This research aims to identify the key fatty acid beta-oxidation(FAO)genes that are altered in kidney renal clear cell carcinoma(KIRC)and to analyze the role of these genes in KIRC The Gene Expression Omnibus(GEO)and ...This research aims to identify the key fatty acid beta-oxidation(FAO)genes that are altered in kidney renal clear cell carcinoma(KIRC)and to analyze the role of these genes in KIRC The Gene Expression Omnibus(GEO)and FAO datasets were used to identify these key genes.Wilcoxon rank sum test was used to assess the levels of acyl-CoA dehydrogenase medium chain(ACADM)between KIRC and non cancer samples.The logistic regression and Wilcoxon rank sum test were used to explore the association between ACADM and clinical features.The diagnostic performance of ACADM for KIRC was asessed using a diagnostic receiver operating ch aracteristic(ROC)curve.The co-expressed genes of ACADM were identifed in LinkedOmics database,and their function and pathway enrichment were analyzed.The correlation between ACADM expression level and immune infitration was analyzed by Gene Set Variation Analysis(GSVA)method Additionally,the proliferation,migration,and invasion abilities of KIRC cells were assessed after overexpressing ACADM.Following differential analysis and intersection,we identifed six hub genes,induding ACADM.We found that the expression level of ACADM was decreased in KIRC tissues and had a better diagnostic efect(AUC=0.916).Survival analysis suggested that patients with decreased ACADM expression had a worse prognosis.According to correlation analysis,a variety of dinical features were associated with the expression level of ACADML By analyzing the infiltration level of immune cells,we found that ACADM may be related to the enrichment of immune cells.Finally,ACADM overexpression inhibited proliferation,migration,and invasion of KIRC cells.In conclusion,our findings suggest that reduced ACADM expression in KIRC patients is indicative of poor prognosis.These results imply that ACADM may be a diagnostic and prognostic marker for individuals with KIRC,offering a reference for dinicians in diagnosis and treatment.展开更多
BACKGROUND Renal clear cell carcinoma(RCC)is a malignant tumor of the genitourinary system with a predilection for males.The most common metastatic sites are the lung,liver,lymph nodes,contralateral kidney or adrenal ...BACKGROUND Renal clear cell carcinoma(RCC)is a malignant tumor of the genitourinary system with a predilection for males.The most common metastatic sites are the lung,liver,lymph nodes,contralateral kidney or adrenal gland,however,skin metastasis has only been seen in 1.0%-3.3%of cases.The most common site of skin metastasis is the scalp,and metastasis to the nasal ala region is rare.CASE SUMMARY A 55-year-old man with clear cell carcinoma of the left kidney was treated with pembrolizumab and axitinib for half a year after surgery and was found to have a red mass on his right nasal ala for 3 mo.The skin lesion of the patient grew rapidly to the size of 2.0 cm×2.0 cm×1.2 cm after discontinuation of targeted drug therapy due to the coronavirus disease 2019 epidemic.The patient was finally diagnosed with skin metastasis of RCC in our hospital.The patient refused to undergo surgical resection and the tumor shrank rapidly after resuming target therapy for 2 wk.CONCLUSION It is rare for an RCC to metastasize to the skin of the nasal ala region.The tumor size change of this patient before and after treatment with targeted drugs shows the effectiveness of combination therapy for skin metastasis.展开更多
AIM:To clarify the therapeutic strategies and prognosis factors of primary clear cell carcinoma of the liver(PCCCL) . METHODS:The clinical pathological data of 64 patients with PCCCL treated with hepatectomy in our ho...AIM:To clarify the therapeutic strategies and prognosis factors of primary clear cell carcinoma of the liver(PCCCL) . METHODS:The clinical pathological data of 64 patients with PCCCL treated with hepatectomy in our hospital from January 2000 to January 2006 were analyzed retrospectively.The patients were divided into two groups to make treatment analysis:curative resection only(n=40) ;and curative resection and postoperative chemotherapy with calcium folinate and tegafur(n= 24) .Meanwhile,the PCCCL patients were subdivided into two subgroups on the basis of the proportion of clear cells in the tumor for pathological analysis.There were 36 cases in subgroup A for which the proportion of clear cells was more than 70%,and 28 cases in subgroup B for which the proportion was less or equal to 70%,comparing analysis of median survival time of the counterpart groups.Univariate and multivariate analyses were performed to examine factors that affect-ed clinical prognosis,recurrence and metastasis. RESULTS:Median survival period of the curative surgery group was 38 mo,while the counterpart was 41 mo.Median survival period for group A was 41 mo,while group B was 19 mo.The Kaplan-Meier method showed that capsule formation,preoperative liver function,hepatitis C virus infection,large vascular invasion and multiple tumor occurrences were related to disease-free survival.Cox regression analysis showed that the clear cell ratio,capsule formation,preoperative liver function and large vascular invasion were independent risk factors for overall survival. CONCLUSION:Postoperative chemotherapy has no obvious effect on survival of patients with PCCCL. Clear cell ratio,capsule formation,preoperative liver function,and vascular invasion were independent risk factors for prognosis.展开更多
BACKGROUND Hyalinizing clear cell carcinoma(HCCC)is an uncommon tumor that originates in the salivary glands.This neoplasia constitutes less than 1%of minor salivary gland tumors.CASE SUMMARY A 67-year-old female visi...BACKGROUND Hyalinizing clear cell carcinoma(HCCC)is an uncommon tumor that originates in the salivary glands.This neoplasia constitutes less than 1%of minor salivary gland tumors.CASE SUMMARY A 67-year-old female visited the maxillofacial surgery department owing to a smooth,slightly yellowish protruding mass on the left side of the floor of the mouth,at the level of the molars;the tumor mass had a soft consistency on palpation and did not adhere to deep planes.The microscopical analysis of the excisional biopsy showed that the lesion was composed of sheets and cords of clear cells separated by thick eosinophilic bands of hyaline collagen.Normal glandular tissue was absent,periodic acid-Schiff with and without diastase stains,and immunohistochemical reactions were performed to confirm the diagnosis.This is the second case reported in the literature of HCCC arising in the floor of the mouth.CONCLUSION HCCC is a rare salivary gland tumor that has not been studied extensively.Its diagnosis is usually challenging,because clinically,it can be confused with a benign neoplasm.展开更多
The chemokine ligand 13-chemokine receptor 5(CXCL13-CXCR5)axis has been characterized as a critical tumor-promoting signaling pathway in the tumor microenvironment(TME)in multiple types of solid tumors.In this study,w...The chemokine ligand 13-chemokine receptor 5(CXCL13-CXCR5)axis has been characterized as a critical tumor-promoting signaling pathway in the tumor microenvironment(TME)in multiple types of solid tumors.In this study,we analyzed the expression profile of CXCL13 in kidney clear cell carcinoma(KIRC)and its correlation with tumor-infiltrating immune cells(TIICs).A monoclonal antibody against CXCL13 with high affinity and purity was generated in our lab for western blot and immunohistochemistry(IHC).Bioinformatic analysis was performed based on bulk-seq data from the Cancer Genome Atlas(TCGA)-KIRC and single-cell RNA-seq data from scRNASeqDB and PanglaoDB.Results showed that high CXCL13 expression in TME was associated with shorter progression-free survival(PFS),disease-specific survival(DSS),and overall survival(OS).KIRC cell lines,as well as several other cancer cell lines,had negative CXCL13 expression.IHC staining from the Human Protein Atlas(HPA)and our tissue array indicated that CXCL13 might be mainly expressed by TIICs,but not KIRC tumor cells.CXCL13 expression was strongly and positively correlated withγδT cell abundance in TME.Besides,γδT cell infiltration was associated with poor survival of KIRC.Methylation 450k array data showed that CXCL13 promoter hypomethylation was common in TIICs.The methylation level of cg16361705 within the CXCL13 promoter might play an important role in modulating CXCL13 transcription.In conclusion,our study revealed that CXCL13 expression andγδT cell infiltration in TME is associated with unfavorable survival of KIRC.TIICs,most possiblyγδT cells,are the dominant source of CXCL13 in KIRC TME.展开更多
BACKGROUND To investigate the clinicopathological features of endometrial clear cell carcinoma that has invaded the right oviduct with a cooccurring ipsilateral oviduct adenomatoid tumor.CASE SUMMARY A case of endomet...BACKGROUND To investigate the clinicopathological features of endometrial clear cell carcinoma that has invaded the right oviduct with a cooccurring ipsilateral oviduct adenomatoid tumor.CASE SUMMARY A case of endometrial clear cell carcinoma invading the right oviduct with a cooccurring ipsilateral oviduct adenomatoid tumor was collected and analyzed using pathomorphology and immunohistochemistry.Endometrial clear cell carcinoma cells were distributed in a solid nest,papillary,shoe nail-like,and glandular tube-like distribution.There was infiltrative growth,and tumor cells had clear cytoplasm and obvious nuclear heteromorphism.The cancer tissue was necrotic and mitotic.The cancer tissue invaded the right oviduct.The ipsilateral oviduct also had an adenomatoid tumor.The adenomatoid tumor was arranged in microcapsules lined with flat or cubic cells that were surrounded by smooth muscle tissue.The adenomatoid tumor cells were round in shape.CONCLUSION Clear cell carcinoma of the endometrium can invade the oviduct and occur simultaneously with tubal adenomatoid tumors.Upon pathological diagnosis,one should pay close attention to distinguishing whether an endometrial clear cell carcinoma is invading the oviduct or whether it is accompanied by an adenomatoid tumor of the oviduct.Immunohistochemistry is helpful to differentiate these two disease entities.Endometrial clear cell carcinomas express Napsin-A and P16 and are negative for estrogen receptor and progesterone receptor.The presence of endometrial clear cell carcinoma does not affect the expression of CK and calretinin in adenomatoid tumors.展开更多
Medullary sponge kidney(MSK)is a characteristic renal malformation,with a relatively low incidence.Radiologically,identification of MSK is sometimes ambiguous when compared to a renal mass.Here,we report a novel renal...Medullary sponge kidney(MSK)is a characteristic renal malformation,with a relatively low incidence.Radiologically,identification of MSK is sometimes ambiguous when compared to a renal mass.Here,we report a novel renal clear cell carcinoma in MSK,and discuss our approach to treatment.We recommended that a preoperative biopsy should be performed,followed by a comprehensive discussion regarding the appropriate perioperative preparations and careful surgical techniques that should be performed for this complex disease.展开更多
Clear cell carcinoma (CCC) of the uterine cervix is rare, and its etiology is unclear, except for reports of prenatal diethylstilbestrol (DES) exposure. In this case report of a 78-year-old postmenopausal Japanese wom...Clear cell carcinoma (CCC) of the uterine cervix is rare, and its etiology is unclear, except for reports of prenatal diethylstilbestrol (DES) exposure. In this case report of a 78-year-old postmenopausal Japanese woman with pelvic endometriosis, cervical CCC presented as a deep interstitial tumor, strongly suggesting the patient suffered from cervical endometriosis for a long time. A </span><span style="font-family:Verdana;">cystic lesion without solid components was detected in the uterine cervix.</span><span style="font-family:Verdana;"> Although the patient had regular gynecological examinations every 6 months, she presented 5 years later with a complaint of watery vaginal discharge. Ul</span><span style="font-family:Verdana;">trasonography and magnetic resonance imaging (MRI) detected a uterine</span><span style="font-family:Verdana;"> cervical cystic mass with a solid component. Although no malignancy was confirmed preoperatively, surgery was performed under a high suspicion of cervical cancer. Intraoperative pathology revealed CCC in a solid tumor, so debulking surgery, including lymphadenectomy, was done. Endometrial tissue was found adjacent to the tumor, strongly suggesting the tumor arose from cervical endometriosis. Because endometriosis in ectopic sites carries a risk of </span><span style="font-family:Verdana;">carcinogenesis, as is the case in ovarian endometriosis, it may be recom</span><span style="font-family:Verdana;">mended that a cervical cystic lesion with pelvic endometriosis should be followed up regularly for the early detection of uterine cancer.展开更多
This report documents a rare case of complete spontaneous regression of clear cell carcinoma of the endometrium. An elderly woman with paranoid schizophrenia was admitted to the hospital because of vaginal bleeding. D...This report documents a rare case of complete spontaneous regression of clear cell carcinoma of the endometrium. An elderly woman with paranoid schizophrenia was admitted to the hospital because of vaginal bleeding. Diagnostic curetting and biopsy were performed and she was diagnosed with clear cell carcinoma of endometrium. Anti-tumour therapy was not possible because of her poor psychiatric status. 13 months later the woman died of a natural cause and at autopsy the endometrial tumour could no longer be identified. Myocardial infarction, aggravated by poor functional status of organism due to sepsis, was concluded to be the cause of death.展开更多
Background: Ovarian clear cell carcinoma (CCC) is often diagnosed at stage I. However, because of the poor prognosis of recurrent cases, even for stage Ia CCC, treatment strategies such as expansion of fertility-spari...Background: Ovarian clear cell carcinoma (CCC) is often diagnosed at stage I. However, because of the poor prognosis of recurrent cases, even for stage Ia CCC, treatment strategies such as expansion of fertility-sparing treatment and omission of adjuvant chemotherapy have been carefully discussed in recent years. We previously reported the possibility of the maximum standardized uptake value (SUVmax) as a biomarker of CCC prognosis prediction at all stages. In this study, we confirmed differences in SUVmax within stage I CCC and considered treatment strategies. Methods: We selected all 31 patients with ovarian CCC stage I who underwent fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) before treatment between 2006 and 2013 at our institution. This retrospective study was based on their medical records. Results: Clinical tumor stage was Ia in 13 patients, and Ic in 18 (Ic (b) in 11, and Ic (1) + Ic (2) in seven). There were no differences in serum CA125 level, maximum tumor diameter or mural nodules. Median SUVmax was significantly higher in stage Ic (5.87) than stage Ia (3.08) cases (P = 0.02). Progression-free survival was longer in the low SUVmax group than the high SUVmax group (P = 0.08). Conclusions: SUVmax for primary lesions in CCC was significantly higher in stage Ic than stage Ia. As SUVmax represents a prognostic factor in stage I CCC, these findings may suggest SUVmax as an indicator for the application of fertility-sparing surgery and omission of adjuvant chemotherapy for stage Ia CCC.展开更多
Background:Tumor heterogeneity is closely related to the occurrence,progression and recurrence of renal clear cell carcinoma(ccRCC),making early diagnosis and effective treatment difficult.DNA methylation is an import...Background:Tumor heterogeneity is closely related to the occurrence,progression and recurrence of renal clear cell carcinoma(ccRCC),making early diagnosis and effective treatment difficult.DNA methylation is an important regulator of gene expression and can affect tumor heterogeneity.Methods:In this study,we investigated the prognostic value of subtypes based on DNA methylation status in 506 ccRCC samples with paired clinical data from the TCGA database.Differences in DNA methylation levels were associated with differences in T,N and M categories,age,stage and prognosis.Finally,the samples were divided into the training group and the testing group according to 450K and 27K.Univariate and multivariate Cox regression analysis was used to construct the prediction model in the training group,and the model was verified and evaluated in the testing group.Results:By univariate Cox regression analysis,21,122 methylation sites and 6,775 CpG sites were identified as potential DNA methylation biomarkers for overall survival of ccRCC patients(P<0.05).3,050 CpG sites independently associated with prognosis were identified with T,N,M,stage and age as covariables.Consensus cluster of 3,050 potential prognostic methylation sites was used to identify different DNA methylation subsets of ccRCC for prognostic purposes.We performed functional enrichment analysis on these 3,640 genes and identified 75 significantly enriched pathways(P<0.05).We then researched the expression of methylated genes in subgroups.Verifing with the training set,suggesting that DNA methylation levels generally reflect the expression of these genes.Conclusion:Based on TCGA database and a series of bioinformatics methods,We identified prognostic specific methylation sites and established prognostic prediction models for ccRCC patients.This model helps to identify novel biomarkers,precision drug targets and disease molecular subtypes in patients with ccRCC.Therefore,this model may be useful in predicting the prognosis,clinical diagnosis and management of patients with different epigenetic subtypes of ccRCC.展开更多
Objective To explore the diagnosis and treatment features of tuberous sclerosis complex associated renal cell carcinoma. Methods A 22-year-old boy with a childhood history of epilepsy and mental retardation pres-
AIM: To retrospectively analyze the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of primary clear cell carcinoma of the liver (PCCCL) and compare the imaging appearances of PCCCL and commo...AIM: To retrospectively analyze the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of primary clear cell carcinoma of the liver (PCCCL) and compare the imaging appearances of PCCCL and common type hepatocellular carcinoma (CHCC) to determine whether any differences exist between the two groups. METHODS: Twenty cases with pathologically proven PCCCL and 127 cases with CHCC in the Second Affiliated Hospital of Sun Yat-sen University were included in this study. CT or MRI images from these patients were retrospectively analyzed. The following imaging findings were reviewed: the presence of liver cirrhosis, tumor size, the enhancement pattern on dynamic contrast scanning, the presence of pseudo capsules, tumor rupture, portal vein thrombosis and lymph node metastasis. RESULTS: Both PCCCL and CHCC were prone to occur in patients with liver cirrhosis, the association rate of liver cirrhosis was 80.0% and 78.7%, respectively (P > 0.05). The mean sizes of PCCCL and CHCC tumors were (7.28 ± 4.25) cm and (6.96 ± 3.98) cm, respectively. Small HCCs were found in 25.0% (5/20) of PCCCL and 19.7% (25/127) of CHCC cases. No significant differences in mean size and ratio of small HCCs were found between the two groups (P = 0.658 and 0.803, respectively). Compared with CHCC patients, PCCCL patients were more prone to form pseudo capsules (49.6% vs 75.0%, P = 0.034). Tumor rupture, typical HCC enhancement patterns and portal vein tumor thrombosis were detected in 15.0% (3/20), 72.2% (13/18) and 20.0% (4/20) of patients with PCCCL and 3.1% (4/127), 83.6% (97/116) and 17.3% (22/127) of patients with CHCC, respectively. There were no significant differences between the two groups (all P > 0.05). No patients with PCCCL and 2.4% (3/127) of patients with CHCC showed signs of lymph node metastasis (P > 0.05). CONCLUSION: The imaging characteristics of PCCCL are similar to those of CHCC and could be useful for differentiating these from other liver tumors (such as hemangioma and hepatic metastases). PCCCLs are more prone than CHCCs to form pseudo capsules.展开更多
Objective: Memory stem T cells(Tscm) have attracted attention because of their enhanced self-renewal, multipotent capacity, and anti-tumor capacities. However, little is known about Tscm in patients with renal clear c...Objective: Memory stem T cells(Tscm) have attracted attention because of their enhanced self-renewal, multipotent capacity, and anti-tumor capacities. However, little is known about Tscm in patients with renal clear cell carcinoma(RCC) and the role of Wnt signaling in these cells. We evaluated Tscm from RCC patients concerning their activation of Wnt signaling in vitro and explored the mechanism of preferential survival.Methods: Flow cytometry identified surface markers and cytokines produced from accumulated Tscm in the presence of the glycogen synthase kinase beta inhibitor TWS119. Apoptosis was evaluated after induction using tumor necrosis factor-alpha.Immunofluorescence and Western blot analyses were used to investigate the activation of the nuclear factor-kappa B(NF-КB)pathway.Results: RCC patients had a similar percentage of CD4^+ and CD8^+ Tscm as healthy donors. Activation of Wnt signaling by TWS119 resulted in the accumulation of Tscm in activated T cells, but reversal of differentiated T cells to Tscm was not achieved.Preferential survival of Tscm was associated with increased anti-apoptotic ability mediated downstream of the NF-КB activation pathway.Conclusions: The finding that Tscm can accumulate by Wnt signaling in vitro in blood from RCC patients will help in devising new cancer therapy strategies of Tscm-based adoptive immunotherapy, such as dendritic cell-stimulated Tscm, and T cell receptor or chimeric antigen receptor-engineered Tscm.展开更多
We report the case of a 67-year-old female who presented with a large renal mass. Gross examination of the nephrectomy specimen demonstrated a 6-cm renal mass that invaded into the renal sinus and perinephric fat. His...We report the case of a 67-year-old female who presented with a large renal mass. Gross examination of the nephrectomy specimen demonstrated a 6-cm renal mass that invaded into the renal sinus and perinephric fat. Histologic examination revealed two distinct tumor types. The first type was a conventional(clear cell) renal cell carcinoma that was of low nuclear grade and comprised the minority of the overall tumor. The second type was a high-grade collecting duct carcinoma with glandular/tubular differentiation and composed the majority of the tumor. Immunohistochemical studies demonstrated distinctive patterns of the two tumor types, thus confirming two distinct lineages. Five months postoperatively, the patient developed metastasis to the lungs and right hilar lymph node region. A fine needle aspiration of a lung nodule demonstrated a metastatic, poorly differentiated carcinoma, similar to the collecting duct carcinoma component in the kidney. Collision tumors of the kidney are rare with fewer than 10 cases reported in the literature. Our report further expands the spectrum of this rare phenomenon.展开更多
The clivus is an atypical metastatic site for renal clear cell carcinoma(RCCC). Here we report a 54 year old man with acute cavernous sinus syndrome. Brain magnetic resonance imaging identified a clival-based lesion w...The clivus is an atypical metastatic site for renal clear cell carcinoma(RCCC). Here we report a 54 year old man with acute cavernous sinus syndrome. Brain magnetic resonance imaging identified a clival-based lesion with associated bony erosion. The patient underwent endoscopic endonasal biopsy and partial resection of the clival mass. Because histologic examination of the resected specimen resulted in a diagnosis of RCCC, contrast-enhanced computed tomography scan of the abdomen was performed and showed an enhanced left renal mass. The patient subsequently underwent laparoscopic left radical nephrectomy and gamma knife was planned for the residual clival lesion. We also retrospectively reviewed available published reports on clival metastases, specifically those from RCCC, since 1990.展开更多
Objective:To explore the expression of Netrin-1 protein in human renal clear cell carcinoma(RCCC) and the relationships between Netrin-1.pathology and prognosis.Methods:72 cases of RCCC admitted in our hospital from 2...Objective:To explore the expression of Netrin-1 protein in human renal clear cell carcinoma(RCCC) and the relationships between Netrin-1.pathology and prognosis.Methods:72 cases of RCCC admitted in our hospital from 2008 June to 2009 June and their adjacent tissues were selected for study.They included 30 cases in stage Ⅰ-Ⅱ.42 cases in stage Ⅲ-Ⅳ;9 cases in grade Ⅰ.9 cases in grade Ⅱ.40 cases in grade Ⅲ and 14 cases in grade Ⅳ.All cases were followed up for more than 5 years.Survival analysis lines were made by Kaplan—Meier method and the difference between groups was tested by the Log-rank test.The expression of Netrin-1 protein was detected by immunohistochemistry staining and its clinical significance was analyzed.Results:Renal clear cell carcinoma:51 cases in high expression of Netrin-1and 21 cases in low expression,normal tissues:12 cases in high expression of Netrin-1and 60 cases in low expression,the difference between the two groups is significant(x^2=42.921,P<0.01).The difference of the expression of Netrin-lin Fuhrman grade and AJCC clinical stage is significant(x^2=8.000.x^2=6.203:P<0.05).The 5-year survival rate in low protein expression group and in high protein expression group was 79% (17/21) and 62% (32/51).The survival curve had different trend,with no significant difference between groups(x^2=1.360.P=0.245).Conclusions:Netrin-1 protein plays an important role in the development of RCCC.It might be a new specific tumor marker of RCCC.and might become a new target in treatment of RCCC.展开更多
Objective To evaluate the application of weak cation exchange (WCX) magnetic bead-based Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) in detecting differentially expressed...Objective To evaluate the application of weak cation exchange (WCX) magnetic bead-based Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) in detecting differentially expressed proteins in the urine of renal clear cell carcinoma (RCCC) and its value in the early diagnosis of RCCC.Methods Eleven newly diagnosed patients (10 males and 1 female, aged 46-78, mean 63 years) of renal clear cell carcinoma by biopsy and 10 healthy volunteers (all males, aged 25-32, mean 29.7 years) were enrolled in this study. Urine samples of the RCCC patients and healthy controls were collected in the morning.Weak cation exchange (WCX) bead-based MALDI-TOF MS technique was applied in detecting differential protein peaks in the urine of RCCC. ClinProTools2.2 software was utilized to determine the characteristic proteins in the urine of RCCC patients for the predictive model of RCCC.Results The technique identified 160 protein peaks in the urine that were different between RCCC patients and health controls; and among them, there was one peak (molecular weight of 2221.71 Da) with statistical significance (P=0.0304). With genetic algorithms and the support vector machine, we screened out 13 characteristic protein peaks for the predictive model.Conclusions The application of WCX magnetic bead-based MALDI-TOF MS in detecting differentiallyexpressed proteins in urine may have potential value for the early diagnosis of RCCC.展开更多
Primary clear cell carcinoma of the breast is a rare tumor with different morphological characteristics compared to ordinary breast carcinomas. The clear cell morphology of the neoplastic population in these tumors ha...Primary clear cell carcinoma of the breast is a rare tumor with different morphological characteristics compared to ordinary breast carcinomas. The clear cell morphology of the neoplastic population in these tumors has been ascribed to the presence of intracellular lipid, mucin or glycogen, or to myoepithelaial, apocrine, or neuroendocrine differentiation. We describe 2 cases of glycogen-rich clear cell carcinoma of the breast as follows.展开更多
基金the National Natural Science Foundation of China(Grant Nos.82072816 and 81672553)the Natural Science Foundation of Shandong Province(Grant No.ZR2021LZY003).
文摘This research aims to identify the key fatty acid beta-oxidation(FAO)genes that are altered in kidney renal clear cell carcinoma(KIRC)and to analyze the role of these genes in KIRC The Gene Expression Omnibus(GEO)and FAO datasets were used to identify these key genes.Wilcoxon rank sum test was used to assess the levels of acyl-CoA dehydrogenase medium chain(ACADM)between KIRC and non cancer samples.The logistic regression and Wilcoxon rank sum test were used to explore the association between ACADM and clinical features.The diagnostic performance of ACADM for KIRC was asessed using a diagnostic receiver operating ch aracteristic(ROC)curve.The co-expressed genes of ACADM were identifed in LinkedOmics database,and their function and pathway enrichment were analyzed.The correlation between ACADM expression level and immune infitration was analyzed by Gene Set Variation Analysis(GSVA)method Additionally,the proliferation,migration,and invasion abilities of KIRC cells were assessed after overexpressing ACADM.Following differential analysis and intersection,we identifed six hub genes,induding ACADM.We found that the expression level of ACADM was decreased in KIRC tissues and had a better diagnostic efect(AUC=0.916).Survival analysis suggested that patients with decreased ACADM expression had a worse prognosis.According to correlation analysis,a variety of dinical features were associated with the expression level of ACADML By analyzing the infiltration level of immune cells,we found that ACADM may be related to the enrichment of immune cells.Finally,ACADM overexpression inhibited proliferation,migration,and invasion of KIRC cells.In conclusion,our findings suggest that reduced ACADM expression in KIRC patients is indicative of poor prognosis.These results imply that ACADM may be a diagnostic and prognostic marker for individuals with KIRC,offering a reference for dinicians in diagnosis and treatment.
基金Supported by the National Natural Science Foundation of China,No.81803160.
文摘BACKGROUND Renal clear cell carcinoma(RCC)is a malignant tumor of the genitourinary system with a predilection for males.The most common metastatic sites are the lung,liver,lymph nodes,contralateral kidney or adrenal gland,however,skin metastasis has only been seen in 1.0%-3.3%of cases.The most common site of skin metastasis is the scalp,and metastasis to the nasal ala region is rare.CASE SUMMARY A 55-year-old man with clear cell carcinoma of the left kidney was treated with pembrolizumab and axitinib for half a year after surgery and was found to have a red mass on his right nasal ala for 3 mo.The skin lesion of the patient grew rapidly to the size of 2.0 cm×2.0 cm×1.2 cm after discontinuation of targeted drug therapy due to the coronavirus disease 2019 epidemic.The patient was finally diagnosed with skin metastasis of RCC in our hospital.The patient refused to undergo surgical resection and the tumor shrank rapidly after resuming target therapy for 2 wk.CONCLUSION It is rare for an RCC to metastasize to the skin of the nasal ala region.The tumor size change of this patient before and after treatment with targeted drugs shows the effectiveness of combination therapy for skin metastasis.
文摘AIM:To clarify the therapeutic strategies and prognosis factors of primary clear cell carcinoma of the liver(PCCCL) . METHODS:The clinical pathological data of 64 patients with PCCCL treated with hepatectomy in our hospital from January 2000 to January 2006 were analyzed retrospectively.The patients were divided into two groups to make treatment analysis:curative resection only(n=40) ;and curative resection and postoperative chemotherapy with calcium folinate and tegafur(n= 24) .Meanwhile,the PCCCL patients were subdivided into two subgroups on the basis of the proportion of clear cells in the tumor for pathological analysis.There were 36 cases in subgroup A for which the proportion of clear cells was more than 70%,and 28 cases in subgroup B for which the proportion was less or equal to 70%,comparing analysis of median survival time of the counterpart groups.Univariate and multivariate analyses were performed to examine factors that affect-ed clinical prognosis,recurrence and metastasis. RESULTS:Median survival period of the curative surgery group was 38 mo,while the counterpart was 41 mo.Median survival period for group A was 41 mo,while group B was 19 mo.The Kaplan-Meier method showed that capsule formation,preoperative liver function,hepatitis C virus infection,large vascular invasion and multiple tumor occurrences were related to disease-free survival.Cox regression analysis showed that the clear cell ratio,capsule formation,preoperative liver function and large vascular invasion were independent risk factors for overall survival. CONCLUSION:Postoperative chemotherapy has no obvious effect on survival of patients with PCCCL. Clear cell ratio,capsule formation,preoperative liver function,and vascular invasion were independent risk factors for prognosis.
文摘BACKGROUND Hyalinizing clear cell carcinoma(HCCC)is an uncommon tumor that originates in the salivary glands.This neoplasia constitutes less than 1%of minor salivary gland tumors.CASE SUMMARY A 67-year-old female visited the maxillofacial surgery department owing to a smooth,slightly yellowish protruding mass on the left side of the floor of the mouth,at the level of the molars;the tumor mass had a soft consistency on palpation and did not adhere to deep planes.The microscopical analysis of the excisional biopsy showed that the lesion was composed of sheets and cords of clear cells separated by thick eosinophilic bands of hyaline collagen.Normal glandular tissue was absent,periodic acid-Schiff with and without diastase stains,and immunohistochemical reactions were performed to confirm the diagnosis.This is the second case reported in the literature of HCCC arising in the floor of the mouth.CONCLUSION HCCC is a rare salivary gland tumor that has not been studied extensively.Its diagnosis is usually challenging,because clinically,it can be confused with a benign neoplasm.
基金funded by the National Science and Technology Major Project for Major New Drug Innovation and Development(2017ZX09302010).
文摘The chemokine ligand 13-chemokine receptor 5(CXCL13-CXCR5)axis has been characterized as a critical tumor-promoting signaling pathway in the tumor microenvironment(TME)in multiple types of solid tumors.In this study,we analyzed the expression profile of CXCL13 in kidney clear cell carcinoma(KIRC)and its correlation with tumor-infiltrating immune cells(TIICs).A monoclonal antibody against CXCL13 with high affinity and purity was generated in our lab for western blot and immunohistochemistry(IHC).Bioinformatic analysis was performed based on bulk-seq data from the Cancer Genome Atlas(TCGA)-KIRC and single-cell RNA-seq data from scRNASeqDB and PanglaoDB.Results showed that high CXCL13 expression in TME was associated with shorter progression-free survival(PFS),disease-specific survival(DSS),and overall survival(OS).KIRC cell lines,as well as several other cancer cell lines,had negative CXCL13 expression.IHC staining from the Human Protein Atlas(HPA)and our tissue array indicated that CXCL13 might be mainly expressed by TIICs,but not KIRC tumor cells.CXCL13 expression was strongly and positively correlated withγδT cell abundance in TME.Besides,γδT cell infiltration was associated with poor survival of KIRC.Methylation 450k array data showed that CXCL13 promoter hypomethylation was common in TIICs.The methylation level of cg16361705 within the CXCL13 promoter might play an important role in modulating CXCL13 transcription.In conclusion,our study revealed that CXCL13 expression andγδT cell infiltration in TME is associated with unfavorable survival of KIRC.TIICs,most possiblyγδT cells,are the dominant source of CXCL13 in KIRC TME.
文摘BACKGROUND To investigate the clinicopathological features of endometrial clear cell carcinoma that has invaded the right oviduct with a cooccurring ipsilateral oviduct adenomatoid tumor.CASE SUMMARY A case of endometrial clear cell carcinoma invading the right oviduct with a cooccurring ipsilateral oviduct adenomatoid tumor was collected and analyzed using pathomorphology and immunohistochemistry.Endometrial clear cell carcinoma cells were distributed in a solid nest,papillary,shoe nail-like,and glandular tube-like distribution.There was infiltrative growth,and tumor cells had clear cytoplasm and obvious nuclear heteromorphism.The cancer tissue was necrotic and mitotic.The cancer tissue invaded the right oviduct.The ipsilateral oviduct also had an adenomatoid tumor.The adenomatoid tumor was arranged in microcapsules lined with flat or cubic cells that were surrounded by smooth muscle tissue.The adenomatoid tumor cells were round in shape.CONCLUSION Clear cell carcinoma of the endometrium can invade the oviduct and occur simultaneously with tubal adenomatoid tumors.Upon pathological diagnosis,one should pay close attention to distinguishing whether an endometrial clear cell carcinoma is invading the oviduct or whether it is accompanied by an adenomatoid tumor of the oviduct.Immunohistochemistry is helpful to differentiate these two disease entities.Endometrial clear cell carcinomas express Napsin-A and P16 and are negative for estrogen receptor and progesterone receptor.The presence of endometrial clear cell carcinoma does not affect the expression of CK and calretinin in adenomatoid tumors.
文摘Medullary sponge kidney(MSK)is a characteristic renal malformation,with a relatively low incidence.Radiologically,identification of MSK is sometimes ambiguous when compared to a renal mass.Here,we report a novel renal clear cell carcinoma in MSK,and discuss our approach to treatment.We recommended that a preoperative biopsy should be performed,followed by a comprehensive discussion regarding the appropriate perioperative preparations and careful surgical techniques that should be performed for this complex disease.
文摘Clear cell carcinoma (CCC) of the uterine cervix is rare, and its etiology is unclear, except for reports of prenatal diethylstilbestrol (DES) exposure. In this case report of a 78-year-old postmenopausal Japanese woman with pelvic endometriosis, cervical CCC presented as a deep interstitial tumor, strongly suggesting the patient suffered from cervical endometriosis for a long time. A </span><span style="font-family:Verdana;">cystic lesion without solid components was detected in the uterine cervix.</span><span style="font-family:Verdana;"> Although the patient had regular gynecological examinations every 6 months, she presented 5 years later with a complaint of watery vaginal discharge. Ul</span><span style="font-family:Verdana;">trasonography and magnetic resonance imaging (MRI) detected a uterine</span><span style="font-family:Verdana;"> cervical cystic mass with a solid component. Although no malignancy was confirmed preoperatively, surgery was performed under a high suspicion of cervical cancer. Intraoperative pathology revealed CCC in a solid tumor, so debulking surgery, including lymphadenectomy, was done. Endometrial tissue was found adjacent to the tumor, strongly suggesting the tumor arose from cervical endometriosis. Because endometriosis in ectopic sites carries a risk of </span><span style="font-family:Verdana;">carcinogenesis, as is the case in ovarian endometriosis, it may be recom</span><span style="font-family:Verdana;">mended that a cervical cystic lesion with pelvic endometriosis should be followed up regularly for the early detection of uterine cancer.
文摘This report documents a rare case of complete spontaneous regression of clear cell carcinoma of the endometrium. An elderly woman with paranoid schizophrenia was admitted to the hospital because of vaginal bleeding. Diagnostic curetting and biopsy were performed and she was diagnosed with clear cell carcinoma of endometrium. Anti-tumour therapy was not possible because of her poor psychiatric status. 13 months later the woman died of a natural cause and at autopsy the endometrial tumour could no longer be identified. Myocardial infarction, aggravated by poor functional status of organism due to sepsis, was concluded to be the cause of death.
文摘Background: Ovarian clear cell carcinoma (CCC) is often diagnosed at stage I. However, because of the poor prognosis of recurrent cases, even for stage Ia CCC, treatment strategies such as expansion of fertility-sparing treatment and omission of adjuvant chemotherapy have been carefully discussed in recent years. We previously reported the possibility of the maximum standardized uptake value (SUVmax) as a biomarker of CCC prognosis prediction at all stages. In this study, we confirmed differences in SUVmax within stage I CCC and considered treatment strategies. Methods: We selected all 31 patients with ovarian CCC stage I who underwent fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) before treatment between 2006 and 2013 at our institution. This retrospective study was based on their medical records. Results: Clinical tumor stage was Ia in 13 patients, and Ic in 18 (Ic (b) in 11, and Ic (1) + Ic (2) in seven). There were no differences in serum CA125 level, maximum tumor diameter or mural nodules. Median SUVmax was significantly higher in stage Ic (5.87) than stage Ia (3.08) cases (P = 0.02). Progression-free survival was longer in the low SUVmax group than the high SUVmax group (P = 0.08). Conclusions: SUVmax for primary lesions in CCC was significantly higher in stage Ic than stage Ia. As SUVmax represents a prognostic factor in stage I CCC, these findings may suggest SUVmax as an indicator for the application of fertility-sparing surgery and omission of adjuvant chemotherapy for stage Ia CCC.
文摘Background:Tumor heterogeneity is closely related to the occurrence,progression and recurrence of renal clear cell carcinoma(ccRCC),making early diagnosis and effective treatment difficult.DNA methylation is an important regulator of gene expression and can affect tumor heterogeneity.Methods:In this study,we investigated the prognostic value of subtypes based on DNA methylation status in 506 ccRCC samples with paired clinical data from the TCGA database.Differences in DNA methylation levels were associated with differences in T,N and M categories,age,stage and prognosis.Finally,the samples were divided into the training group and the testing group according to 450K and 27K.Univariate and multivariate Cox regression analysis was used to construct the prediction model in the training group,and the model was verified and evaluated in the testing group.Results:By univariate Cox regression analysis,21,122 methylation sites and 6,775 CpG sites were identified as potential DNA methylation biomarkers for overall survival of ccRCC patients(P<0.05).3,050 CpG sites independently associated with prognosis were identified with T,N,M,stage and age as covariables.Consensus cluster of 3,050 potential prognostic methylation sites was used to identify different DNA methylation subsets of ccRCC for prognostic purposes.We performed functional enrichment analysis on these 3,640 genes and identified 75 significantly enriched pathways(P<0.05).We then researched the expression of methylated genes in subgroups.Verifing with the training set,suggesting that DNA methylation levels generally reflect the expression of these genes.Conclusion:Based on TCGA database and a series of bioinformatics methods,We identified prognostic specific methylation sites and established prognostic prediction models for ccRCC patients.This model helps to identify novel biomarkers,precision drug targets and disease molecular subtypes in patients with ccRCC.Therefore,this model may be useful in predicting the prognosis,clinical diagnosis and management of patients with different epigenetic subtypes of ccRCC.
文摘Objective To explore the diagnosis and treatment features of tuberous sclerosis complex associated renal cell carcinoma. Methods A 22-year-old boy with a childhood history of epilepsy and mental retardation pres-
文摘AIM: To retrospectively analyze the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of primary clear cell carcinoma of the liver (PCCCL) and compare the imaging appearances of PCCCL and common type hepatocellular carcinoma (CHCC) to determine whether any differences exist between the two groups. METHODS: Twenty cases with pathologically proven PCCCL and 127 cases with CHCC in the Second Affiliated Hospital of Sun Yat-sen University were included in this study. CT or MRI images from these patients were retrospectively analyzed. The following imaging findings were reviewed: the presence of liver cirrhosis, tumor size, the enhancement pattern on dynamic contrast scanning, the presence of pseudo capsules, tumor rupture, portal vein thrombosis and lymph node metastasis. RESULTS: Both PCCCL and CHCC were prone to occur in patients with liver cirrhosis, the association rate of liver cirrhosis was 80.0% and 78.7%, respectively (P > 0.05). The mean sizes of PCCCL and CHCC tumors were (7.28 ± 4.25) cm and (6.96 ± 3.98) cm, respectively. Small HCCs were found in 25.0% (5/20) of PCCCL and 19.7% (25/127) of CHCC cases. No significant differences in mean size and ratio of small HCCs were found between the two groups (P = 0.658 and 0.803, respectively). Compared with CHCC patients, PCCCL patients were more prone to form pseudo capsules (49.6% vs 75.0%, P = 0.034). Tumor rupture, typical HCC enhancement patterns and portal vein tumor thrombosis were detected in 15.0% (3/20), 72.2% (13/18) and 20.0% (4/20) of patients with PCCCL and 3.1% (4/127), 83.6% (97/116) and 17.3% (22/127) of patients with CHCC, respectively. There were no significant differences between the two groups (all P > 0.05). No patients with PCCCL and 2.4% (3/127) of patients with CHCC showed signs of lymph node metastasis (P > 0.05). CONCLUSION: The imaging characteristics of PCCCL are similar to those of CHCC and could be useful for differentiating these from other liver tumors (such as hemangioma and hepatic metastases). PCCCLs are more prone than CHCCs to form pseudo capsules.
基金supported by grants from the National Science and Technology Support Project (Grant No. 2015BAI12B12)the National Natural Science Foundation of China (Grant No. 81401887)+1 种基金the National Natural Science Foundation of China (Grant No. 81470293)the Tianjin Natural Science Foundation (Grant No. 14JCQNJC11500)
文摘Objective: Memory stem T cells(Tscm) have attracted attention because of their enhanced self-renewal, multipotent capacity, and anti-tumor capacities. However, little is known about Tscm in patients with renal clear cell carcinoma(RCC) and the role of Wnt signaling in these cells. We evaluated Tscm from RCC patients concerning their activation of Wnt signaling in vitro and explored the mechanism of preferential survival.Methods: Flow cytometry identified surface markers and cytokines produced from accumulated Tscm in the presence of the glycogen synthase kinase beta inhibitor TWS119. Apoptosis was evaluated after induction using tumor necrosis factor-alpha.Immunofluorescence and Western blot analyses were used to investigate the activation of the nuclear factor-kappa B(NF-КB)pathway.Results: RCC patients had a similar percentage of CD4^+ and CD8^+ Tscm as healthy donors. Activation of Wnt signaling by TWS119 resulted in the accumulation of Tscm in activated T cells, but reversal of differentiated T cells to Tscm was not achieved.Preferential survival of Tscm was associated with increased anti-apoptotic ability mediated downstream of the NF-КB activation pathway.Conclusions: The finding that Tscm can accumulate by Wnt signaling in vitro in blood from RCC patients will help in devising new cancer therapy strategies of Tscm-based adoptive immunotherapy, such as dendritic cell-stimulated Tscm, and T cell receptor or chimeric antigen receptor-engineered Tscm.
文摘We report the case of a 67-year-old female who presented with a large renal mass. Gross examination of the nephrectomy specimen demonstrated a 6-cm renal mass that invaded into the renal sinus and perinephric fat. Histologic examination revealed two distinct tumor types. The first type was a conventional(clear cell) renal cell carcinoma that was of low nuclear grade and comprised the minority of the overall tumor. The second type was a high-grade collecting duct carcinoma with glandular/tubular differentiation and composed the majority of the tumor. Immunohistochemical studies demonstrated distinctive patterns of the two tumor types, thus confirming two distinct lineages. Five months postoperatively, the patient developed metastasis to the lungs and right hilar lymph node region. A fine needle aspiration of a lung nodule demonstrated a metastatic, poorly differentiated carcinoma, similar to the collecting duct carcinoma component in the kidney. Collision tumors of the kidney are rare with fewer than 10 cases reported in the literature. Our report further expands the spectrum of this rare phenomenon.
文摘The clivus is an atypical metastatic site for renal clear cell carcinoma(RCCC). Here we report a 54 year old man with acute cavernous sinus syndrome. Brain magnetic resonance imaging identified a clival-based lesion with associated bony erosion. The patient underwent endoscopic endonasal biopsy and partial resection of the clival mass. Because histologic examination of the resected specimen resulted in a diagnosis of RCCC, contrast-enhanced computed tomography scan of the abdomen was performed and showed an enhanced left renal mass. The patient subsequently underwent laparoscopic left radical nephrectomy and gamma knife was planned for the residual clival lesion. We also retrospectively reviewed available published reports on clival metastases, specifically those from RCCC, since 1990.
基金supported by Sichuan Province Natural Science Foundation of China:sc271123
文摘Objective:To explore the expression of Netrin-1 protein in human renal clear cell carcinoma(RCCC) and the relationships between Netrin-1.pathology and prognosis.Methods:72 cases of RCCC admitted in our hospital from 2008 June to 2009 June and their adjacent tissues were selected for study.They included 30 cases in stage Ⅰ-Ⅱ.42 cases in stage Ⅲ-Ⅳ;9 cases in grade Ⅰ.9 cases in grade Ⅱ.40 cases in grade Ⅲ and 14 cases in grade Ⅳ.All cases were followed up for more than 5 years.Survival analysis lines were made by Kaplan—Meier method and the difference between groups was tested by the Log-rank test.The expression of Netrin-1 protein was detected by immunohistochemistry staining and its clinical significance was analyzed.Results:Renal clear cell carcinoma:51 cases in high expression of Netrin-1and 21 cases in low expression,normal tissues:12 cases in high expression of Netrin-1and 60 cases in low expression,the difference between the two groups is significant(x^2=42.921,P<0.01).The difference of the expression of Netrin-lin Fuhrman grade and AJCC clinical stage is significant(x^2=8.000.x^2=6.203:P<0.05).The 5-year survival rate in low protein expression group and in high protein expression group was 79% (17/21) and 62% (32/51).The survival curve had different trend,with no significant difference between groups(x^2=1.360.P=0.245).Conclusions:Netrin-1 protein plays an important role in the development of RCCC.It might be a new specific tumor marker of RCCC.and might become a new target in treatment of RCCC.
文摘Objective To evaluate the application of weak cation exchange (WCX) magnetic bead-based Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) in detecting differentially expressed proteins in the urine of renal clear cell carcinoma (RCCC) and its value in the early diagnosis of RCCC.Methods Eleven newly diagnosed patients (10 males and 1 female, aged 46-78, mean 63 years) of renal clear cell carcinoma by biopsy and 10 healthy volunteers (all males, aged 25-32, mean 29.7 years) were enrolled in this study. Urine samples of the RCCC patients and healthy controls were collected in the morning.Weak cation exchange (WCX) bead-based MALDI-TOF MS technique was applied in detecting differential protein peaks in the urine of RCCC. ClinProTools2.2 software was utilized to determine the characteristic proteins in the urine of RCCC patients for the predictive model of RCCC.Results The technique identified 160 protein peaks in the urine that were different between RCCC patients and health controls; and among them, there was one peak (molecular weight of 2221.71 Da) with statistical significance (P=0.0304). With genetic algorithms and the support vector machine, we screened out 13 characteristic protein peaks for the predictive model.Conclusions The application of WCX magnetic bead-based MALDI-TOF MS in detecting differentiallyexpressed proteins in urine may have potential value for the early diagnosis of RCCC.
文摘Primary clear cell carcinoma of the breast is a rare tumor with different morphological characteristics compared to ordinary breast carcinomas. The clear cell morphology of the neoplastic population in these tumors has been ascribed to the presence of intracellular lipid, mucin or glycogen, or to myoepithelaial, apocrine, or neuroendocrine differentiation. We describe 2 cases of glycogen-rich clear cell carcinoma of the breast as follows.
