Radiation sclerosing proliferative atypical nephropathy of peritumoral tissue of renal-cell carcinomas after the Chernobyl accident in Ukraine

Abstract

After the Chernobyl accident, the morbidity of renal-cell carcinomas in Ukraine increased gradually from 4.7 to 7.5 per 100,000 of the total population. Cesium 137 (137Cs) is responsible for 80-90% of the internal radioactivity in people living in radiocontaminated areas of Ukraine, and 90% of 137Cs is eliminated through the kidneys. Histological and immunohistochemical study of proliferating cell nuclear antigen (PCNA) and K-ras protein was performed in peritumoral kidney tissues of 167 Ukrainian patients (groups I-III, according to varying degrees of internal exposure to radiation), and of 85 analog Spanish patients, as a control group. Our data showed in the majority of Ukrainian patients a radiation sclerosing proliferative atypical nephropathy (RSPAN) in association with an increase in the incidences of tubular epithelial nuclear atypia and carcinoma in situ (CIS). Areas of epithelial nuclear atypia and CIS of the cortex and medulla showed significant PCNA expression with means of extent as 12, 14, and 15% of stained nuclei in groups I, II, and III respectively. K-ras expression of the same areas occurred in 67, 87, and 85% of cases in groups I, II, and III respectively. The present study points to a strong relationship between the long term of low-dose radiation exposure of the Ukrainian population and the development of RSPAN as a possible precursor of malignancy. In addition, it confirms the possible initiator, promoter, or progressor role of chronic low-level radiation of renal human carcinogenesis in Ukraine.

Chernobyl-Related Cancer and Precancerous Lesions: Incidence Increase Vs. Late Diagnostics

“…In accordance with this hypothesis, the tumors from Ukraine had on average a higher histological grade than the control cases from Spain (Romanenko 2006a;Jargin 2007). In particular, "the dramatic increase of aggressivity and proliferative activity" was found in RCC from Ukraine (Romanenko et al 2000a), while "the majority of the high grade tumors occurred in the Ukrainian (rather than in the Spanish) groups" (Romanenko et al 2001a), which can be explained by the on average earlier detection of malignancies in Spain.…”

Malignancies after Chernobyl Accident: What Is True and What Is Untrue

“…However, the incidence increase of renal cell carcinoma (RCC) due to the Chernobyl fallout has never been proven scientifically; some increase could have been caused by improved diagnostics [56]. Furthermore, the following was pointed out: "The strong significant differences between the Ukrainian and Spanish groups were found in tumoral nuclear grade" [57] and "Our data showed in the majority of Ukrainian patients a radiation sclerosing proliferative atypical nephropathy in association with an increase in the incidences of tubular epithelial nuclear atypia and carcinoma in situ" [58]. It was reported that in 73 % of RCC patients from contaminated territories and 72 % of patients from noncontaminated areas of Ukraine, the tumor displayed a relatively high level of microvessel density: the average density in both Ukrainian groups combined was 1.65 times higher than in a control group from Spain [55].…”

The INK4a/ARF locus: role in cell cycle control for renal cell epithelial tumor growth after the Chernobyl accident

“…Recent studies by our group have shown that during the period subsequent to the Chernobyl accident, increases in morbidity, aggressivity and proliferative activity of renal-cell carcinomas (RCCs) in Ukrainian patients were recognized. The development of "radiation sclerosing proliferative atypical nephropathy" in the peritumoral kidney tissue then followed and demonstrated a good correlation with the duration of radiation exposure [22]. In addition, the influence of chronic, regular and sustained low-dose IR on renal carcinogenesis in the population living in 137 Cs-contaminated areas of Ukraine was confirmed [21].…”