Department of Urology, Center for Prostate Cancer, Research Institute and National Cancer Center, Goyang, Korea.
Department of Pathology, Center for Prostate Cancer, Research Institute and National Cancer Center, Goyang, Korea.
Investig Clin Urol. 2019 May;60(3):148-155. doi: 10.4111/icu.2019.60.3.148. Epub 2019 Apr 1.
Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) and clear cell renal cell carcinoma with cystic change (MCRCC) have different prognoses despite similar histologic characteristics. The aim of this study was to identify differentially mutated genes in resected tumor specimens from patients diagnosed with MCRNLMP and MCRCC using a kidney cancer gene panel.
Between 2009 and 2016, 13 MCRNLMP and 17 MCRCC cases were selected. Tumor tissues from 5 MCRNLMP and 16 MCRCC cases were subjected to gene sequencing to detect mutations among 88 genes selected from a kidney cancer gene panel after quality control. Fisher's exact test was used to compare gene mutation profiles between the two diseases. Genes were considered to be positive for mutation according to the presence of an in-frame/frameshift deletion or insertion, missense/nonsense mutation, or multi-hit mutation.
During a median follow-up period of 66.2 months, there was only one case of MCRCC recurrence among all 30 patients. Target gene sequencing showed that 35 genes tended to be more frequently positive in either disease group, with six genes showing a significantly different frequency of mutation between the groups: (odds ratio [OR], 5.735), (OR, 6.787), (OR, 4.588), (OR, 6.266), (OR, 8.167), and (OR, 4.474).
Six candidate genes showed significantly different mutation patterns between MCRNLMP and MCRCC, providing insight into their pathogenic mechanisms and differential prognoses.
多房囊性肾肿瘤低恶性潜能(MCRNLMP)和伴有囊性变的透明细胞肾细胞癌(MCRCC)具有相似的组织学特征,但预后不同。本研究旨在通过肾脏肿瘤基因panel 检测 MCRNLMP 和 MCRCC 患者切除肿瘤标本中差异突变基因。
2009 年至 2016 年,选择 13 例 MCRNLMP 和 17 例 MCRCC 病例。对 5 例 MCRNLMP 和 16 例 MCRCC 肿瘤组织进行基因测序,对从肾脏肿瘤基因 panel 中选择的 88 个基因进行质量控制后检测突变。采用 Fisher 确切检验比较两种疾病的基因突变谱。根据框架/移码缺失或插入、错义/无义突变或多击突变的存在,将基因视为阳性突变。
在 30 例患者的中位随访期 66.2 个月内,仅 1 例 MCRCC 复发。靶基因测序显示,35 个基因在两种疾病组中更常呈阳性,6 个基因的突变频率在两组间有显著差异: (比值比[OR],5.735), (OR,6.787), (OR,4.588), (OR,6.266), (OR,8.167)和 (OR,4.474)。
6 个候选基因在 MCRNLMP 和 MCRCC 之间显示出明显不同的突变模式,为其发病机制和不同预后提供了深入了解。