MicroRNAs in renal cell carcinoma: implications for pathogenesis, diagnosis, prognosis and therapy.

Renal cell carcinoma (RCC) is a potentially curable disease, especially if the tumor is limited to the kidneys and no systemic metastatic spread has occurred by the time of diagnosis. Despite the potential for successful surgical removal of the tumor-bearing organ in localized stages and the likelihood of treatment success, the complications and long-term morbidity and mortality of RCC are difficult to accurately predict. The currently used drugs were developed based on the understanding of the molecular details of pathogenesis at the time, which has improved over the past several decades. However, more efforts should be made to improve early diagnosis, the surveillance of patients who undergo resection and treatment for metastatic RCC. Recently, small non-coding RNAs (microRNAs) were found to play pivotal roles in the metastatic dissemination of tumor cells in different types of cancer. The aim of this review is to provide an overview of the role of microRNAs in the pathogenesis of RCC and to discuss their potential as diagnostic, prognostic and, ultimately, therapeutic biomolecules.

Follow-up of men obtaining a six-core versus a ten-core benign prostate biopsy 7 years previously.

The aim of this study is to evaluate the proportion of repeat biopsies after 7 years in men with an initial benign six- or ten-core biopsy as well as the incidence of prostate cancer (PC) in the repeat biopsies. In this retrospective longitudinal study, 116 men with an elevated prostate-specific antigen (PSA) and/or a suspicious digital rectal examination (DRE) who have had a benign prostate biopsy between January 1997 and September 1997 were included. Fifty-eight men had an initial benign six-core biopsy (median PSA 7.5 ng/ml, range 0.3-67) (group A), and 58 men had an initial benign ten-core biopsy (median PSA 7.5 ng/ml, range 0.8-91.4) (group B). We analysed men with a pathological PSA velocity, a persistently elevated PSA, an abnormal DRE, a high-grade prostatic intraepithelial neoplasia or atypical adenomatous hyperplasia, or atypical small acinar proliferation as indication for rebiopsy. Furthermore, we analysed a subgroup with exclusively an increased PSA velocity (>0.75 ng/ml per year) as indication for rebiopsy. In group A, 14 men had a follow-up biopsy. In this group, follow-up biopsies yielded PC in eight men (13.8%), six (10.3%) had a negative follow-up biopsy. In contrast, in group B only four men (3.4%) had a follow-up biopsy (P=0.005). Two of them (3.4%) had PC (P=0.02), two cases (3.4%) showed a benign histology (P=0.06). The use of an extended biopsy protocol at the initial evaluation reduces the number of repeat biopsies required and decreases the number of PC detection in the follow-up biopsy cohort.