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Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 2000 May;37(5):348–353. doi: 10.1136/jmg.37.5.348

Familial clear cell renal cell carcinoma (FCRC): clinical features and mutation analysis of the VHL, MET, and CUL2 candidate genes

E Woodward 1, S Clifford 1, D Astuti 1, N Affara 1, E Maher 1
PMCID: PMC1734586  PMID: 10807693

Abstract

Familial renal cell carcinoma (RCC) is genetically heterogeneous. Genetic predisposition to clear cell RCC (CCRCC) is a major feature of von Hippel-Lindau (VHL) disease (MIM 193300) and has rarely been associated with chromosome 3 translocations. In addition, familial papillary (non-clear cell) RCC may result from germline mutations in the MET proto-oncogene (MIM 164860). However, rare kindreds with familial CCRCC (FCRC) not linked to the VHL tumour suppressor gene have been described suggesting that further familial RCC susceptibility genes exist. To investigate the genetic epidemiology of FCRC, we undertook a clinical and molecular study of FCRC in nine kindreds with two or more cases of CCRCC in first degree relatives. FCRC was characterised by an earlier age at onset (mean 47.1 years, 52% of cases <50 years of age) than sporadic cases. These findings differ from the only previous report of two FCRC kindreds and have important implications for renal surveillance in FCRC. The molecular basis of CCRCC susceptibility was investigated in nine FCRC kindreds and seven isolated cases with features of possible genetic susceptibility to CCRCC (four bilateral CCRCC aged <50 years and three with unilateral CCRCC aged <30 years). No germline mutations were detected in the VHL or MET genes, suggesting that FCRC is not allelic with VHL disease or HPRC. As binding of the VHL gene product to the CUL2 protein is important for pVHL function, we then searched for germline CUL2 mutations. Although CUL2 polymorphisms were identified, no pathogenic mutations were detected. These findings further define the clinical features of FCRC and exclude a major role for mutations in VHL, MET, or CUL2 in this disorder.


Keywords: familial clear cell renal carcinoma; VHL; MET; CUL2

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Selected References

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  1. Bodmer D., Eleveld M. J., Ligtenberg M. J., Weterman M. A., Janssen B. A., Smeets D. F., de Wit P. E., van den Berg A., van den Berg E., Koolen M. I. An alternative route for multistep tumorigenesis in a novel case of hereditary renal cell cancer and a t(2;3)(q35;q21) chromosome translocation. Am J Hum Genet. 1998 Jun;62(6):1475–1483. doi: 10.1086/301888. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brauch H., Kishida T., Glavac D., Chen F., Pausch F., Höfler H., Latif F., Lerman M. I., Zbar B., Neumann H. P. Von Hippel-Lindau (VHL) disease with pheochromocytoma in the Black Forest region of Germany: evidence for a founder effect. Hum Genet. 1995 May;95(5):551–556. doi: 10.1007/BF00223868. [DOI] [PubMed] [Google Scholar]
  3. Bugert P., Wilhelm M., Kovacs G. FHIT gene and the FRA3B region are not involved in the genetics of renal cell carcinomas. Genes Chromosomes Cancer. 1997 Sep;20(1):9–15. [PubMed] [Google Scholar]
  4. Chen F., Slife L., Kishida T., Mulvihill J., Tisherman S. E., Zbar B. Genotype-phenotype correlation in von Hippel-Lindau disease: identification of a mutation associated with VHL type 2A. J Med Genet. 1996 Aug;33(8):716–717. doi: 10.1136/jmg.33.8.716. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Clifford S. C., Prowse A. H., Affara N. A., Buys C. H., Maher E. R. Inactivation of the von Hippel-Lindau (VHL) tumour suppressor gene and allelic losses at chromosome arm 3p in primary renal cell carcinoma: evidence for a VHL-independent pathway in clear cell renal tumourigenesis. Genes Chromosomes Cancer. 1998 Jul;22(3):200–209. doi: 10.1002/(sici)1098-2264(199807)22:3<200::aid-gcc5>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
  6. Cohen A. J., Li F. P., Berg S., Marchetto D. J., Tsai S., Jacobs S. C., Brown R. S. Hereditary renal-cell carcinoma associated with a chromosomal translocation. N Engl J Med. 1979 Sep 13;301(11):592–595. doi: 10.1056/NEJM197909133011107. [DOI] [PubMed] [Google Scholar]
  7. Crossey P. A., Eng C., Ginalska-Malinowska M., Lennard T. W., Wheeler D. C., Ponder B. A., Maher E. R. Molecular genetic diagnosis of von Hippel-Lindau disease in familial phaeochromocytoma. J Med Genet. 1995 Nov;32(11):885–886. doi: 10.1136/jmg.32.11.885. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Foster K., Prowse A., van den Berg A., Fleming S., Hulsbeek M. M., Crossey P. A., Richards F. M., Cairns P., Affara N. A., Ferguson-Smith M. A. Somatic mutations of the von Hippel-Lindau disease tumour suppressor gene in non-familial clear cell renal carcinoma. Hum Mol Genet. 1994 Dec;3(12):2169–2173. doi: 10.1093/hmg/3.12.2169. [DOI] [PubMed] [Google Scholar]
  9. Gemmill R. M., West J. D., Boldog F., Tanaka N., Robinson L. J., Smith D. I., Li F., Drabkin H. A. The hereditary renal cell carcinoma 3;8 translocation fuses FHIT to a patched-related gene, TRC8. Proc Natl Acad Sci U S A. 1998 Aug 4;95(16):9572–9577. doi: 10.1073/pnas.95.16.9572. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Gnarra J. R., Tory K., Weng Y., Schmidt L., Wei M. H., Li H., Latif F., Liu S., Chen F., Duh F. M. Mutations of the VHL tumour suppressor gene in renal carcinoma. Nat Genet. 1994 May;7(1):85–90. doi: 10.1038/ng0594-85. [DOI] [PubMed] [Google Scholar]
  11. Kamura T., Koepp D. M., Conrad M. N., Skowyra D., Moreland R. J., Iliopoulos O., Lane W. S., Kaelin W. G., Jr, Elledge S. J., Conaway R. C. Rbx1, a component of the VHL tumor suppressor complex and SCF ubiquitin ligase. Science. 1999 Apr 23;284(5414):657–661. doi: 10.1126/science.284.5414.657. [DOI] [PubMed] [Google Scholar]
  12. Kinzler K. W., Vogelstein B. Lessons from hereditary colorectal cancer. Cell. 1996 Oct 18;87(2):159–170. doi: 10.1016/s0092-8674(00)81333-1. [DOI] [PubMed] [Google Scholar]
  13. Kok K., Naylor S. L., Buys C. H. Deletions of the short arm of chromosome 3 in solid tumors and the search for suppressor genes. Adv Cancer Res. 1997;71:27–92. doi: 10.1016/s0065-230x(08)60096-2. [DOI] [PubMed] [Google Scholar]
  14. Kovacs G., Brusa P., De Riese W. Tissue-specific expression of a constitutional 3;6 translocation: development of multiple bilateral renal-cell carcinomas. Int J Cancer. 1989 Mar 15;43(3):422–427. doi: 10.1002/ijc.2910430313. [DOI] [PubMed] [Google Scholar]
  15. Latif F., Tory K., Gnarra J., Yao M., Duh F. M., Orcutt M. L., Stackhouse T., Kuzmin I., Modi W., Geil L. Identification of the von Hippel-Lindau disease tumor suppressor gene. Science. 1993 May 28;260(5112):1317–1320. doi: 10.1126/science.8493574. [DOI] [PubMed] [Google Scholar]
  16. Li F. P., Decker H. J., Zbar B., Stanton V. P., Jr, Kovacs G., Seizinger B. R., Aburatani H., Sandberg A. A., Berg S., Hosoe S. Clinical and genetic studies of renal cell carcinomas in a family with a constitutional chromosome 3;8 translocation. Genetics of familial renal carcinoma. Ann Intern Med. 1993 Jan 15;118(2):106–111. doi: 10.7326/0003-4819-118-2-199301150-00005. [DOI] [PubMed] [Google Scholar]
  17. Lonergan K. M., Iliopoulos O., Ohh M., Kamura T., Conaway R. C., Conaway J. W., Kaelin W. G., Jr Regulation of hypoxia-inducible mRNAs by the von Hippel-Lindau tumor suppressor protein requires binding to complexes containing elongins B/C and Cul2. Mol Cell Biol. 1998 Feb;18(2):732–741. doi: 10.1128/mcb.18.2.732. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Lott S. T., Lovell M., Naylor S. L., Killary A. M. Physical and functional mapping of a tumor suppressor locus for renal cell carcinoma within chromosome 3p12. Cancer Res. 1998 Aug 15;58(16):3533–3537. [PubMed] [Google Scholar]
  19. Maher E. R. Inherited renal cell carcinoma. Br J Urol. 1996 Oct;78(4):542–545. doi: 10.1046/j.1464-410x.1996.01749.x. [DOI] [PubMed] [Google Scholar]
  20. Maher E. R., Kaelin W. G., Jr von Hippel-Lindau disease. Medicine (Baltimore) 1997 Nov;76(6):381–391. doi: 10.1097/00005792-199711000-00001. [DOI] [PubMed] [Google Scholar]
  21. Maher E. R., Webster A. R., Richards F. M., Green J. S., Crossey P. A., Payne S. J., Moore A. T. Phenotypic expression in von Hippel-Lindau disease: correlations with germline VHL gene mutations. J Med Genet. 1996 Apr;33(4):328–332. doi: 10.1136/jmg.33.4.328. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Maher E. R., Yates J. R. Familial renal cell carcinoma: clinical and molecular genetic aspects. Br J Cancer. 1991 Feb;63(2):176–179. doi: 10.1038/bjc.1991.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Maher E. R., Yates J. R., Ferguson-Smith M. A. Statistical analysis of the two stage mutation model in von Hippel-Lindau disease, and in sporadic cerebellar haemangioblastoma and renal cell carcinoma. J Med Genet. 1990 May;27(5):311–314. doi: 10.1136/jmg.27.5.311. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Maher E. R., Yates J. R., Harries R., Benjamin C., Harris R., Moore A. T., Ferguson-Smith M. A. Clinical features and natural history of von Hippel-Lindau disease. Q J Med. 1990 Nov;77(283):1151–1163. doi: 10.1093/qjmed/77.2.1151. [DOI] [PubMed] [Google Scholar]
  25. Maxwell P. H., Wiesener M. S., Chang G. W., Clifford S. C., Vaux E. C., Cockman M. E., Wykoff C. C., Pugh C. W., Maher E. R., Ratcliffe P. J. The tumour suppressor protein VHL targets hypoxia-inducible factors for oxygen-dependent proteolysis. Nature. 1999 May 20;399(6733):271–275. doi: 10.1038/20459. [DOI] [PubMed] [Google Scholar]
  26. Neumann H. P., Eng C., Mulligan L. M., Glavac D., Zäuner I., Ponder B. A., Crossey P. A., Maher E. R., Brauch H. Consequences of direct genetic testing for germline mutations in the clinical management of families with multiple endocrine neoplasia, type II. JAMA. 1995 Oct 11;274(14):1149–1151. [PubMed] [Google Scholar]
  27. Ohta M., Inoue H., Cotticelli M. G., Kastury K., Baffa R., Palazzo J., Siprashvili Z., Mori M., McCue P., Druck T. The FHIT gene, spanning the chromosome 3p14.2 fragile site and renal carcinoma-associated t(3;8) breakpoint, is abnormal in digestive tract cancers. Cell. 1996 Feb 23;84(4):587–597. doi: 10.1016/s0092-8674(00)81034-x. [DOI] [PubMed] [Google Scholar]
  28. Pause A., Lee S., Worrell R. A., Chen D. Y., Burgess W. H., Linehan W. M., Klausner R. D. The von Hippel-Lindau tumor-suppressor gene product forms a stable complex with human CUL-2, a member of the Cdc53 family of proteins. Proc Natl Acad Sci U S A. 1997 Mar 18;94(6):2156–2161. doi: 10.1073/pnas.94.6.2156. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Richards F. M., Webster A. R., McMahon R., Woodward E. R., Rose S., Maher E. R. Molecular genetic analysis of von Hippel-Lindau disease. J Intern Med. 1998 Jun;243(6):527–533. doi: 10.1046/j.1365-2796.1998.00334.x. [DOI] [PubMed] [Google Scholar]
  30. Schmidt L., Duh F. M., Chen F., Kishida T., Glenn G., Choyke P., Scherer S. W., Zhuang Z., Lubensky I., Dean M. Germline and somatic mutations in the tyrosine kinase domain of the MET proto-oncogene in papillary renal carcinomas. Nat Genet. 1997 May;16(1):68–73. doi: 10.1038/ng0597-68. [DOI] [PubMed] [Google Scholar]
  31. Schmidt L., Junker K., Weirich G., Glenn G., Choyke P., Lubensky I., Zhuang Z., Jeffers M., Vande Woude G., Neumann H. Two North American families with hereditary papillary renal carcinoma and identical novel mutations in the MET proto-oncogene. Cancer Res. 1998 Apr 15;58(8):1719–1722. [PubMed] [Google Scholar]
  32. Schmidt L., Li F., Brown R. S., Berg S., Chen F., Wei M. H., Tory K., Lerman I., Zbar B. Mechanism of tumorigenesis of renal carcinomas associated with the constitutional chromosome 3;8 translocation. Cancer J Sci Am. 1995 Sep-Oct;1(3):191–195. [PubMed] [Google Scholar]
  33. Shimizu M., Yokota J., Mori N., Shuin T., Shinoda M., Terada M., Oshimura M. Introduction of normal chromosome 3p modulates the tumorigenicity of a human renal cell carcinoma cell line YCR. Oncogene. 1990 Feb;5(2):185–194. [PubMed] [Google Scholar]
  34. Shuin T., Kondo K., Torigoe S., Kishida T., Kubota Y., Hosaka M., Nagashima Y., Kitamura H., Latif F., Zbar B. Frequent somatic mutations and loss of heterozygosity of the von Hippel-Lindau tumor suppressor gene in primary human renal cell carcinomas. Cancer Res. 1994 Jun 1;54(11):2852–2855. [PubMed] [Google Scholar]
  35. Stebbins C. E., Kaelin W. G., Jr, Pavletich N. P. Structure of the VHL-ElonginC-ElonginB complex: implications for VHL tumor suppressor function. Science. 1999 Apr 16;284(5413):455–461. doi: 10.1126/science.284.5413.455. [DOI] [PubMed] [Google Scholar]
  36. Stolle C., Glenn G., Zbar B., Humphrey J. S., Choyke P., Walther M., Pack S., Hurley K., Andrey C., Klausner R. Improved detection of germline mutations in the von Hippel-Lindau disease tumor suppressor gene. Hum Mutat. 1998;12(6):417–423. doi: 10.1002/(SICI)1098-1004(1998)12:6<417::AID-HUMU8>3.0.CO;2-K. [DOI] [PubMed] [Google Scholar]
  37. Teh B. T., Giraud S., Sari N. F., Hii S. I., Bergerat J. P., Larsson C., Limacher J. M., Nicol D. Familial non-VHL non-papillary clear-cell renal cancer. Lancet. 1997 Mar 22;349(9055):848–849. doi: 10.1016/S0140-6736(05)61751-5. [DOI] [PubMed] [Google Scholar]
  38. Thoenes W., Störkel S., Rumpelt H. J. Histopathology and classification of renal cell tumors (adenomas, oncocytomas and carcinomas). The basic cytological and histopathological elements and their use for diagnostics. Pathol Res Pract. 1986 May;181(2):125–143. doi: 10.1016/S0344-0338(86)80001-2. [DOI] [PubMed] [Google Scholar]
  39. Woodward E. R., Eng C., McMahon R., Voutilainen R., Affara N. A., Ponder B. A., Maher E. R. Genetic predisposition to phaeochromocytoma: analysis of candidate genes GDNF, RET and VHL. Hum Mol Genet. 1997 Jul;6(7):1051–1056. doi: 10.1093/hmg/6.7.1051. [DOI] [PubMed] [Google Scholar]
  40. Zbar B., Glenn G., Lubensky I., Choyke P., Walther M. M., Magnusson G., Bergerheim U. S., Pettersson S., Amin M., Hurley K. Hereditary papillary renal cell carcinoma: clinical studies in 10 families. J Urol. 1995 Mar;153(3 Pt 2):907–912. [PubMed] [Google Scholar]
  41. van den Berg A., Dijkhuizen T., Draaijers T. G., Hulsbeek M. M., Maher E. R., van den Berg E., Störkel S., Buys C. H. Analysis of multiple renal cell adenomas and carcinomas suggests allelic loss at 3p21 to be a prerequisite for malignant development. Genes Chromosomes Cancer. 1997 Aug;19(4):228–232. doi: 10.1002/(sici)1098-2264(199708)19:4<228::aid-gcc4>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  42. van den Berg A., Draaijers T. G., Kok K., Timmer T., Van der Veen A. Y., Veldhuis P. M., de Leij L., Gerhartz C. D., Naylor S. L., Smith D. I. Normal FHIT transcripts in renal cell cancer- and lung cancer-derived cell lines, including a cell line with a homozygous deletion in the FRA3B region. Genes Chromosomes Cancer. 1997 Aug;19(4):220–227. doi: 10.1002/(sici)1098-2264(199708)19:4<220::aid-gcc3>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]

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