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Kidney Cancer Panel

Apolipoprotein A-II (ApoA2) belongs to the family of apolipoproteins and it is the second most abundant protein of the high density lipoprotein (HDL) particles. The protein is found in plasma as a monomer, homodimer, or heterodimer with apolipoprotein D. It may also stabilize HDL structure by its association with lipids, and affect the HDL metabolism. Defects in this gene may result in apolipoprotein A-II deficiency or hypercholeste­rolemia. Although some studies have found an overexpression of ApoA2 in hypertriglyce­ridemic, obese and insulin-resistant subjects, another research adds that ApoA-II is associated with a decreased risk of future coronary artery disease in apparently healthy people, its role in humans is still controversial. The –256C > T polymorphism in the ApoA2 gene promoter is one of the most studied, and CC genotype has been associated with increased Body Mass Index (BMI) or obesity in different populations. This polymorphism also influences other cardiovascular risk factors such as the ratio ApoA1/ApoA2 or the development of atherosclerosis. There were also observed the lipoprotein changes in the human apoA-II transgenic mice on a regular chow diet. ApoA2 is probably a differential protein of hepatocellular carcinoma (HCC) and maybe related to the pathogenesis of HCC. C-Reactive Protein (CRP) belongs to the pentraxin family of calciumdependent ligand-binding plasma proteins, the other member of which in humans is serum amyloid P component (SAP). Human CRP physiologically binds with highest affinity to phosphocholine residues, but it also binds to a variety of other autologous and extrinsic ligands, and it aggregates or precipitates the cellular, particulate, or molecular structures bearing these ligands. It was the first acute-phase protein to be described and it is a sensitive systemic marker of inflammation and tissue damage. The human CRP molecule (Mr 115,135) is composed of five identical nonglycosylated polypeptide subunits. However, surprisingly in view of the sensitivity, speed, and range of the CRP response, subjects in the general population tend to have stable CRP concentrations characteristic for each individual, apart from occasional spikes presumably related to minor or subclinical infections, inflammation, or trauma. CRP responses in infections (bacterial systemic/severe fungal, mycobacterial, viral), allergic complications of infection (Rheumatic fever), inflammation disease (Rheumatoid arthritis, Juvenile chronic arthritis, Psoriatic arthritis, Systemic vasculitis, Crohn disease), necrosis (myocardial infarction, acute pancreatitis), trauma (surgery, burns, fractures), malignancy (lymphoma, carcinoma, sarcoma) and others. Elevated CRP has been alsp associated with several malignancies in addition to a worse prognosis for those malignancies. CRP correlate with melanoma disease progression. CD117 (KIT), encoded by the proto-oncogene c-kit, is a transmembrane protein belonging to the type III subfamily of the receptor tyrosine kinases. It has extracellular, intramembranous and intracellular domains. Normally KIT is activated (phosphorylated) by binding of its ligand, the stem cell factor (SCF). This leads to a phosphorylation cascade ultimately activating various transcription factors in different cell types. Such activation regulates cellular activities as apoptosis, cell differentiation, proliferation, chemotaxis, and cell adhesion. Expression of CD117 has been described in numerous normal cells, including haematopoietic cells, germ cells, mast cells, melanocytes, breast epithelial cells, Cajal cells of the gastrointestinal tract. CD117 have been identi¬fied as a key oncogenic driver in a variety of tumors including mast cell leukemia, Ewing sarcoma, neuroblastoma, melanoma, thyroid, endometrial, ovarian and breast cancers. CD117 positivity has been variably reported in sarcomas. It is also expressed in pulmonary and other small cell carcinomas, adenoid cystic carcinoma, renal chro

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