IMMUNOLOGICAL DIAGNOSTICS AND PREDICTION OF THE COURSE OF RENAL PARENCHYMA CANCER (LITERATURE REVIEW)

Abstract

Despite the expansion of diagnostic capabilities to detect renal parenchymal tumors, one third of patients already have remote metastases at primary examination, which significantly limits the possibility of radical treatment. A close relationship was found between qualitative and quantitative changes of components of the immune system and histological structure of malignant neoplasm parenchyma of the kidney. In the cell link of immunity at early stages of development of renal parenchymal tumor, there is a pathological correlation between functional changes of regulatory T-lymphocytes, cytotoxic T-lymphocytes and natural killers. This dependence leads to immunological evasion of tumor cells and further proliferation of tumor tissue. In later stages, a key factor in the pathogenesis of anti-tumor immunological tolerance is the violation of immune humoral link factors (changes in serum concentration of immunoglobulins, activation of interleukins). The functional duality of interleukins under normal conditions balances proliferative and cytotoxic pathways of disease pathogenesis, leading to recovery. However, in the stroma of a tumor and its microenvironment, this duality not only promotes an increase in the tumor mass, but also leads to regional and distant metastasis. Clarification of the mechanisms of immunological changes leading to the development of anti-tumor immunological tolerance in patients with renal parenchymal cancer will allow early diagnosis of the oncological process, monitoring the effectiveness of personalized anti-tumor therapy. Definition of clear criteria for changing the composition of immune cells, identification of markers of the organism’s immunological tolerance to tumor tissue is quite relevant and can serve as a basis for developing methods of predicting the course of the disease and monitoring the effectiveness of the treatment.