Recent advances in renal cell carcinoma from a pathological point of view

Shuji Mikami, Mototsugu Oya, Ryuichi Mizuno, Takeo Kosaka, Masaru Ishida, Naoto Kuroda, Yoji Nagashima, Ken ichi Katsube, Yasunori Okada

Research output: Contribution to journalReview article

26 Citations (Scopus)

Abstract

The purpose of this article is to review the recent advances in renal cell carcinoma (RCC) from a pathological point of view. Because the genetic features and morphological characteristics have become major criteria for the classification of RCC, special techniques, such as immunohistochemistry, are essential to the differential diagnosis of renal tumors. Metastasis is frequently observed among the RCC patients with curative nephrectomy, and extracellular matrix-degrading enzymes, such as matrix metalloproteinases (MMP) and heparanase, play a key role in invasion and metastasis of RCC. Snail and Slug, transcription factors of epithelial-mesenchymal transition (EMT), accelerate cancer cell invasion through downregulation of E-cadherin and up-regulation of MMP. Therapies targeted at the vascular endothelial growth factor pathway have become the standard treatment of metastatic RCC. Although they lead to tumor shrinkage mainly by inhibiting angiogenesis, they have typically been associated with drug resistance. The mechanism of the resistance remains largely unknown, but complex events including re-activation of angiogenesis, EMT and cancer stem cells, and immune escape are implicated in the refractory response to the therapy. Recent advances of the research on RCC have caused the changes of classification and therapy, and pathologists should take overall view of these as integrated pathology.

Original languageEnglish
Pages (from-to)481-490
Number of pages10
JournalPathology international
Volume66
Issue number9
DOIs
Publication statusPublished - 2016

Keywords

  • cancer stem cell
  • epithelial and mesenchymal transition
  • molecular-targeted therapy
  • renal cell carcinoma
  • resistance

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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