Prognostic markers in renal cell carcinoma.
OBJECTIVE
This article reviews recent reports on prognostic markers in renal cell carcinoma.


RESULTS
Inclusion in studies of larger cohorts of patients has yielded enhanced prognostic information from integrated pathological markers; the findings suggest that adjustment to the TNM (tumour-node-metastasis) system is warranted. A number of patient-related factors remain important prognostically, including performance status, C-reactive protein and thrombocytosis, but also immunological factors (e.g. expression of B7-H1 by renal cell carcinomas is associated with progression). Additional prognostic information may be derived from a range of molecular markers. Findings of gene array and methylation studies may yield independent prognostic information. Enhanced knowledge of signalling pathways has facilitated better understanding of underlying biology and prediction of response to treatment. Other genes involved in regulating hypoxia-inducible factor [e.g. genes encoding carbonic anhydrase-IX and PTEN (phosphatase and tensin homolog)] were reported to be prognostically important in renal cell carcinoma. Other markers independently predicted survival (e.g. thymidine-phosphorylase and survivin).


CONCLUSIONS
The potential of molecular markers suggested by clinical research is encouraging. Knowledge of various pathways will facilitate creation of systems of biomarkers that are predictive of individual response to therapy. Useful biomarkers may have potential as therapeutic targets.
Ljungberg
Börje
B
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden. borje.ljungberg@urologi.umu.se
D042501:Angiogenic Proteins / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics; D002292:Carcinoma, Renal Cell / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D004273:DNA, Neoplasm / Q000032:analysis; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007680:Kidney Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D018579:Patient Selection; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome
D042501:Angiogenic Proteins; D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm