Renal Cell Carcinoma Clinical Trial
Official title:
Role of Immunohistochemical Markers , Geminin and Mcm2 in Prognosis of Renal Cell Carcinoma, and Its Clinicopathological Correlation. A Prospective Controlled Study
The study aim is to prospectively assess the prognostic significance of immunohistochemical markers Geminin and Mcm-2 in cases of renal cell carcinoma and to detect its clinicopathological correlation.
Renal cell carcinoma (RCC) is one of the most common urological malignancies. Approximately
338,000 people are diagnosed with RCC worldwide each year, representing approximately 2-3 %
of all cancers.
RCC can be classified into non-epithelial and epithelial, according to cell origin. The four
major types are of epithelial origin includes: clear cell renal carcinoma (ccRCC), papillary,
chromophobe renal carcinoma (chRCC) and collecting duct carcinoma. The most common subtype of
RCC is ccRCC which accounts for approximately 70-80% of all renal cell carcinomas.
Prognostic factors for RCC can be classified into: anatomical, histological, clinical, and
molecular factors. Anatomical factors include tumor size, venous invasion, renal capsular
invasion, adrenal involvement, Lymph node and distant metastasis. Histological factors
include tumour grade, RCC subtype, sarcomatoid features, microvascular invasion, tumour
necrosis, and invasion of the collecting system. Clinical factors include performance status,
local symptoms, cachexia, anaemia, platelet count, neutrophil/lymphocyte ratio, C-reactive
protein (CRP) and serum albumin.
As regard the molecular factors, numerous markers such as carbonic anhydrase IX, vascular
endothelial growth factor (VEGF), hypoxia-inducible factor (HIF), Ki67, PTEN (phosphatase and
tensin homolog), osteopontin and other cell cycle and proliferative markers are being
investigated.
The efficiency and accuracy of biomarkers studies using immunohistochemical and tissue
microarray techniques are still variable and unclear in regards to prognostic significance in
patients with renal tumors. Multiple biomarkers shown to be significant to assess diagnosis
and prognosis in these patients and other were not significant.
In the RCC cell cycle, minichromosome maintenance 2 (Mcm2), Geminin define the proliferative
state. Investigators are able to determine differential levels of expression of various
markers in normal tissue compared with indolent and aggressive tumors. Among platforms used
in determining the presence of biological markers in surgical pathology specimens,
immunohistochemistry is perhaps the most commonly available tool in the routine diagnostic
laboratory. Immunohistochemistry allows detection of antigens expressed on tumor cells, hence
permitting characterization of the tumor.
This study was designed to assess the prognostic significance of Geminin and Mcm-2 in cases
of renal cell carcinoma and to assess its clinicopathological correlation.
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