Möglichkeiten der molekularen Diagnostik von Nierenzelltumoren

Zusammenfassung

Die primär histologisch definierten Subtypen (klarzellig, papillär, chromophob, Onkozytom) der Nierenzelltumoren müssen aufgrund ihrer spezifischen differenten molekularen Veränderungen sowie der unterschiedlichen Prognose als eigenständige Tumorentitäten betrachtet werden. Immunhistochemische und genetische Analysen können zur Diagnosestellung in unklaren Fällen eingesetzt werden und gewinnen mehr und mehr Bedeutung für die individuelle Therapieentscheidung. Eine weitere Differenzierung der Prognose innerhalb der Subtypen scheint zukünftig durch molekulare Signaturen des Primärtumors möglich, die eine individuelle Vorhersage der Aggressivität und insbesondere des Metastasierungspotenzials erlauben werden. Prädiktive molekulare Marker aus dem Blut sowie aus Tumorgewebeproben werden zu einer individuellen Vorhersage des Therapieansprechens beitragen. Um die vielversprechenden Ansätze beim Nierenzellkarzinom auch in die klinische Praxis umzusetzen, sind Validierungsstudien notwendig, die nach klaren Kriterien, ähnlich wie sie für Therapiestudien definiert sind, durchgeführt werden.

Abstract

Histologically defined subtypes of renal cell tumors (clear cell, papillary, chromophobe, oncocytoma) have to be accepted as distinct tumor entities based on specific and distinct molecular alterations and different prognosis. Immunochemistry and genetic analysis can be used for diagnosis in uncertain cases and are more and more important for individual therapy selection. Differentiation of prognosis in each subtype seems possible by using molecular signatures of primary tumors allowing individual assessment of aggressiveness and metastatic potential. Molecular markers from blood as well as from tumor tissues can predict therapy response in the future. In order to transfer these promising data into clinical practice it is mandatory to develop validation studies which have to be performed based on defined criteria similar to those for therapeutic clinical trials.

Schlüsselwörter

Nierentumoren - molekulare Diagnostik - Prognoseparameter

Key words

kidney cancer - molecular diagnostics - prognostic parameters -

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