Ribback Silvia
Institut für Pathologie, Universitätsmedizin Greifswald, Friedrich-Loeffler-Straße 23e, 17489, Greifswald, Deutschland.
Pathologe. 2020 Dec;41(Suppl 2):83-90. doi: 10.1007/s00292-020-00879-5. Epub 2020 Dec 21.
The focus of these five studies was on human clear cell, glycogen-storing lesions of the liver and kidney, which pertain to preneoplastic lesions of hepatocellular carcinoma and renal cell carcinoma in animal models of diabetes-associated carcinogenesis.
Noncirrhotic hepatic and renal tissue of humans, rats, and mice were analyzed with histology, immunohistochemistry, electron microscopy, and molecular biologic methods.
In humans, clear cell lesions often occur in noncirrhotic liver and renal tissue. They resemble preneoplastic lesions of experimental hepato- and nephrocarcinogenesis regarding glycogen storage, increased proliferative activity, upregulation of glycolysis and de novo lipogenesis (lipogenic phenotype), and activated protooncogenic signaling pathway of AKT/mTOR. In two models of murine hepatocarcinogenesis, the important role of the transcription factor ChREBP as a "metabolic oncogene" was characterized.
In these studies, the significance of small glycogen storing parenchymal alterations for carcinogenesis in human noncirrhotic liver and kidney was demonstrated due to their already present metabolic and molecular alterations. Therefore, they have to represent indicator lesions for an increased risk of carcinogenesis. Activation of the protooncogenic pathway AKT/mTOR as well as the transcription factor ChREBP and the manifestation of the lipogenic phenotype are crucial during the processes of carcinogenesis.
这五项研究聚焦于人类肝脏和肾脏的透明细胞糖原储存性病变,这些病变与糖尿病相关致癌动物模型中肝细胞癌和肾细胞癌的癌前病变相关。
采用组织学、免疫组织化学、电子显微镜和分子生物学方法对人类、大鼠和小鼠的非肝硬化肝脏和肾脏组织进行分析。
在人类中,透明细胞病变常发生于非肝硬化肝脏和肾脏组织。它们在糖原储存、增殖活性增加、糖酵解和从头脂肪生成上调(脂肪生成表型)以及AKT/mTOR原癌基因信号通路激活方面类似于实验性肝和肾致癌的癌前病变。在两种小鼠肝癌发生模型中,转录因子ChREBP作为“代谢癌基因”的重要作用得到了表征。
在这些研究中,已证明人类非肝硬化肝脏和肾脏中少量糖原储存性实质改变对致癌作用具有重要意义,因为它们已经存在代谢和分子改变。因此,它们必须代表致癌风险增加的指示性病变。原癌基因通路AKT/mTOR以及转录因子ChREBP的激活和脂肪生成表型的表现是致癌过程中的关键因素。