateral renal cell carcinoma (RCC), as because it is rare the single-institutional experience is limited. PATIENTS AND METHODS We retrospectively studied 10 337 patients from 12 urological centres to identify patients with N0M0 synchronous bilateral RCC; the clinicopathological features and cancer-specific survival were compared to a cohort treated for N0M0 unilateral RCC. RESULTS In all, 153 patients had synchronous bilateral solid renal tumours, of whom 135 (88%) had synchronous bilateral RCC, 118 with nonmetastatic disease; 91% had nonfamilial bilateral RCC. Bilateral clear cell RCC was the major histological subtype (76%), and papillary RCC was the next most frequent (19%). Multifocality was found in 54% of bilateral RCCs. Compared with unilateral RCC, patients did not differ in Eastern Cooperative Oncology Group performance status (ECOG PS) and T classification, but bilateral RCCs were more frequently multifocal (54% vs 16%, P < 0.001) and of the papillary subtype (19% vs 12%), and less frequently clear cell RCC (76% vs 83%, P = 0.005). For the outcome, patients with nonmetastatic synchronous bilateral RCC and unilateral RCC had a similar prognosis (P = 0.63); multifocality did not affect survival (P = 0.60). Multivariate analysis identified ECOG PS, T classification, and Fuhrman grade, but not laterality, as independent prognostic factors for cancer-specific survival. CONCLUSIONS Patients with N0M0 synchronous bilateral RCC and N0M0 unilateral RCC have a similar prognosis. The frequency of a familial history for RCC (von Hippel-Lindau disease or familial RCC) was significantly greater in bilateral synchronous than in unilateral RCC. The significant pathological findings in synchronous bilateral RCC are papillary subtype and multifocality.
Collapse
Affiliation(s)
- Tobias Klatte
- Department of Urology, David Geffen School of Medicine at UCLA, University of California-Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90025, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Luisa Arranz M, Luz Parra M, Terriza D. Carcinoma de células renales bilateral y múltiple (hipernefroma, adenocarcinoma renal). RADIOLOGIA 2005. [DOI: 10.1016/s0033-8338(05)72797-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|