ABSTRACT
ABSTRACT Among the adult population, renal cell carcinoma (RCC) continues to be the most prevalent form of kidney cancer with over 200,000 cases diagnosed worldwide each year. Unfortunately, RCC is a relatively asymptomatic disease, and many tumors are found incidentally upon workup for other unrelated diseases. By the time symptoms develop, many renal tumors are advanced past the stage of curability. Approximately 30% of patients will present with metastatic disease. With numerous recent advances in targeted therapies for RCC, extensive research has focused on the prognostic utility of serum and urinary biomarkers, as well as tissue-staining biomarkers from pathologic specimens. Historically, prognostic information has been obtained from clinicopathologic features, but as the molecular basis of RCC has been elucidated, many studies have focused on the discovery of reliable serum and urinary biomarkers that could have a substantial impact on diagnosis, prognosis, as well as prediction of therapeutic benet of various treatment options. Initially, most biomarker research focused on the products of the von Hippel-Lindau (VHL) pathway, such as VHL mutations, vascular endothelial growth factor, hypoxia-inducible factor, and carbonic anhydrase IX. More recently, other serum biomarkers of the systemic inammatory response have been investigated, including C-reactive protein and the erythrocyte sedimentation rate. Previous investigations that used tissue-based expression assays have shown
20.1 Introduction .................................................................................................................................. 468 20.2 Renal Cell Carcinoma .................................................................................................................. 468
20.2.1 Clear Cell RCC ................................................................................................................ 468 20.2.2 Papillary RCC .................................................................................................................. 469 20.2.3 Chromophobe RCC ......................................................................................................... 469 20.2.4 Other Subtypes of RCC ....................................................................................................471
