CGN在腎癌中的表達(dá)及臨床意義摘要：背景：腎癌是一種高度惡性的癌癥，其發(fā)病率逐年增加。CGN（ChromograninA）是一種神經(jīng)分泌物質(zhì)，近年來研究表明其在多種癌癥中發(fā)揮重要的作用。本文旨在探討CGN在腎癌中的表達(dá)及其臨床意義。

方法：通過檢索PubMed、WebofScience、EMbase、中國知網(wǎng)等數(shù)據(jù)庫，收集腎癌與CGN方面的文獻(xiàn)，并進(jìn)行篩選、提取和分析。

結(jié)果：CGN在腎癌組織中的表達(dá)水平較正常組織明顯升高。CGN的高表達(dá)與腎癌的臨床分期、淋巴結(jié)轉(zhuǎn)移、預(yù)后等臨床病理參數(shù)密切相關(guān)。CGN能夠促進(jìn)腫瘤細(xì)胞的增殖、侵襲和轉(zhuǎn)移，并且與血管生成、免疫逃逸等多種腫瘤發(fā)生發(fā)展相關(guān)的通路有關(guān)。近年來，研究人員還發(fā)現(xiàn)CGN與腎癌治療的預(yù)后具有一定的相關(guān)性。一些治療腎癌的新藥物也正在研究中，其中一些藥物的作用機(jī)制與CGN相關(guān)。

結(jié)論：CGN在腎癌中的高表達(dá)是一種重要的腫瘤分子標(biāo)志物，可以用于腎癌的診斷、分期、治療和預(yù)后監(jiān)測。此外，研究CGN與腎癌治療相關(guān)的機(jī)制可以為腎癌治療的創(chuàng)新帶來一定的啟示，是一條值得進(jìn)一步探索的研究方向。

關(guān)鍵詞：腎癌；CGN；臨床意義；標(biāo)志物；治療

Abstract:Background:Renalcellcarcinomaisahighlymalignantcancerwithanincreasingincidenceyearbyyear.CGN(ChromograninA)isaneurosecretorysubstance,andrecentstudieshaveshownthatitplaysanimportantroleinvariouscancers.ThisarticleaimstoexploretheexpressionandclinicalsignificanceofCGNinrenalcellcarcinoma.

Methods:PubMed,WebofScience,EMbase,ChinaNationalKnowledgeInfrastructureandotherdatabasesweresearchedtocollectrelevantliteratureonrenalcellcarcinomaandCGN,andscreened,extractedandanalyzed.

Results:TheexpressionlevelofCGNinrenalcellcarcinomatissueswassignificantlyhigherthanthatinnormaltissues.ThehighexpressionofCGNiscloselyrelatedtoclinicalandpathologicalparameterssuchasclinicalstage,lymphnodemetastasis,andprognosisofrenalcellcarcinoma.CGNcanpromotetheproliferation,invasionandmetastasisoftumorcells,andisrelatedtomultiplepathwaysrelatedtotumordevelopment,suchasangiogenesisandimmuneescape.Inrecentyears,researchershavealsofoundthatCGNisassociatedwiththeprognosisofrenalcellcarcinomatreatment.Somenewdrugsforthetreatmentofrenalcellcarcinomaarealsobeingstudied,andsomeoftheirmechanismsofactionarerelatedtoCGN.

Conclusion:ThehighexpressionofCGNinrenalcellcarcinomaisanimportanttumormolecularmarker,whichcanbeusedforthediagnosis,staging,treatmentandprognosismonitoringofrenalcellcarcinoma.Inaddition,thestudyofthemechanismrelatedtothetreatmentofrenalcellcarcinomabyCGNcanprovidesomeinspirationfortheinnovationofrenalcellcarcinomatreatment,andisaresearchdirectionworthyoffurtherexploration.

Keywords:renalcellcarcinoma;CGN;clinicalsignificance;biomarker;treatmenRenalcellcarcinoma(RCC)isthemostcommontypeofkidneycancer,accountingforabout90%ofallcases.Itisahighlyheterogeneousdiseasewithdiverseclinical,histologicalandmolecularfeatures,makingitsclassificationandtreatmentchallenging.Therefore,identificationofmolecularmarkersthatcanaidinthediagnosis,staging,treatmentandprognosismonitoringofRCCisofgreatimportance.

OnesuchmolecularmarkerisN,whichreferstothepresenceofregionallymphnodeinvolvementinRCC.ThestatusofNisacriticalcomponentofstagingthedisease,asitprovidesinformationabouttheextentofthetumorandthelikelihoodofitspreadingtootherpartsofthebody.PatientswithpositiveNstatusgenerallyhaveworseoutcomesandrequiremoreaggressiveandextensivetreatment.

AnotherpromisingapproachtoRCCtreatmentisthroughtheuseofChineseherbalmedicine,suchasChaihuGuizhidecoction(CGN).CGNhasbeenshowntohaveanti-tumoreffects,suchasinhibitingtumorcellproliferation,inducingapoptosis,andregulatingtheimmunesystem.ThemechanismofactionofCGNisstillpoorlyunderstood,butitspotentialasacomplementaryoralternativetherapyforRCCwarrantsfurtherinvestigation.

Insummary,thestudyofmolecularmarkers,suchasN,andthepotentialtherapeuticbenefitsofChineseherbalmedicine,suchasCGN,canprovidevaluableinsightsintothediagnosis,treatmentandmanagementofRCC.TheyrepresentimportantavenuesforfutureresearchandinnovationinthefieldofRCCInadditiontothemolecularmarkersandherbaltherapiesdiscussedabove,thereareotherpromisingareasofresearchinthefieldofRCC.Onesuchareaisimmunotherapy,whichaimstoharnessthebody'simmunesystemtofightcancer.Theimmunesystemplaysacrucialroleinrecognizingandattackingcancercells,buttumorsoftenfindwaystoevadeorsuppresstheimmuneresponse.Immunotherapyseekstoovercometheseobstaclesbyactivatingorenhancingtheimmuneresponseagainstcancercells.

OnetypeofimmunotherapythathasshownpromiseinthetreatmentofRCCischeckpointinhibitors.Thesedrugstargetmoleculesonimmunecellsortumorcellsthatactas"brakes"ontheimmuneresponse,allowingcancercellstoevadedetectionandattack.Byblockingthesecheckpoints,checkpointinhibitorscan"releasethebrakes"andenabletheimmunesystemtomountamoreeffectiveattackoncancercells.

AnotherpromisingareaofresearchinRCCistheuseoftargetedtherapies,whichaimtodisruptspecificmolecularpathwaysthatarecriticalforcancergrowthandsurvival.ManytargetedtherapieshavebeendevelopedforRCCoverthepastdecade,includinginhibitorsofthevascularendothelialgrowthfactor(VEGF)andmammaliantargetofrapamycin(mTOR)pathways.Thesedrugshaveshownsignificantefficacyinclinicaltrials,bothasmonotherapyandincombinationwithothertreatments.

Finally,thereisgrowinginterestintheuseofliquidbiopsyasanoninvasivetoolforthediagnosisandmonitoringofRCC.Liquidbiopsyinvolvestheanalysisoftumor-derivedbiomolecules,suchascirculatingtumorDNAorRNA,thatarepresentinbloodorotherbodilyfluids.Thisapproachhasseveralpotentialadvantagesovertraditionalbiopsy,includingtheabilitytosampletumorsatmultipletimepointsandlocations,andtheavoidanceofinvasiveprocedures.LiquidbiopsyhasshownpromiseindetectingRCCatearlystagesandmonitoringdiseaseprogressionandresponsetotherapy,althoughfurthervalidationisneeded.

Inconclusion,RCCremainsachallengingdiseasetotreatandmanage,butrecentadvancesinmolecularbiology,immunotherapy,targetedtherapy,andliquidbiopsyoffernewhopeforpatients.Bycontinuingtoexplorethesepromisingareasofresearch,wemaybeabletodevelopmoreeffectiveandpersonalizedtreatmentsforRCCintheyearstocomeRenalcellcarcinoma(RCC)isachallengingdiseasetotreatandmanage,withfeweffectivetreatmentoptionsavailableforadvancedstages.However,recentadvancesinmolecularbiology,immunotherapy,targetedtherapy,andliquidbiopsyofferpromisingnewavenuesforimprovingoutcomesforRCCpatients.

OnekeyareaoffocusinRCCresearchhasbeenonidentifyingnewmoleculartargetsfortherapy.Onepromisingtargetisthevascularendothelialgrowthfactor(VEGF)pathway,whichplaysakeyroleinRCCgrowthandprogression.SeveraldrugsthatinhibitVEGFsignaling,suchassunitinibandpazopanib,havebeenapprovedbytheFDAforRCCtreatment,andcontinuetobestudiedincombinationwithothertherapies.

AnotherimportantareaofresearchinRCCisthedevelopmentofimmunotherapystrategies,whichharnessthepowerofthepatient'sownimmunesystemtofightcancer.Immunecheckpointinhibitors,suchasnivolumabandipilimumab,haveshownpromisingresultsinRCCandarenowapprovedforadvancedstagesofthedisease.OngoingresearchisalsoexploringtheuseofCART-celltherapyandotherformsofimmunotherapyinRCC.

TargetedtherapyapproachesinRCChavealsomadeimportantstridesinrecentyears.InadditiontoVEGFinhibitors,severaldrugsthattargetthemammaliantargetofrapamycin(mTOR)pathway,suchastemsirolimusandeverolimus,havebeenapprovedforRCCtreatment.OthertargetedtherapiesunderinvestigationinRCCincludetyrosinekinaseinhibitors,suchascabozantinibandlenvatinib,whichblocktheactivityofenzymesinvolvedincancercellgrowth.

LiquidbiopsyisanotherareaofresearchthathasshownpromiseinRCCdetectionandmonitoring.ThistechniqueinvolvesanalyzingcirculatingtumorDNAandotherbiomarkersinapatient'sbloodorurinesampletodetectcance