{"id":7486,"date":"2023-08-16T06:21:27","date_gmt":"2023-08-16T06:21:27","guid":{"rendered":"http:\/\/d1s07skqdwll4z.cloudfront.net\/mrcc-tool\/1-introduction-rcc\/1-6-pathophysiology\/"},"modified":"2024-03-28T17:51:41","modified_gmt":"2024-03-28T17:51:41","slug":"1-6-pathophysiology","status":"publish","type":"page","link":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/1-introduction-rcc\/1-6-pathophysiology\/","title":{"rendered":"1.6 Pathophysiology"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:-60px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-search-element fusion-search-element-1 fusion-search-form-clean\" style=\"--awb-border-radius:7px;--awb-text-color:var(--awb-color8);--awb-border-color:var(--awb-color8);--awb-bg-color:var(--awb-color3);\">\t\t<form role=\"search\" class=\"searchform fusion-search-form  fusion-live-search fusion-search-form-clean\" method=\"get\" action=\"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/\">\n\t\t\t<div class=\"fusion-search-form-content\">\n\n\t\t\t\t\n\t\t\t\t<div class=\"fusion-search-field search-field\">\n\t\t\t\t\t<label><span class=\"screen-reader-text\">Search for:<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"search\" class=\"s fusion-live-search-input\" name=\"s\" id=\"fusion-live-search-input-0\" autocomplete=\"off\" placeholder=\"Search...\" required aria-required=\"true\" aria-label=\"Search...\"\/>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"fusion-search-button search-button\">\n\t\t\t\t\t<input type=\"submit\" class=\"fusion-search-submit searchsubmit\" aria-label=\"Search\" value=\"&#xf002;\" \/>\n\t\t\t\t\t\t\t\t\t\t<div class=\"fusion-slider-loading\"><\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t<input type=\"hidden\" name=\"post_type[]\" value=\"any\" \/><input type=\"hidden\" name=\"search_limit_to_post_titles\" value=\"0\" \/><input type=\"hidden\" name=\"live_min_character\" value=\"4\" \/><input type=\"hidden\" name=\"live_posts_per_page\" value=\"100\" \/><input type=\"hidden\" name=\"live_search_display_featured_image\" value=\"1\" \/><input type=\"hidden\" name=\"live_search_display_post_type\" value=\"1\" \/><input type=\"hidden\" name=\"fs\" value=\"1\" \/>\n\t\t\t<\/div>\n\n\n\t\t\t\t\t\t\t<div class=\"fusion-search-results-wrapper\"><div class=\"fusion-search-results\"><\/div><\/div>\n\t\t\t\n\t\t<\/form>\n\t\t<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-top:4px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-title-center fusion-title-text fusion-title-size-five\" style=\"--awb-text-color:#c1c1c1;--awb-sep-color:#e2e2e2;\"><div class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h5 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">1.6 Patofysiologi<\/h5><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-top:4px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p>De flesta fall av sporadisk klarcellig RCC k\u00e4nnetecknas av en defekt i tum\u00f6rsuppressorgenen von Hippel-Lindau (VHL).<\/p>\n<p>VHL-proteinet spelar en viktig roll i regleringen av cellul\u00e4r respons p\u00e5 hypoxi genom regleringen av hypoxi-inducerbar faktor (HIF) som transkriptionsfaktor.<\/p>\n<p>Inaktivering av VHL-genen efterliknar ett hypoxiskt tillst\u00e5nd som orsakar ackumulering av HIF, vilket \u00f6kar produktionen av olika tillv\u00e4xtfaktorer, d\u00e4ribland vaskul\u00e4r endotelial tillv\u00e4xtfaktor (VEGF), trombocytderiverad tillv\u00e4xtfaktor (PDGF) och transformerande tillv\u00e4xtfaktor alfa (TGF-\u03b1), som stimulerar celltillv\u00e4xt samt bildning av nya blodk\u00e4rl. Nybildning av blodk\u00e4rl kallas \u00e4ven angiogenes och spelar en viktig roll i patogenesen f\u00f6r RCC.1<\/p>\n<p>Tillv\u00e4xtfaktorer som VEGF och PDGF-\u03b2 binder till sina respektive receptorer p\u00e5 endotelceller och cancerceller och aktiverar tyrosinkinas i den intracellul\u00e4ra delen av receptorn, vilket i sin tur leder till aktivering av intracellul\u00e4ra signaltransduktionsv\u00e4gar, inklusive RAF\/MEK\/ERK- och PI3K\/AKT\/mTOR-signalv\u00e4garna. Dessa signalv\u00e4gar p\u00e5verkar i sin tur cellernas beteende, d\u00e4ribland celltillv\u00e4xt och angiogenes. N\u00e4r nya blodk\u00e4rl bildas kan tum\u00f6ren f\u00e5 syre och n\u00e4ring s\u00e5 att den kan v\u00e4xa och sprida sig.<\/p>\n<\/div><div class=\"fusion-image-element \" style=\"text-align:center;--awb-margin-top:20px;--awb-margin-bottom:20px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"1600\" height=\"493\" title=\"1.6_1\" src=\"https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120157\/1.6_1.jpg\" alt class=\"img-responsive wp-image-10021\" srcset=\"https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120157\/1.6_1-200x62.jpg 200w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120157\/1.6_1-400x123.jpg 400w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120157\/1.6_1-600x185.jpg 600w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120157\/1.6_1-800x247.jpg 800w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120157\/1.6_1-1200x370.jpg 1200w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120157\/1.6_1.jpg 1600w\" sizes=\"(max-width: 640px) 100vw, 1200px\" \/><\/span><\/div><div class=\"fusion-text fusion-text-2\"><p><span style=\"font-family: var(--awb-text-font-family); font-size: var(--awb-font-size); font-style: var(--awb-text-font-style); letter-spacing: var(--awb-letter-spacing); text-align: var(--awb-content-alignment); text-transform: var(--awb-text-transform);\">Mutationer i VHL-genen orsakar \u00f6verproduktion av tillv\u00e4xtfaktorer<\/span><\/p>\n<ul>\n<li>Mutation eller inaktivering av VHL-genen st\u00f6r VHL-genens funktion och HIF bryts inte ned<sup>1,2<\/sup><\/li>\n<li>HIF:er f\u00f6rflyttar sig till k\u00e4rnan d\u00e4r de ackumuleras och orsakar transkription av hypoxi-inducerbara gener och \u00f6verproduktion av tillv\u00e4xtfaktorer (t.ex. VEGF, TGF-\u03b1 och PDGF)<sup>2,3<\/sup><\/li>\n<li>Bindning av tillv\u00e4xtfaktorer till receptorerna p\u00e5 ytan av endotel- och cancerceller fr\u00e4mjar angiogenes och celltillv\u00e4xt<sup>1,2<\/sup><\/li>\n<\/ul>\n<\/div><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-four\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">VEGF:s roll i angiogenesen<\/h4><\/div><div class=\"fusion-text fusion-text-3\"><ul>\n<li>\u00d6kat VEGF-uttryck har p\u00e5visats vid RCC, vilket korrelerar med mikrok\u00e4rldensiteten, ett m\u00e5tt p\u00e5 angiogenesens omfattning<sup>1<\/sup><\/li>\n<li>Efter aktivering av HIF uppregleras VEGF och PDGF och binder till receptorerna p\u00e5 endotelcellernas yta<sup>2,3<\/sup><\/li>\n<li>Fr\u00e4mjar migration och proliferation av endotelceller, vilket \u00e4r avg\u00f6rande f\u00f6r utvecklingen av nya tum\u00f6rinducerade blodk\u00e4rl<sup>1,2<\/sup><\/li>\n<\/ul>\n<\/div><div class=\"fusion-image-element \" style=\"text-align:center;--awb-margin-top:20px;--awb-margin-bottom:20px;--awb-max-width:51%;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-2 hover-type-none\"><img decoding=\"async\" width=\"1030\" height=\"693\" title=\"1.6_2\" src=\"https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120155\/1.6_2.jpg\" alt class=\"img-responsive wp-image-10026\" srcset=\"https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120155\/1.6_2-200x135.jpg 200w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120155\/1.6_2-400x269.jpg 400w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120155\/1.6_2-600x404.jpg 600w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120155\/1.6_2-800x538.jpg 800w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120155\/1.6_2.jpg 1030w\" sizes=\"(max-width: 640px) 100vw, 1030px\" \/><\/span><\/div><div class=\"fusion-text fusion-text-4\"><p>VEGF och VEGFR \u00e4r attraktiva molekyl\u00e4ra m\u00e5l f\u00f6r behandling av RCC eftersom de spelar en viktig roll i tum\u00f6rens angiogenes<sup>2<\/sup><\/p>\n<\/div><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-text fusion-title-size-four\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Inaktivering av VHL<\/h4><\/div><div class=\"fusion-text fusion-text-5\"><p>Inaktivering av VHL uppreglerar ocks\u00e5 tyrosinkinasreceptorns hepatocyttillv\u00e4xtfaktorreceptor (MET) och arrest-specific protein 6-receptorn (AXL).<sup>6,7<\/sup><\/p>\n<\/div>\n<div class=\"table-1\">\n<table width=\"100%\">\n<thead>\n<tr>\n<th align=\"left\">RECEPTOR<\/th>\n<th align=\"left\"><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td rowspan=\"3\" align=\"left\">MET<\/td>\n<td align=\"left\">Loss of VHL expression\/VHL mutation and hypoxia lead to up-regulation of MET in ccRCC<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">Activation of MET through gene mutations identified in hereditary\/sporadic papillary RCC<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">Dysregulation of MET is implicated in tumour development, invasion and angiogenesis<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"2\" align=\"left\">AXL<\/td>\n<td align=\"left\">AXL expression is directly activated by HIF-1 and HIF-2<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">Increased AXL expression in primary ccRCC tumours correlates with aggressive tumour behaviour and increased risk of death<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:10px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-6\"><p>\u00d6kat uttryck av MET och AXL vid RCC \u00e4r associerat med d\u00e5lig prognos och resistens mot VEGFR-h\u00e4mmare.<sup>6,8<\/sup><\/p>\n<p><i><span style=\"font-size: 13px;\" data-fusion-font=\"true\">AXL, anexelekto (grekiska: okontrollerad); ccRCC, klarcellig RCC; MET, hepatocyttillv\u00e4xtfaktorreceptor<\/span><\/i><\/p>\n<\/div><div class=\"fusion-title title fusion-title-4 fusion-sep-none fusion-title-text fusion-title-size-four\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">MET:s och AXL:s roll i tum\u00f6rprogression och resistens mot VEGF-receptorh\u00e4mmare.<sup>9<\/sup><\/h4><\/div><div class=\"fusion-image-element \" style=\"text-align:center;--awb-margin-top:20px;--awb-margin-bottom:20px;--awb-max-width:77%;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-3 hover-type-none\"><img decoding=\"async\" width=\"1700\" height=\"890\" title=\"1.6_3\" src=\"https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120153\/1.6_3.jpg\" alt class=\"img-responsive wp-image-10031\" srcset=\"https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120153\/1.6_3-200x105.jpg 200w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120153\/1.6_3-400x209.jpg 400w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120153\/1.6_3-600x314.jpg 600w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120153\/1.6_3-800x419.jpg 800w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120153\/1.6_3-1200x628.jpg 1200w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120153\/1.6_3.jpg 1700w\" sizes=\"(max-width: 640px) 100vw, 1200px\" \/><\/span><\/div><div class=\"fusion-text fusion-text-7\"><p><span style=\"font-size: 13px;\" data-fusion-font=\"true\"><i>FGF: fibroblasttillv\u00e4xtfaktor; HIF: hypoxi-inducerbar faktor<\/i><\/span><\/p>\n<\/div><div class=\"fusion-text fusion-text-8\"><p>Vid njurcancer anses MET och AXL fungera som flyktv\u00e4gar som potentiellt kan bidra till resistens mot en mer selektiv VEGFR-riktad behandling. <sup>9<\/sup><\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-5 fusion-sep-none fusion-title-text fusion-title-size-four\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Referenser<\/h4><\/div><div class=\"fusion-text fusion-text-9\"><ol class=\"reference\">\n<li><em>Rini BI, Campbell SC, Escudier B. Renal cell carcinoma. 2009;373(9669):1119\u20131132.<\/em><\/li>\n<li><em>Linehan WM, Bratslavsky G, Pinto PA, et al. Molecular diagnosis and therapy of kidney cancer. Annu Rev Med. 2010;61:329-343.<\/em><\/li>\n<li><em>Semenza GL. HIF-1 mediates metabolic responses to intratumoral hypoxia and oncogenic mutations. J Clin Invest. 2013;123(9):3664-3671.<\/em><\/li>\n<li><em>Banumathy G, Cairns P. Signaling pathways in renal cell carcinoma. Cancer Biol Ther. 2010;10(7):658\u2013664.<\/em><\/li>\n<li><em>Pili R, Kauffman E, Rodriguez R. Cancer of the kidney. I: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff\u2019s Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:1416\u20131444.<\/em><\/li>\n<li><em>Choueiri TK, et al. N Engl J Med 2015;373:1814\u201323<\/em><\/li>\n<li><em>Gibney GT, et al. Ann Oncol 2013;24:343\u20139<\/em><\/li>\n<li><em>Rankin EB, et al. PNAS 2014;111:13373\u20138<\/em><\/li>\n<li><em>Zhou L, et al. Oncogene 2016;35:2687\u201397<\/em><\/li>\n<\/ol>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-overflow:hidden;--awb-bg-image:linear-gradient(180deg, rgba(0,60,104,0.07) 0%,rgba(0,60,104,0.001) 100%);--awb-bg-size:cover;--awb-border-radius:7px 7px 7px 7px;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form fusion-form-builder fusion-form-form-wrapper fusion-form-9748\" style=\"--awb-margin-top:20px;--awb-tooltip-text-color:#ffffff;--awb-tooltip-background-color:#333333;\" data-form-id=\"9748\" data-config=\"{&quot;form_id&quot;:9748,&quot;form_post_id&quot;:9748,&quot;post_id&quot;:7486,&quot;form_type&quot;:&quot;ajax&quot;,&quot;confirmation_type&quot;:&quot;message&quot;,&quot;redirect_url&quot;:&quot;&quot;,&quot;field_labels&quot;:{&quot;test_16&quot;:&quot;&quot;},&quot;field_logics&quot;:{&quot;test_16&quot;:&quot;[]&quot;,&quot;fusion_text_10&quot;:&quot;[]&quot;,&quot;fusion_text_11&quot;:&quot;[{\\&quot;operator\\&quot;:\\&quot;and\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;test_16\\&quot;,\\&quot;value\\&quot;:\\&quot;Hyperoxiska celler fris\\u00e4tter tillv\\u00e4xtfaktorer som stimulerar tillv\\u00e4xten av blodk\\u00e4rl f\\u00f6r att tillf\\u00f6ra det syre som cellerna beh\\u00f6ver under syrebegr\\u00e4nsande f\\u00f6rh\\u00e5llanden.\\&quot;}]&quot;,&quot;fusion_text_12&quot;:&quot;[{\\&quot;operator\\&quot;:\\&quot;and\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;test_16\\&quot;,\\&quot;value\\&quot;:\\&quot;Hyperoxiska celler fris\\u00e4tter tillv\\u00e4xtfaktorer som stimulerar tillv\\u00e4xten av blodk\\u00e4rl f\\u00f6r att tillf\\u00f6ra det syre som cellerna beh\\u00f6ver under syrebegr\\u00e4nsande f\\u00f6rh\\u00e5llanden.\\&quot;}]&quot;,&quot;fusion_text_13&quot;:&quot;[{\\&quot;operator\\&quot;:\\&quot;or\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;test_16\\&quot;,\\&quot;value\\&quot;:\\&quot;VEGF och VEGFR \\u00e4r attraktiva molekyl\\u00e4ra m\\u00e5l f\\u00f6r nya behandlingar av RCC\\&quot;},{\\&quot;operator\\&quot;:\\&quot;and\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;test_16\\&quot;,\\&quot;value\\&quot;:\\&quot;Mutation eller inaktivering av VHL-genen st\\u00f6r VHL-genens funktion och HIF bryts inte ned\\&quot;}]&quot;,&quot;fusion_text_14&quot;:&quot;[{\\&quot;operator\\&quot;:\\&quot;or\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;test_16\\&quot;,\\&quot;value\\&quot;:\\&quot;VEGF och VEGFR \\u00e4r attraktiva molekyl\\u00e4ra m\\u00e5l f\\u00f6r nya behandlingar av RCC\\&quot;},{\\&quot;operator\\&quot;:\\&quot;and\\&quot;,\\&quot;comparison\\&quot;:\\&quot;equal\\&quot;,\\&quot;field\\&quot;:\\&quot;test_16\\&quot;,\\&quot;value\\&quot;:\\&quot;Mutation eller inaktivering av VHL-genen st\\u00f6r VHL-genens funktion och HIF bryts inte ned\\&quot;}]&quot;},&quot;field_types&quot;:{&quot;test_16&quot;:&quot;radio&quot;,&quot;fusion_text_10&quot;:&quot;fusion_text&quot;,&quot;fusion_text_11&quot;:&quot;fusion_text&quot;,&quot;fusion_text_12&quot;:&quot;fusion_text&quot;,&quot;fusion_text_13&quot;:&quot;fusion_text&quot;,&quot;fusion_text_14&quot;:&quot;fusion_text&quot;},&quot;nonce_method&quot;:&quot;ajax&quot;}\"><form action=\"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/1-introduction-rcc\/1-6-pathophysiology\/\" method=\"post\" class=\"fusion-form fusion-form-9748\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-color:var(--awb-color8);--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-6 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-four\"><h4 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Testa dina kunskaper<\/h4><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.88%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-7 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Ett av p\u00e5st\u00e5endena \u00e4r felaktigt<\/h5><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-10 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-border-color:var(--awb-color8);--awb-border-style:solid;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-radio-field fusion-form-label-above\" style=\"\" data-form-id=\"9748\"><fieldset><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-test_16-1-0\" type=\"radio\" value=\"VEGF och VEGFR \u00e4r attraktiva molekyl\u00e4ra m\u00e5l f\u00f6r nya behandlingar av RCC\" name=\"test_16\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-test_16-1-0\">VEGF och VEGFR \u00e4r attraktiva molekyl\u00e4ra m\u00e5l f\u00f6r nya behandlingar av RCC<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-test_16-1-1\" type=\"radio\" value=\"Mutation eller inaktivering av VHL-genen st\u00f6r VHL-genens funktion och HIF bryts inte ned\" name=\"test_16\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-test_16-1-1\">Mutation eller inaktivering av VHL-genen st\u00f6r VHL-genens funktion och HIF bryts inte ned<\/label><\/div><div class=\"fusion-form-radio\"><input tabindex=\"\" id=\"radio-test_16-1-2\" type=\"radio\" value=\"Hyperoxiska celler fris\u00e4tter tillv\u00e4xtfaktorer som stimulerar tillv\u00e4xten av blodk\u00e4rl f\u00f6r att tillf\u00f6ra det syre som cellerna beh\u00f6ver under syrebegr\u00e4nsande f\u00f6rh\u00e5llanden.\" name=\"test_16\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"radio-test_16-1-2\">Hyperoxiska celler fris\u00e4tter tillv\u00e4xtfaktorer som stimulerar tillv\u00e4xten av blodk\u00e4rl f\u00f6r att tillf\u00f6ra det syre som cellerna beh\u00f6ver under syrebegr\u00e4nsande f\u00f6rh\u00e5llanden.<\/label><\/div><\/fieldset><\/div><div class=\"fusion-text fusion-text-10 fusion-animated\" data-animationType=\"fadeInLeft\" data-animationDuration=\"0.3\" data-animationOffset=\"top-into-view\"><p><small>(Anv\u00e4ndning av quizen \u00e4r helt anonym!)<\/small><\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-11 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-11 fusion-animated fusion-form-field-hidden\" data-animationType=\"fadeInLeft\" data-animationDuration=\"0.3\" data-animationOffset=\"top-into-view\" data-form-element-name=\"fusion_text_11\"><div class=\"fusion-fa-align-center\"><i class=\"fb-icon-element-1 fb-icon-element fontawesome-icon fa-check fas circle-no\" style=\"--awb-iconcolor:var(--awb-color4);--awb-font-size:47px;\"><\/i><\/div>\n<\/div><div class=\"fusion-text fusion-text-12 fusion-animated fusion-form-field-hidden\" data-animationType=\"fadeInLeft\" data-animationDuration=\"0.3\" data-animationOffset=\"top-into-view\" data-form-element-name=\"fusion_text_12\"><p style=\"text-align: center;\">Det \u00e4r r\u00e4tt!<\/p>\n<\/div><div class=\"fusion-text fusion-text-13 fusion-animated fusion-form-field-hidden\" data-animationType=\"fadeInLeft\" data-animationDuration=\"0.3\" data-animationOffset=\"top-into-view\" data-form-element-name=\"fusion_text_13\"><div class=\"fusion-fa-align-center\"><i class=\"fb-icon-element-2 fb-icon-element fontawesome-icon fa-times fas circle-no\" style=\"--awb-iconcolor:#ff4242;--awb-font-size:47px;\"><\/i><\/div>\n<\/div><div class=\"fusion-text fusion-text-14 fusion-animated fusion-form-field-hidden\" data-animationType=\"fadeInLeft\" data-animationDuration=\"0.3\" data-animationOffset=\"top-into-view\" data-form-element-name=\"fusion_text_14\"><p style=\"text-align: center;\">Det \u00e4r fel!<\/p>\n<\/div>\n<\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-12 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><\/div><\/div><\/form><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-1 fusion-button-default-span fusion-button-default-type\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/2-symptoms-and-diagnosis\/2-1-symptoms-of-kidney-cancer\/\"><span class=\"fusion-button-text\">Forts\u00e4tt till n\u00e4sta avsnitt: 2.1 Symtom p\u00e5 njurcancer<\/span><i class=\"fa-arrow-alt-circle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-5 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:7px;--awb-border-radius-top-right:7px;--awb-border-radius-bottom-right:7px;--awb-border-radius-bottom-left:7px;--awb-overflow:hidden;--awb-margin-top:4px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-13 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-8 fusion-title-center fusion-title-text fusion-title-size-five\" style=\"--awb-text-color:#c1c1c1;--awb-margin-top:25px;--awb-sep-color:#e2e2e2;\"><div class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h5 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\"><p style=\"text-align: center;\">Utforska den h\u00e4r kapitelmenyn<\/p><\/h5><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-14 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-15 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.88%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-2 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_bevel_color:rgba(89,96,104,0.7);--button_bevel_color_hover:rgba(89,96,104,0.9);--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:15px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/1-introduction-rcc\/1-1-introduction\/\"><span class=\"fusion-button-text\">1.1 Introduktion<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-3 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/1-introduction-rcc\/1-2-risk-factors\/\"><span class=\"fusion-button-text\">1.2 Riskfaktorer<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-4 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/1-introduction-rcc\/1-3-pathology\/\"><span class=\"fusion-button-text\">1.3 Patologi<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-5 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/1-introduction-rcc\/1-4-the-spread-of-rcc\/\"><span class=\"fusion-button-text\">1.4 Spridning av RCC<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-6 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/1-introduction-rcc\/1-5-anatomical-staging-of-rcc\/\"><span class=\"fusion-button-text\">1.5 Anatomisk stadieindelning av RCC<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-7 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/1-introduction-rcc\/1-6-pathophysiology\/\"><span class=\"fusion-button-text\">1.6 Patofysiologi<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-16 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7462,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7486","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7486","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/comments?post=7486"}],"version-history":[{"count":13,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7486\/revisions"}],"predecessor-version":[{"id":11165,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7486\/revisions\/11165"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7462"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/media?parent=7486"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}