Extracellular matrix metalloproteinases in pathophysiology, diagnostics and treatment of renal cell carcinoma - current state of knowledge and future perspectives.

Abstract

Introduction and objective: Despite a significant improvement in the diagnosis and treatment of renal cell carcinoma over the past two decades, this cancer still remains one of the most lethal urological neoplasms.

Review methods: Databases were searched using the keywords: 'RCC', 'MMP', 'TIMP', 'signaling pathway', and 'pathophysiological'. The titles of these entries were analyzed to assess complementarity, obtaining 721 entries. Relevance was then assessed by analyzing the abstracts, and 387 entries were selected. Based on criteria such as number of citations, research methods, sample size and representativeness, 248 references were finally selected. Finally, 181 items were included in the literature.

Brief description of the state of knowledge: Extracellular matrix metalloproteinases plays an important role in the remodeling of the extracellular matrix. They participate in the initiation and regulation of inflammatory and carcinogenic processes.

Summary: The analysis of available literature shows that, from a biochemical point of view, the most important influence on the development of renal cell carcinoma and the formation of metastases is the imbalance between the activity of metalloproteinases and the concentration of their tissue inhibitors. Hope for the future lies in monoclonal antibodies used to selectively block individual metalloproteinases, which may be of particula importance in highly vascularized tumours, which undoubtedly include renal cell carcinoma. Additionally, assessment of metalloproteinases activity could assist in selecting patients for surgical treatment or active surveillance.