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GENES.TXT
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1994-03-25
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EVIDENCE FOR A GENE INVOLVED IN THE
ORIGIN OF HUMAN RENAL CELL CARCINOMA*
* Adapted from a presentation by Dr. W. Marston Linehan,
National Cancer Institute
The Malnoti Symposium on Urological Cancer
Northwestern University Medical School
October 4th, 1990.
In the early 1970's Knudson suggested that there may be
a recessive oncogene or tumor suppressor gene associated
with the initiation of some forms of kidney cancer. In
1979, a familial form of renal cell carcinoma was found
to be associated with the relocation of some genetic
material from chromosome 3 to chromosome 8. Later, in
1982, Pathak and coworkers reported a second family with
renal cell carcinoma in which there was a chromosome 3
to chromosome 11 translocation. These two studies
provide evidence that there may be a linkage between a
structural change in chromosome 3 in hereditary as well
as sporadic renal cell carcinoma.
These observations lead to a search for a missing piece
of chromosome 3 in sporadic kidney cancer. Genetic DNA
analysis techniques suggested the presence of a tumor
suppressor gene on chromosome 3 based on tissue from 11
out of 11 patients with renal cell carcinoma.
Subsequent studies performed with tumor tissue from
other kidney cancer patients found missing genes on
chromosome 3 in most patients. Researchers at the
National Cancer Institute recently evaluated tissue from
58 patients with advanced kidney cancer. Abnormalities
on chromosome 3 were found in 51 of the 58 patients, 88
percent. These abnormalities called "loss of hetero-
zygosity" were found in patients with both localized and
advanced disease. When NCI analyzed chromosome 3 for
patients with a "benign" renal tumor, oncocytoma, no
loss of heterozygosity was found.
NCI has also analyzed chromosomes 11, 13, and 17 for
loss of heterozygosity. It found genetic abnormalities
in tissue from some patients with advanced disease;
however, it did not identify any missing DNA in patients
with early stage disease. This finding suggests that
abnormalities on chromosome 11, 13, and 17 may be
associated with disease progression.
These observations raise the possibility that there is a
gene located on chromosome 3 which is involved in kidney
cancer. These observations are further supported by
observations of patients with von Hippel-Lindau (VHL)
disease, a rare hereditary kidney illness. Individuals
who inherit the gene for von Hippel-Lindau disease have
a predisposition to develop a variety of cancers,
including: retinal angiomas, spinal and cerebellar
hemangioblastomas, pheochromocytomas, renal and pancre-
atic cysts, cystadenomas of the epididymis and renal
cell carcinomas.
Patients with VHL often get kidney cancer at an early
age, in both kidneys and with multiple tumors.
Research by Seizinger and his coworkers has shown that
the gene for VHL is located on chromosome 3.
When NCI analyzed renal cell carcinomas from patients
with VHL, all renal cell carcinomas had a loss on
chromosome 3. There was also a pattern of loss on
chromosome 3 in hereditary renal cell carcinoma.
Multiple renal cell tumors in individual patients with
VHL showed the same loss on chromosome 3, indicating
that the same gene was missing in each tumor.
Hereditary renal cell carcinomas examined by NCI for
maternal or paternal origin show losses on chromosome
3. These observations indicate that the loss of a
"balancing" gene may be a prerequisite for the initia-
tion of renal cell carcinoma associated with VHL. More
recent research confirms this linkage.
The NCI's research indicates that there may be at least
one gene located on chromosome 3 which is associated
with renal cell carcinoma and strongly suggests that
the mechanism of the formation of renal cell carcinoma
involves inactivation of both copies of this renal cell
carcinoma gene. Current NCI research is aimed at
identifying this tumor suppressor gene which is
involved in the development of sporadic as well as
familial renal cell carcinoma and to provide further
understanding of the gene's function in order to
develop a more effective means of therapy for kidney
cancer.
The implications of NCI's research are that once kidney
cancer has occurred in a family, the other members of
the family have an above average probability of also
getting kidney cancer because they may share many of
the same genes. All kidney cancer families should be
active in the fight against kidney cancer.