Team:Worldshaper-Wuhan/Background

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  BACKGROUND
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Our Background

Renal Cell Carcinoma

Even though it only represents approximately 2-3% of all adult cancer diagnoses, Renal Cell Carcinoma (RCC) is the most common kidney malignancy, accounting for 90% of them, and is the most deadliest among urologic cancer [1], consisting 70% of clear cell RCC, 25% of papillary and chromophobe RCC, and 5% of medullary and collecting system RCC [2]. With an approximate annual 295,000 new diagnosed cases and 134,000 deaths, kidney cancer generally has a male to female ratio of 2:1, and is found to be more prevalent in developed countries [3]. According to the National Cancer Registry under the National Cancer Center of China, RCC in China was ranking 15th of all adult malignancies in 2011 in terms of prevalence, with the incidence of 3.35/100,000 and reaches a peak of 14.7/100,000 in the 75-80 years old age group [4].

The incidence and mortality of renal cell carcinoma (RCC) appears to be rising and ~64,000 new cases were diagnosed in 2017 in the United States, resulting in more than 14,400 deaths, usually from metastatic disease. (Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30.)

The Limitation of Current Renal Cell Carcinoma Detection Methods

Currently, the detection of renal cell carcinoma includes ultrasound, magnetic resonance imaging (MRI), angiography, biopsy, and computed tomography (CT). Of these methods, computed tomography, which detects whether a lesion enhances after intravenous administration of iodinated contrast material, is the most preferred way of diagnosing RCC for its high resolution, efficiency, and acceptable cost [5,6]. However, there are also some drawbacks for performing a CT. For example, attenuation measurements for small cystic lesions may faultily indicate enhancement because of pseudoenhancement, which is an artifactual increase in attenuation after the contrast agent administration, therefore leading to erroneously interpreting small renal cyst to be enhancing and perform unnecessary intervention [6]. Other than computed tomography, another approach could be renal mass biopsy (RMB), which is safe and reliable. Nevertheless, limitations also exists within this method: sampling errors could lead to nondiagnostic biopsy and biopsy could lead to potential tumor dissemination [7,8].

The Limitations of Treatments for Renal Cell Cancer

RCC staging in T1 or T2, which are two stages that the tumor is local and restrained in an organ, could be treated surgically by total or partial nephrectomy [8]. Patient with advanced tumor who lost their chance for surgery could use radiotherapy as an alternative. Also, new drugs introduced in 2005 including 5 VEGF and 2 mTOR inhibitors have prolonged metastatic renal cell carcinoma survival time. Although improvements on diagnosis and treatment have greatly affected survival time for RCC carriers [8], with 5-year survival rate of 82%-92% in papillary tumors and 78%-92% in chromophobe tumors, clear cell RCC subtype, less favorable in this case for its symptomatic characteristic, which makes it to present at advanced stage of tumor and has likely metastasized, has a 5-year survival rate of only 44%-69% [1]. Take in consider of all the pain and great inconvenience that come along with cancer treatments, better early detection methods of such cancer should be researched and brought to reality to eliminate advanced stage tumor as much as possible.

Therefore, our team is committed to design a new model based on new biomarkers that can diagnose renal cell cancer with specificity, accuracy and ease, which also has the potential to be used in cancer treatment in the future.

What is the lncRNA?

Long non-coding RNAs (lncRNAs), a class of noncoding transcripts, are longer than 200 nucleotides, with little protein-coding potential. lncRNAs have emerged as regulators in diverse biological processes, such as embryonic development, cell differentiation and tumor metastasis. lncRNAs are critical regulators in the development and progression of various tumors. And dysregulation of lncRNAs has been associated with various tumorigenesis. Hence, roles for lncRNAs as drivers of tumor suppressive or oncogenic functions have appeared in many common cancer types. Recent study also shows several lncRNAs, including HOTAIR, HUG1, regulated the proliferation and metastasis of renal cell carcinoma. LncRNAs may facilitate the diagnosis of and prognosis for renal cell carcinoma, which may serve as effective therapeutic targets for renal cell carcinoma intervention. However, the potential functions of these renal cell carcinoma-associated lncRNAs and the related molecular mechanisms remain largely unexplored.

What is the IL7-AS?

IL7-AS [located anti-sense to interleukin-7 (Il7) gene; Accession number: NM_000880.3] is a newly discovered lncRNA that can be induced across multiple human and mouse cell types and has been reported to regulate the expression of interleukin-6 (IL6) [9]. IL6 is emerging as a major regulator of renal cell cancer [10]. However, roles of IL7-AS in renal cell cancer and the related molecular mechanisms remain largely undetermined.

Works Cited

1. Low, Gavin, et al. “Review of Renal Cell Carcinoma and Its Common Subtypes in Radiology.” World Journal of Radiology, vol. 8, no. 5, 28 May 2016, p. 484., doi:10.4329/wjr.v8.i5.484.

2. Shingarev, Roman, and Edgar A. Jaimes. “Renal Cell Carcinoma: New Insights and Challenges for a Clinician Scientist.” American Journal of Physiology-Renal Physiology, vol. 313, no. 2, 1 Aug. 2017, doi:10.1152/ajprenal.00480.2016.

3. Hsieh, James J., et al. “Renal Cell Carcinoma.” Nature Reviews Disease Primers, vol. 3, 2017, p. 17009., doi:10.1038/nrdp.2017.9.

4. Guo, Jun, et al. “Chinese Guidelines on the Management of Renal Cell Carcinoma (2015 Edition).” Chinese Guidelines on the Management of Renal Cell Carcinoma (2015 Edition), 4 Nov. 2015, doi:10.3978/j.issn.2305-5839.2015.11.21.

5. Baumgarten, Deborah A. “Renal Cell Carcinoma Imaging.” Renal Cell Carcinoma Imaging, Edited by Eugene C Lin, 14 Aug. 2015.

6. Wang, Zhen J., et al. “Renal Cyst Pseudoenhancement at Multidetector CT: What Are the Effects of Number of Detectors and Peak Tube Voltage?” Radiology, vol. 248, no. 3, 1 Sept. 2008, pp. 910–916., doi:10.1148/radiol.2482071583.

7. Wu, Yan, et al. “Magnetic Resonance Imaging as a Biomarker for Renal Cell Carcinoma.” Disease Markers, vol. 2015, 30 Sept. 2015, pp. 1–9., doi:10.1155/2015/648495.

8. Doehn, Christian, et al. “The Diagnosis, Treatment, and Follow-up of Renal Cell Carcinoma.” Deutsches Aerzteblatt Online, 2016, doi:10.3238/arztebl.2016.0590.

9. Roux, Benoit T., et al. “Catalog of Differentially Expressed Long Non-Coding RNA Following Activation of Human and Mouse Innate Immune Response.” Frontiers in Immunology, vol. 8, 2017, doi:10.3389/fimmu.2017.01038.

10. Kamińska, Katarzyna, et al. “Interleukin-6 as an Emerging Regulator of Renal Cell Cancer.” Urologic Oncology: Seminars and Original Investigations, vol. 33, no. 11, 18 Aug. 2015, pp. 476–485., doi:10.1016/j.urolonc.2015.07.010.