| Abstract
| - BACKGROUND: Organ-confined renal malignancies can be cured in the majority of patients,whereas more extensive lesions have a poor prognosis. We sought to develop a noninvasive testfor renal cancer detection based on a novel molecular approach. METHODS: Matched urine andserum DNA samples were obtained before surgery from 30 patients with clinically organ-confinedsolid renal masses (25 with malignant tumors and five with tumors of low malignant potential) andwere subjected to microsatellite analysis. Serum samples and urine samples obtained from 16individuals without clinical evidence of genitourinary malignancy served as controls. RESULTS:Nineteen (76%) of the 25 patients with malignant tumors were found to have one or moremicrosatellite DNA alterations in their urine specimen, and 15 (60%) were found to havealterations in their serum DNA by microsatellite analysis. In every case, the microsatellite changes in urine or serum were identical to those found in the primary tumor. Three of five patients withtumors of low malignant potential were found to have DNA alterations in their urine, but nonedisplayed alterations in their serum. Moreover, microsatellite alterations were not identified ineither the urine or the serum samples from normal control subjects and patients with hematuriadue to nephrolithiasis (renal stones). CONCLUSION: These data suggest that microsatellite DNAanalysis of urine specimens provides a potentially valuable tool for the early detection ofresectable kidney cancer. Furthermore, microsatellite analysis of serum samples reveals evidenceof circulating tumor-specific DNA in approximately half of these patients and may reflect thepropensity of these tumors to spread to distant sites at an early stage.
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