Diagnosis of renal cancer by molecular urinalysis
Diagnosis of renal cancer by molecular urinalysis
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DOI：
10.1093/jnci/91.23.2028
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发表时间：
1999-12-01
影响因子：
10.3
通讯作者：
Sidransky, D
中科院分区：
文献类型：
--
作者：
Eisenberger, CF;Schoenberg, M;Sidransky, D
背景：器官局限性肾脏恶性肿瘤大多数患者可以治愈，而更广泛的病变预后差。我们试图开发一种非侵入性的检测肾癌检测的基础上，一种新的分子approach.Methods：匹配的尿液和血清DNA样本手术前获得的30例临床器官局限性实体肾肿块（25例恶性肿瘤和5个肿瘤的低恶性潜能），并进行微卫星分析。结果：25例恶性肿瘤患者中，19例（76%）尿标本中发现一个或多个微卫星DNA改变，15例（60%）血清中发现一个或多个微卫星DNA改变。在每个病例中，尿液或血清中的微卫星变化与原发性肿瘤中发现的变化相同。5例低恶性潜能肿瘤患者中有3例在尿液中发现DNA改变，但在血清中没有显示出改变。此外，未发现微卫星改变，无论是在尿液或血清样本正常对照组和患者血尿由于肾结石（肾结石）。结论：这些数据表明，尿液标本的微卫星DNA分析提供了一个潜在的有价值的工具，可切除的肾癌的早期检测。此外，血清样本的微卫星分析揭示了这些患者中大约一半的循环肿瘤特异性DNA的证据，并可能反映了这些肿瘤在早期阶段扩散到远处的倾向。
Background: Organ confined renal malignancies can be cured in the majority of patients, whereas more extensive lesions have a poor prognosis. We sought to develop a noninvasive test for renal cancer detection based on a novel molecular approach.Methods: Matched urine and serum DNA samples were obtained before surgery from 30 patients with clinically organ-confined solid renal masses (25 with malignant tumors and five with tumors of low malignant potential) and were subjected to microsatellite analysis. Serum samples and urine samples obtained from 16 individuals without clinical evidence of genitourinary malignancy served as controls.Results: Nineteen (76%) of the 25 patients with malignant tumors were found to have one or more microsatellite DNA alterations in their urine specimen, and 15 (60%) were found to have alterations in their serum DNA by microsatellite analysis. Zn every case, the microsatellite changes in urine or serum were identical to those found in the primary tumor. Three of five patients with tumors of low malignant potential were found to have DNA alterations in their urine, but none displayed alterations in their serum. Moreover, microsatellite alterations were not identified in either the urine or the serum samples from normal control subjects and patients with hematuria due to nephrolithiasis (renal stones).Conclusion: These data suggest that microsatellite DNA analysis of urine specimens provides a potentially valuable tool for the early detection of resectable kidney cancer. Furthermore, microsatellite analysis of serum samples reveals evidence of circulating tumor-specific DNA in approximately half of these patients and may reflect the propensity of these tumors to spread to distant sites at an early stage.