Complexity of tumor vasculature in clear cell renal cell carcinoma

Authors

  • Chao-Nan Qian MD, PhD,

    Corresponding author
    1. The State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
    2. Laboratory of Cancer Genetics, Van Andel Research Institute, Grand Rapids, Michigan
    3. NCCS-VARI Translational Research Laboratory, National Cancer Center, Singapore
    • The State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, P.R. China
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    • Fax: (011) 86-20-87343624

  • Dan Huang PhD,

    1. Laboratory of Cancer Genetics, Van Andel Research Institute, Grand Rapids, Michigan
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  • Bill Wondergem BS,

    1. Laboratory of Cancer Genetics, Van Andel Research Institute, Grand Rapids, Michigan
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  • Bin Tean Teh MD, PhD

    Corresponding author
    1. Laboratory of Cancer Genetics, Van Andel Research Institute, Grand Rapids, Michigan
    2. NCCS-VARI Translational Research Laboratory, National Cancer Center, Singapore
    • The Laboratory of Cancer Genetics, Van Andel Research Institute, 333 Bostwick Ave. NE, Grand Rapids, MI 49503
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    • Fax: (616) 234-5297


  • This educational proceedings publication is based on a symposium held on June 27-28, 2008, in Cambridge, Massachusetts.

Abstract

Clear cell renal cell carcinoma (CCRCC) is a highly vascularized cancer resistant to conventional chemotherapy and radiotherapy. Antiangiogenic therapy has achieved some effectiveness against this unique malignancy. The complexity of the tumor vasculature in CCRCC has led to differences in correlating tumor microvessel density with patient prognosis. The authors' recent findings demonstrated that there were at least 2 major categories of tumor vessels in CCRCC—namely, undifferentiated and differentiated—correlating with patient prognosis in contrasting ways, with higher undifferentiated vessel density indicating poorer prognosis, and higher differentiated vessel density correlating with better prognosis. Furthermore, the presence of pericytes supporting the differentiated vessels varied in CCRCC. The distributions of pericyte coverage and differentiated vessels in CCRCC were uneven. The tumor margin had a higher pericyte coverage rate for differentiated vessels than did the inner tumor area. The uneven distributions of pericyte coverage and differentiated vessels in CCRCC prompted the authors to revisit the mechanism of tumor central necrosis, which was also known to be a prognostic indicator for CCRCC. The discrepancy of prognostic correlation between protein and messenger RNA levels of vascular endothelial growth factor in CCRCC was discussed. The complexity of the tumor vasculature in CCRCC also led the authors to begin to re‒evaluate the therapeutic effects of antiangiogenic agents for each type of tumor vessel, which will in turn significantly broaden understanding of tumor angiogenesis and improve therapeutic effect. Cancer 2009;115(10 suppl):2282-9. © 2009 American Cancer Society.

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