From the Guidelines
There is no specific tumor marker that is routinely used for the diagnosis or monitoring of renal cancer. Unlike some other cancers that have reliable blood tests (such as PSA for prostate cancer or AFP for liver cancer), renal cell carcinoma lacks a single sensitive and specific biomarker for clinical use 1. Some markers that have been studied include CA-125, CA-15-3, and CA-19-9, but these lack sufficient sensitivity and specificity for renal cancer detection. Researchers have investigated potential markers such as carbonic anhydrase IX (CAIX), hypoxia-inducible factors (HIFs), and various urinary proteins, but none have been validated for standard clinical practice 1. Currently, diagnosis of renal cancer relies primarily on imaging studies (CT scans, MRI, or ultrasound) followed by histological examination of tissue samples. Blood tests may be used to assess overall kidney function and health status but not specifically to detect renal cancer. This lack of a reliable biomarker makes early detection challenging, which is why many renal cancers are discovered incidentally during imaging performed for other reasons.
Some key points to consider:
- The most recent guidelines from the National Comprehensive Cancer Network (NCCN) do not recommend the use of any specific tumor marker for the diagnosis or monitoring of renal cancer 1.
- The European Society for Medical Oncology (ESMO) also notes that there is no established tumor marker for renal cell carcinoma, and diagnosis relies on imaging and histological examination 1.
- Researchers are actively investigating potential biomarkers, including PD-L1 expression, gene expression signatures, and tumor mutation burden, but these have not yet been validated for clinical use 1.
- The lack of a reliable biomarker highlights the importance of imaging studies and histological examination in the diagnosis and monitoring of renal cancer.
In terms of potential future developments, researchers are exploring various biomarkers and molecular concepts, including the use of circulating DNA, microRNA, and DNA methylation status, which may have prognostic relevance in renal cell carcinoma 1. However, further studies are needed to validate these findings and determine their clinical utility.
From the Research
Renal Cancer Tumor Markers
- There are no specific tumor markers available for the diagnosis, prognostic, or predictive purposes of renal cell carcinoma (RCC) 2.
- Molecular profiling is an emerging tool for new biomarker identification in RCC, which can provide a better understanding of the pathogenesis of RCC and pave the way towards new targeted therapy discovery 2.
- Some markers, such as Ki67, p53, gelsolin, carbonic anhydrase (CA)9, CA12, PTEN, epithelial cell adhesion molecule, and vimentin, have been identified as potential predictors of survival in patients with metastatic RCC 3.
- A combined molecular and clinical prognostic model that includes markers such as CA9, PTEN, vimentin, p53, T category, and performance status can be used to predict disease-specific survival in patients with clear cell RCC 3.
- Molecular tumor markers can be used to aid in the differential diagnosis of RCC, monitor disease progression and recurrence, and provide prognostic information 4.
- Genetic changes detected by molecular and cytogenetic methods can provide markers specific for RCC, and high-throughput DNA and tissue microarray techniques can be used to discover and validate novel molecular markers 4.