AI Article Synopsis

  • The study aims to profile juxtaglomerular cell tumors (JXG) and their histologic mimics by examining renin expression and non-JXG tumors from TCGA data.
  • Thirteen JXGs and 10 glomus tumors were assessed for clinicopathological features, while additional analysis revealed a significant link between renin production and hypertension (HTN) in JXG.
  • Results showed a 64% prevalence of HTN among nonmetastatic clear cell renal cell carcinoma (CC-RCC) patients, with those treated with angiotensin signaling inhibitors (ASI) experiencing better progression-free survival compared to untreated patients with HTN.

Article Abstract

Objective: To profile juxtaglomerular cell tumors (JXG) and histologic mimics by analyzing renin expression; to identify non-JXG renin-producing tumors in The Cancer Genome Atlas (TCGA) data sets; and to define the prevalence of hypertension (HTN) and patient outcomes with angiotensin signaling inhibitor (ASI) use in tumors of interest.

Patients And Methods: Thirteen JXGs and 10 glomus tumors (GTs), a histologic mimic, were evaluated for clinicopathologic features; TCGA data were analyzed to identify non-JXG renin-overexpressing tumors. An institutional registry was queried to determine the incidence of HTN, the use of ASIs in hypertensive patients, and the impact of ASIs on outcomes including progression-free survival (PFS) in a tumor type with high renin expression (clear cell renal cell carcinoma [CC-RCC] diagnosed between January 1, 2005, and December 31, 2012).

Results: We found an association between renin production and HTN in JXG compared with GT. Analysis of TCGA data found that a subset of CC-RCCs overexpress renin relative to 29 other tumor types. Furthermore, analysis of our institutional registry revealed a high prevalence (64%) of HTN among 1203 patients treated with radical or partial nephrectomy for nonmetastatic CC-RCC. On multivariable Cox regression, patients with HTN treated with ASIs (34%) had improved PFS (hazard ratio, 0.76; 95% CI, 0.57 to 1.00; P=.05) compared with patients with HTN not treated with ASIs (30%).

Conclusion: The identification of renin expression in a subset of CC-RCC may provide a biologic rationale for the high prevalence of HTN and improved PFS with ASI use in hypertensive patients with nonmetastatic CC-RCC.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10225974PMC
http://dx.doi.org/10.1016/j.mayocp.2022.03.034DOI Listing

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