Assuntos
Carcinoma de Células Renais/genética , Carcinoma de Células Renais/secundário , Epigênese Genética/genética , Modelos Genéticos , Proteínas de Neoplasias/genética , Neoplasias Urológicas/genética , Animais , Carcinoma de Células Renais/diagnóstico , Metilação de DNA/genética , Regulação Neoplásica da Expressão Gênica/genética , Marcadores Genéticos/genética , Humanos , Prognóstico , Neoplasias Urológicas/diagnósticoRESUMO
Molecular prognostic factors and genetic alterations as predictive markers for cancer-specific targeted therapies are used today in the clinic for many malignancies. In recent years, many molecular markers for urogenital cancers have also been identified. However, these markers are not clinically used yet. In prostate cancer, novel next-generation sequencing methods revealed a detailed picture of the molecular changes. There is growing evidence that a combination of classical histopathological and validated molecular markers could lead to a more precise estimation of prognosis, thus, resulting in an increasing number of patients with active surveillance as a possible treatment option. In patients with urothelial carcinoma, histopathological factors but also the proliferation of the tumor, mutations in oncogenes leading to an increasing proliferation rate and changes in genes responsible for invasion and metastasis are important. In addition, gene expression profiles which could distinguish aggressive tumors with high risk of metastasis from nonmetastasizing tumors have been recently identified. In the future, this could potentially allow better selection of patients needing systemic perioperative treatment. In renal cell carcinoma, many molecular markers that are associated with metastasis and survival have been identified. Some of these markers were also validated as independent prognostic markers. Selection of patients with primarily organ-confined tumors and increased risk of metastasis for adjuvant systemic therapy could be clinically relevant in the future.
Assuntos
Biomarcadores Tumorais/análise , Biomarcadores Tumorais/genética , Técnicas de Diagnóstico Molecular/métodos , Neoplasias Urogenitais/genética , Neoplasias Urogenitais/patologia , Adulto , Idoso , Carcinoma de Células Renais/genética , Carcinoma de Células Renais/patologia , Carcinoma de Células de Transição/genética , Carcinoma de Células de Transição/patologia , Estudos de Associação Genética/métodos , Humanos , Rim/patologia , Neoplasias Renais/genética , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Gradação de Tumores , Polimorfismo de Nucleotídeo Único , Valor Preditivo dos Testes , Prognóstico , Próstata/patologia , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/genética , Neoplasias da Bexiga Urinária/patologiaRESUMO
Molecular biological tumor markers and prognostic parameters are necessary for differential diagnosis, individual prognosis, and therapy in patients with renal cell tumors. By using high throughput technologies for DNA, RNA, and protein analysis, it is possible to comprehensively characterize tumor samples. We identified specific molecular patterns of metastatic tumors, allowing the determination of metastatic potential of the primary tumor. Different therapeutic options are now available for patients with metastatic renal cell carcinoma. Therefore, it is necessary to select the best therapy for each patient and to detect therapy resistance very early. Biomarkers in tumor tissue and serum were found correlating with therapy response.