[Preneoplastic glycogenotic lesions of the liver and kidney : Metabolic and molecular alterations in preneoplastic clear cell lesions of the liver and the kidney in experimental and human carcinogenesis]. / Präneoplastische glykogenotische Läsionen der Leber und der Niere : Metabolische und molekulare Alterationen in klarzelligen präneoplastischen Läsionen der Leber und der Niere in der experimentellen und humanen Karzinogenese.

AIM: 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. MATERIAL AND METHODS: Noncirrhotic hepatic and renal tissue of humans, rats, and mice were analyzed with histology, immunohistochemistry, electron microscopy, and molecular biologic methods. RESULTS: 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. CONCLUSION: 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.