Classical pathology versus molecular pathology in renal cell carcinoma

Abstract

Renal cell carcinoma (RCC) has been characterized based on histology, stage, and grading to predict behavior and guide therapy; however, RCC is still unpredictable, with poor prognosis in metastatic disease. The classification of RCC has been revised to account for molecular characteristics, and there has been an increasing understanding of the hereditary forms of RCC. This has led to further elucidation of pathways in the development of RCC including the hypoxia-inducible pathway and angiogenesis. Many other promising molecular modalities are in development, including gene expression profiling, nuclear parameters, and proliferation/apoptotic markers. This article discusses the current understanding of the classical pathologic features of RCC and highlights recent developments in the cellular and molecular characterization of RCC, which aim to improve the classification, prognostication, and treatment of RCC.

Molecular and cytogenetic insights into the pathogenesis, classification, differential diagnosis, and prognosis of renal epithelial neoplasms

“…Molecular classification and gene expression profiling study of renal cancers may prove to be useful in diagnosis, prognosis, and therapeutic selections [172][173][174][175][176][177][178][179].…”

Estudios auxiliares en el diagnóstico diferencial de tumores epiteliales renales con células granulares

“…CK7 es incluido como marcador negativo para CC y OC, finalmente, CD10 y vimentina son incluidos como marcadores negativos para CPC y OC. Las características morfológicas son muy importantes en el diagnóstico diferencial de los tumores renales con células granulares 1,2,15,16 ( Fig. 1).…”

Molecular profiling of small renal masses: Current status and future directions

“…At best, limited information is available regarding the prognostic value of biomarkers in the context of papillary or chromophobe RCC – the data from ccRCC cannot be extrapolated to these other variants as they are biologically dissimilar. [78] The evaluation of biomarkers is predominantly semiquantitative and can be subject to observer bias. The determination of cutoff point for clinical significance is sometimes arbitrary and can alter the prognostic significance in the final analysis.…”

“…It is well known that RCCs are comprised of pathologically and genetically diverse population of cancers. [78] This implies that regardless of tumor size and histology, the molecular attributes of a RCC can determine its risk of recurrence and metastasis. Therefore, characterizing the molecular biology of a tumor can provide vital information to the surgeon to help stratify risk and thereby guide therapy.…”