Molecular differential diagnosis of renal cell carcinomas by microsatellite analysis.

Recent application of molecular cytogenetic techniques has resulted in a new type of genetic classification of renal cell tumors. The key aspect of the novel diagnostic concept is reflected by biologically distinct entities, each characterized by a specific combination of genetic changes. To work out a diagnostic/prognostic approach, we have applied polymorphic microsatellite markers for a quick analysis, based on polymerase chain reaction, of 82 tumor specimens. We compared the results to previously evaluated cytogenetic and histological data. All nonpapillary and chromophobe renal cell carcinomas, which make up approximately 90% of all malignant renal cell tumors, and a subset of renal oncocytomas were correctly diagnosed by detection of loss of heterozygosity at chromosomal sites 1, 2, and 3p. Allelic losses at chromosomal regions 8p, 9p, and 14q are associated with an advanced pathological stage of nonpapillary renal cell carcinomas. A loss of heterozygosity at chromosomes 6, 10, 13, 17, and 21, in addition to those at chromosomes 1 and 2, confirm the diagnosis of chromophobe renal cell tumors. Using this approach, the differential diagnosis of renal cell tumors could be carried out within 1 or 2 days.