Renal and Bladder Cancers

The cytogenetic features of renal and bladder cancers have been defined only over the past 10 yr, but it is already clear that these parameters have substantial diagnostic and prognostic relevance. In fact, the clinical ramifications of chromosome aberrations in genitourinary tumors are in many respects a paradigm for the potential uses of cytogenetics in other types of solid tumors. Very characteristic chromosome aberrations have been identified in different histologic types of renal cancer, and these distinctive cytogenetic profiles are discussed at some length in this chapter (Table 1). Of particular note are the ubiquitous deletion of chromosome 3 short-arm material in nonpapillary clear cell and granular carcinomas (1–3), extra copy number—particularly trisomies—of several chromosomes in renal adenomas and papillary carcinomas (4–7), and hypodiploid karyotypes in chromophobe carcinomas (8). Likewise, many of the common pediatric renal tumors contain characteristic cytogenetic aberrations. Deletion of 11p is a very well-studied and well-publicized aberration in Wilms tumors, but several other aberrations are more frequent and might have greater prognostic relevance (9–13).