Molecular and Metabolic Basis of Clear Cell Carcinoma of the Kidney

癌变 生物 癌症研究 BAP1型 血管生成 基因 肾透明细胞癌 细胞 表型 抑癌基因 肾细胞癌 细胞生长 遗传学 内科学 医学
作者
Mohammed Akhtar,Issam Al‐Bozom,Turki Al Hussain
出处
期刊:Advances in Anatomic Pathology [Lippincott Williams & Wilkins]
卷期号:25 (3): 189-196 被引量:25
标识
DOI:10.1097/pap.0000000000000185
摘要

Renal cell carcinoma (RCC) is a heterogenous group of tumors, >70% of which belong to the category of clear cell carcinoma. In recent years, crucial advances have been made in our understanding of the molecular and metabolic basis of clear cell carcinoma. This tumor manifests significant alterations in the cellular metabolism, so that the tumor cells preferentially induce the hypoxia response pathway using aerobic glycolysis, rather than the normal oxidative phosphorylation for energy. Most of the clear cell carcinomas (sporadic as well as familial) have mutations and deletions in the VHL gene located at 3p (p3.25). Normally, pVHL plays a crucial role in the proteasomal degradation of hypoxia-inducible factors (HIF)1 and HIF2. Lack of a functioning pVHL owing to genetic alterations results in stabilization and accumulation of these factors, which promotes cell growth, cell proliferation, and angiogenesis, contributing to a neoplastic phenotype. Several other genes normally located adjacent to VHL ( BAP1 , SETD2 , PBRM1 ) may also be lost. These are tumor suppressor genes whose loss not only plays a role in carcinogenesis but may also influence the clinical course of these neoplasms. In addition, interaction among a variety of other genes located at several different chromosomes may also play a role in the genesis and progression of clear cell carcinoma.
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