Indexed and abstracted in Science Citation Index Expanded and in Journal Citation Reports /Science Edition Bratisl Med J 2022; 123 (10) 697 – 704 DOI: 10.4149/BLL_2022_111 REVIEW Renal cell carcinoma – summarising overview, biomarkers, metastases and new perspectives DOVALOVA Daniela 1 , RYBAR Lubos 2 , EL FALOUGHY Hisham 1 , KUBIKOVA Eliska 1 , MIFKOVIC Andrej 1 Institute of Anatomy, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia. mifkovic@gmail.com ABSTRACT Kidney carcinoma is currently the tenth most diagnosed tumour in women and the sixth in men. It makes up about 4 % of all malignant tumours. In urology, it is the third most common malignant disease. It is most often diagnosed between the ages of 40 and 60, and its incidence is still rising. Risk factors include positive family history, high blood pressure, obesity, and smoking. In examining the samples of cancer tissues, histopathological examination methods were used, including biomarkers such as LRRC3B, TCF21, or cadherins and other markers. The use of imaging methods such as computer tomography and sonography improved the detection ability of an asymptomatic kidney tumour. Due to the expansion of diagnostic methods and the introduction of new techniques in surgical treatment, the paradigm in the surgical treatment of this disease has changed in recent years. In the case of a detailed study of the intracellular structures in the carcinogenic processes, more profound knowledge about them can eliminate the need for surgical resection in the future (Tab. 7, Fig. 2, Ref. 48). Text in PDF www.elis.sk KEYWORDS: kidney carcinoma, RCC, biomarkers, diagnostics, surgical treatment. 1 Institute of Anatomy, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia, and 2 Urology Department, St. Cyril and Methodius Hospital, University Hospital, Bratislava, Slovakia. Address for correspondence: Daniela DOVALOVA, MD, Institute of Anatomy, Faculty of Medicine, Comenius University in Bratislava, Spi- talska 24, SK-813 72 Bratislava, Slovakia Introduction Renal cell carcinoma (RCC) is currently the tenth most diag- nosed tumour in women and the sixth most common in men. The tumour incidence is constantly rising, mainly due to the diagno- sis of alleged tumours found during examinations of other or- gans (1) (Fig. 1). The rapid increase in the disease is observed in women in general as well as in the African and African – Ameri- can population (2, 3). A high incidence was recorded in Central Europe, North America, and Australia. On the other hand, a low prevalence was observed mainly in Asia and Africa (4). The val- ues recorded in developing countries may be skewed due to the low accessibility and the level of health care in those countries. Kidney cancer can be clinically manifested by haematuria, weight loss, or palpable pain. We can also see anaemia, fever, cachexia, and hypercalcaemia (5). The classification system, called Clas- sification of Malignant Tumours (TNM), is used in scientific and clinical practice. At present, anatomical classification systems are often used to describe kidney cancer. These systems do not de- scribe only the size of the tumour but also its excessive growth, the relationship of the tumour to the renal pelvis–calyx system, or the vascular supply of the kidney. PADUA system or the ABC scoring system is the most used classification system. It is used when the decision needs to be made for the type of surgical pro- cedure – radical nephrectomy vs partial nephrectomy (6, 7). Table 1 shows the classification from 2017 (8), and Table 2 shows the clinical classification system (8). Anatomical factors (tumour size, venous invasion, renal cap- sular invasion, adrenal involvement, and lymph node and distant metastasis) are commonly gathered in the universally used TNM classification system. Figure 2 presents pathological changes in some of the T stages of renal cancer. Incidence In 2020, the estimated global number of newly diagnosed cases was 431 288. The world-standardised incidence rate (ASR-W) of kidney cancer was 4.6 per 100,000 in the population (6.1 per 100,000 males and 3.2 per 100,000 females). Cancer of the kid- ney accounted for 4.2% of all malignant tumours diagnosed in the Slovak Republic in men and 2.7% in women in 2010, placing them seventh (men) and eighth (women) in the ranking of malignant tumours in the country (except for non-melanoma skin tumours) (9). The incidence of kidney cancer varies considerably accord- ing to the geographical area. Three regions with the highest inci- dence of kidney cancer globally were Central and Northern Europe (Scandinavia), North America, and Australia. The number of new cancer cases in 2020 is provided in Table 3 (10).