BACKGROUND: Renal cell carcinoma (RCC) is a urologic malignancy with a steady rise in incidence and high mortality rate. Between 60 to 70% of patients with renal cell carcinoma can only be cured with surgery but despite advances in early diagnostis, in around 20-30% of cases there is metastasis. For these patients, chemotherapy and radiotherapy are ineffective and hence the prognosis is poor. Retinoids are biologically active compounds of either natural or synthetic origin that are involved in complex physiological and developmental processes in many tissues including cell proliferation and activation of tumour suppression genes. This article reviews the role of retinoids and their cognate nuclear retinoid/rexinoid receptors in relation to renal cell carcinoma. METHODS: A literature search using ScienceDirect and Medline with a focus on the relationship between renal cell carcinoma and nuclear retinoid/rexinoid receptors. RESULTS: Use of retinoids/rexinoids in the treatment of locally advanced and metastatic RCC significantly prolongs median time of tumour progression and overall survival of patients. Combination therapy with other preparations has greater efficacy than treatment with retinoids alone. Patient survival can be predicted on the basis of the expression of different all-trans retinoic acid receptor (RAR) and 9-cis retinoic acid receptor (RXR) subtypes. CONCLUSIONS: Since nuclear retinoid receptors play a crucial role as ligand-activated, DNA binding, trans-acting, transcription-modulating proteins involved in a general molecular mechanism responsible for transcriptional responses in target genes, retinoids might be an alternative approach for the treatment of renal cell carcinoma.

• MeSH
• karcinom z renálních buněk etiologie   MeSH
• lidé MeSH
• nádory ledvin etiologie   MeSH
• receptory cytoplazmatické a nukleární fyziologie   MeSH
• receptory kyseliny retinové fyziologie   MeSH
• retinoidní X receptory fyziologie   MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Cieľ práce: Cieľom uvedenej analýzy je zistiť, či existujú nejaké rozdiely v histopatologických parametrov v skupine solídnych nádorov obličiek a solídnych nádorov s cystickou degeneráciou a komplexnými cystami. Materiál a metódy: Vyhodnotených bolo retrospektívne 147 nádorových lézií obličiek v období (od septembra 2005 do marca 2008). Nádory boli následne rozdelené do troch skupín [(1) 1-3 cm; (2) 3,1-5 cm a (3) 5,1-7 cm]. K veľkosti nádorovej lézie bol vyhodnotený výsledok histopatologického vyšetrenia (typ nádoru, patologické štádium, nukleárny grade podľa Fuhrmanovej, prítomnosť cystického komponentu, nekrózy a hemorágie). V rámci subanalýzy sa porovnali solídne nádory verzus solídne nádory s cystickou degeneráciou a komplexné cysty obličiek do priemeru 5 cm. Výsledky: Počet benígnych lézií bol v uvedených skupinách v (10 %; 10,5 %; 0 %). Nebol štatisticky významný rozdiel v počte malígnych a benígnych nádorov v závislosti od veľkosti nádoru na základe kvalitatívnej analýzy. V rámci subanalýzy solídne nádory obličiek (62 pacientov) proti nádorom s cystickou zložkou (25 pacientov) a komplexným cystám obličiek (35 pacientov) do priemeru 5 cm bol počet benígnych lézií (12,9 %; 4 %; 28,1 %) pre jednotlivé skupiny následovne. Nukleárny grading 1/2 v (74,2 %; 91,7 %; 92 %); grading 3 (14,4 %; 8,3 %; 8 %). Všetky nádory s cystickou zložkou boli diagnostikované v patologickom štádiu pT1a/b, v skupine solídnych nádorov obličiek bolo 12,9 % potvrdených v pokročilom štádiu pT3a/b. Nebol potvrdený štatisticky významný rozdiel medzi typom/štádiom a gradingom nádoru na základe kvalitatívnej analýzy, ale bola štatisticky významná korelácia medzi typom nádoru a gradingom. Pri nepriaznivejšom gradingu je menej pravdepodobný nález cystickej degenerácie, alebo komponentu v solídnom nádore do priemeru 5 cm (Kendall´s Tau B). Záver: Cystická zložka nádoru sa javí ako parameter lepšej prognózy. Sú potrebné ďalšie štúdie, ktoré by potvrdili tieto výsledky s následnou štatistickou analýzou a inkorporáciou prítomnosti cystického komponentu do prognostických systémov.

Aim of the study: The aim of our study was to reveal if there are some differences in histopathologic parameters, when solid versus solid tumors with cystic component and complex renal cysts were compared. Material and methods: 147 kidney tumors were reviewed retrospectively from September 2005 until March 2008. The tumors were divided into three groups according to the tumor size [(1) 1-3 cm; (2) 3.1-5 cm a (3) 5.1-7 cm]. Tumor size was correlated to histological examination (tumor type, pathological TNM stage, and nuclear (Fuhrman) grade, presence of cystic component, necrosis and hemorrhage). In subanalysis solid tumors versus tumors with cystic degeneration versus complex renal cysts up to 5cm in diameter were compared. Results: The number of benign lesions in each category was (10 %, 10.5 %, 0 %). There was no statistically significant difference between the number of malignant and benign tumors stratified by size according to the qualitative analysis. In the subanalysis when solid tumors (total of 62 pts) were compared with tumors with cystic component (25 pts) versus complex renal cysts (35 pts) up to 5 cm in greatest diameter, the number of benign lesions was (12.9 %, 4 %, 28.1 %) for each group respectively. Nuclear grade 1/2 in (74.2 %, 91.7 %, 92 %); grade 3 was (14.4 %, 8.3 %, 8 %). All tumors with cystic component were diagnosed in pathological stage pT1a/b, in the group of solid tumors 12.9 % were diagnosed in pT3a/b stage. There was no statistically significant difference between the tumor type/stage and grade according to the qualitative analysis. But there was a highly significant correlation between tumor type and grade. The higher the grade, the less common finding of presence of the cystic component in solid tumors up to 5 cm in diameter (Kendall´s Tau B). Conclusion: Cystic component of the tumor seems to be a parameter of favorable prognosis. The further studies are necessary to confirm these results followed with statistical analysis and incorporation of the cystic component into the prognostic integrated systems.