Application Of Microwave Ablation In The Treatment Of Renal Cystic Masses And The Role Of Immune Model In The Metastasis Of Renal Cell Carcinoma

ObjectiveTo explore the value of microwave ablation in the treatment of cystic renal masses;To establish and verify an immune model of renal cell carcinoma(RCC),based on which to form a prediction model of metastasis of RCC;To study the role of miR-30a-3p in the progress of RCC.Materials and Methods1.Ninety-five patients with cystic renal masses who were underwent microwave ablation assisted laparoscopic renal cyst decortication(LMWA-RCD)or microwave ablation assisted laparoscopic partial nephrectomy(LMWA-PN)from June 2017 to May 2018 in Shanghai Jiao Tong University School of Medicine affiliated ××Hospital were retrospectively analyzed on baseline characteristics,perioperative data,renal functional and oncological results.2.An integrative analysis of TCGA,GEO and ×× hospital database were performed via bioinformatics and statistical method.And we identified and validated immune genes related with tumors,and then immune model and metastasis prediction model of renal cell carcinoma(RCC)were established.MicroRNAs related to the progress of RCC were screened and also validated.Results1.The LMWA-RCD group included 65 patients,in which Bosniak ?,?,?F,?type were 24,25,13 and 3 cases respectively.The mean maximal diameter of renal cyst was 8.0±2.0cm.All the operations were performed successfully,and two of them were received extra tumor bed microwave ablation.Mean operative time and estimated blood loss was 37.2±9.2min and 10.2±7ml respectively.The complication rate was 3%.The mean follow-up was 19.5 months,with complete remission rate 96.8%.2.The LMWA-RCD group included 30 patients,in which Bosniak ? and ?type was 12 and 18 cases respectively.The mean maximal diameter of renal masses was 3.5±0.8cm.All the operations were performed successfully.Mean operative,warm ischemia time and estimated blood loss was 37.2±9.2min,1.4±3.2min and 10.2±7ml respectively.The complication rate was 9.9%.The mean follow-up was 20.3 months,with no evidence of local recurrence and metastasis3.The clear cell renal cell carcinoma could be divided into H and L immune model,and the survival rate of two immune model was different with statistical significance.Immune gene SLN,AQP9,CPA4 were related to patients' survival.The prediction model combined with immune model was more accurate than conventional prediction model in patients' survival prediction4.miR-30a-3p was down-regulated in RCC cells.And in Transwell experiment,the invasion and migration ability of tumor cells were improved when miR-30a-3p were knocked down.When its mimics was transinfected into 786-O cell line,the expression of ATG12 was down-regulated,vice-versa.The immunohistochemistry results showed that ATG12 down-regulated was related to better prognosisConclusion1.Microwave ablation assisted laparoscopic renal cyst decortication in the treatment of Bosniak type ?,?,?F and ?,microwave ablation assisted laparoscopic partial nephrectomy in the treatment of Bosniak type ? and ? were safe and effective option for selected renal cystic masses.2.Immune model was effective in predicting survival rate of clear cell renal cell carcinoma,and immune metastasis prediction model could provide guidance to patients during the follow up.3.miR-30a-3p related to the progression and metastasis to renal cell carcinoma and could inhibit the ability of invasion and migration of cancer cell via down-regulated ATG12.