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In addition, as somatic VHL inactivation occurs in most clear cell RCC, and this histopathology accounts for ∼75% of all sporadic RCC, it is not unexpected that genetic modifiers of VHL disease RCC risk, might also function as low penetrance RCC susceptibility alleles (e.g. the association between MMP1/MMP3 hapolotypes and RCC).
In some serous and most clear cell tumors, ALDH1A1 expression was found in the stromal fibroblasts.
eEF1A2 protein is expressed at detectable levels in most clear cell tumours (four out of five tumours analysed; 80%), but only one out of 23 serous papillary tumours and two out of 11 endometrioid tumours.
It is now known that the VHL suppressor gene is mutated or silenced in most clear cell renal carcinomas though the initiator(s) of this event are still unknown.
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Mutations of VHL tumour suppressor protein are found in most clear-cell RCC, and loss of VHL protein function leads to elevated levels of HIF α and consequent overexpression of VEGF (Motzer et al, 2006).
Thus germline mutations in the von Hippel-Lindau (VHL) disease tumour suppressor gene (VHL) are the most common cause of familial renal cell carcinoma and somatic inactivation of VHL occurs in most sporadic clear cell RCC [1] [4].
If the impact of the various immune components on patient's relapse share common rules in most malignancies, clear cell renal cell tumors behave differently with regards to immunity.
In particular, the identification of the von Hippel Lindau (VHL) familial cancer syndrome gene (VHL) provided the basis for the discovery that VHL is somatically inactivated in most sporadic clear cell RCC.
From a clinical point of view, three main types of RCC are the most important: clear cell (cRCC), papillary (pRCC), and chromophobe (chRCC) [ 27].
These effects were most clear with cells cultured in GEM-derived supernatant, in which the changes in HLA1 expression were most pronounced.
Most endometrioid and clear cell carcinomas contained an NAA concentration which was comparable to the concentration of NAA in human serum or CFS.
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