Renin production by juxtaglomerular cell tumors and clear cell renal cell carcinoma and the role of angiotensin signaling inhibitors Journal Article
| Authors: | Gupta, S.; Nichols, P.; Lohse, C. M.; Kosari, F.; Kattah, A. G.; Harris, F. R.; Karagouga, G.; Mehra, R.; Fine, S. W.; Reuter, V. E.; Herrera-Hernandez, L.; Zganjar, A. J.; Britton, C. J.; Potretzke, A. M.; Boorjian, S. A.; Thompson, R. H.; Jimenez, R. E.; Leibovich, B. C.; Garovic, V. D.; Cheville, J. C.; Sharma, V. |
| Article Title: | Renin production by juxtaglomerular cell tumors and clear cell renal cell carcinoma and the role of angiotensin signaling inhibitors |
| 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. © 2022 Mayo Foundation for Medical Education and Research |
| Keywords: | signal transduction; adolescent; adult; cancer survival; clinical article; human tissue; protein expression; treatment outcome; aged; middle aged; young adult; gene deletion; clinical feature; hypertension; antineoplastic agents; antineoplastic agent; progression free survival; gene amplification; gene expression; prevalence; pathology; renal cell carcinoma; kidney neoplasms; partial nephrectomy; radical nephrectomy; kidney tumor; carcinoma, renal cell; hazard ratio; trend study; clear cell renal cell carcinoma; renin; very elderly; humans; human; male; female; article; rna sequencing; angiotensin; angiotensins; angiotensin derivative; juxtaglomerular cell tumor; ren gene |
| Journal Title: | Mayo Clinic Proceedings |
| Volume: | 97 |
| Issue: | 11 |
| ISSN: | 0025-6196 |
| Publisher: | Mayo Clinic Proceedings |
| Date Published: | 2022-11-01 |
| Start Page: | 2050 |
| End Page: | 2064 |
| Language: | English |
| DOI: | 10.1016/j.mayocp.2022.03.034 |
| PUBMED: | 35753824 |
| PROVIDER: | scopus |
| PMCID: | PMC10225974 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 December 2022 -- Source: Scopus |
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