Department of Surgical, Oncological and Gastroenterological Sciences, Urological Clinic, University of Padua, 35128 Padua, Italy.
Department of Molecular Medicine, School of Medicine and Surgery, University of Padua, 35128 Padua, Italy.
Int J Mol Sci. 2020 May 10;21(9):3378. doi: 10.3390/ijms21093378.
Men are more frequently diagnosed with kidney cancer than women, with a more aggressive histology, larger tumors, a higher grade and stage, and worse oncological outcomes. Smoking habits and sex steroid hormones seem to have a possible role in explaining these gender disparities. Moreover, the expression of genes involved in tumor growth and immune response in kidney cancer varies between men and women, having an impact on the gender-related response to oncological therapy, such as anti-angiogenic drugs and immunotherapy. Recent advances have been made in our understanding of the molecular and genetic mechanisms involved in kidney cancer, which could partially explain the gender differences, and they are summarized in this paper. However, other key mechanisms, which fully clarify the striking clinical gender-related differences observed in kidney cancer, are not completely understood at present. We reviewed and summarized the most relevant publications about the relationship between gender and kidney cancer. Efforts should be made to progress in bench and clinical research on gender-related signatures and disparities, and their impact on the clinical management of kidney cancer.
男性比女性更常被诊断出患有肾癌,其组织学更具侵袭性,肿瘤更大,分级和分期更高,肿瘤预后更差。吸烟习惯和性激素似乎在解释这些性别差异方面发挥了一定作用。此外,肾癌中与肿瘤生长和免疫反应相关的基因表达在男性和女性之间存在差异,这对包括抗血管生成药物和免疫疗法在内的肿瘤治疗的性别相关反应产生了影响。目前,我们对肾癌相关分子和遗传机制的理解已经取得了一些进展,这些进展可以部分解释性别差异,本文对此进行了总结。然而,目前仍不完全了解其他关键机制,这些机制充分阐明了肾癌中观察到的显著临床性别相关差异。我们回顾并总结了与性别和肾癌相关的最相关的研究。应该努力在与性别相关的特征和差异及其对肾癌临床管理的影响方面,推进基础和临床研究。