He Huiying, Magi-Galluzzi Cristina
*Department of Pathology, Peking University, Health Science Center, Beijing, China †Department of Pathology, R.T. Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH.
Adv Anat Pathol. 2014 May;21(3):174-80. doi: 10.1097/PAP.0000000000000018.
Epithelial-to-mesenchymal transition (EMT) describes a phenotypical change induced in epithelial cells that lose their cell-cell basement membrane contacts and their structural polarity to become spindle-shaped and morphologically similar to mesenchymal/myofibroblast cell. The abnormal induction of EMT has been demonstrated to contribute to cancer dissemination and progression. Renal cell carcinoma (RCC) with sarcomatoid differentiation (sarcomatoid RCC) represents a good example of EMT both morphologically and immunohistochemically. Early spindle cell changes can at times be identified in RCC and likely represent an early step toward EMT. Herein, we present a review of the current understanding of EMT in renal neoplasms including some known signaling regulation, the association of sarcomatoid differentiation in RCC with aggressive behavior and dismal prognosis, and EMT-related tumor biology in sarcomatoid RCC. A better perception of the EMT may contribute toward an improved understanding of the development of sarcomatoid RCC. In addition, a distinct signature for sarcomatoid RCC may have utility in the differential diagnosis for prognostic stratification as well as in identifying novel genes and pathway targets for therapeutic intervention.
上皮-间质转化（EMT）描述了上皮细胞中发生的一种表型变化，这些细胞失去细胞间基底膜接触和结构极性，变成纺锤形，在形态上类似于间充质/肌成纤维细胞。EMT的异常诱导已被证明与癌症的扩散和进展有关。具有肉瘤样分化的肾细胞癌（肉瘤样肾细胞癌）在形态学和免疫组织化学方面都是EMT的一个很好例子。早期纺锤体细胞变化有时可在肾细胞癌中发现，可能代表了向EMT的早期步骤。在此，我们综述了目前对肾肿瘤中EMT的理解，包括一些已知的信号调节、肉瘤样肾细胞癌中肉瘤样分化与侵袭性行为和不良预后的关联，以及肉瘤样肾细胞癌中与EMT相关的肿瘤生物学。对EMT的更好理解可能有助于更好地了解肉瘤样肾细胞癌的发展。此外，肉瘤样肾细胞癌的独特特征可能在预后分层的鉴别诊断以及识别治疗干预的新基因和通路靶点方面具有实用价值。
