肾嫌色细胞癌的临床病理学观察

The clinicopathologic observation of chromophobe cell renal carcinoma

观察肾嫌色细胞癌的病理特点并与其它肾上皮性肿瘤鉴别。方法在光镜观察基础上，运用免疫组织化学检测ＣＫ８及Ｖｉｍｅｎｔｉｎ，并行Ｈａｌｅ胶体铁染色及电镜检查来观察７例肾嫌色细胞癌。并对７例病人进了随访。结果嫌色细胞癌由两种细胞类型组成，即典型型及嗜酸型。这些细胞的特点是ＣＫ８阳性，Ｖｉｍｅｎｔｉｎ阴性，Ｈａｌｅ胶体铁阳性，电镜下见大量胞浆内的单层膜构成的小空泡。随访３～１２６个月（平均７０个月），７例病人均无肿瘤复发及转移并存活至今。结论嫌色细胞癌是具有独特的形态特点及较好预后的肿瘤。根据组织学改变及辅助检测方法，可与其它肾上皮性肿瘤鉴别，具有临床意义。

Abstract: Objective To investigate the pathologic features of chromophobe cell renal carcinoma and make differentia diagno-diagnosis form other renal epithelial tumor. Methods On the basis of light microscopic observation, additional immunohistochemical assays of CK8 and vimentin, Hale' scolloidal iron stain and electron microscopic (EM) examination were used to observe sevencases of chromophobe cell renal carcinoma . Follow-up was carried out for all the patients. Results Chromophobe cell carcino mas were composed of two cell types, typical and eosinophilic type. These cells were characterized by CK8 positive, vimentin negative expression, Hale's colloidal iron positive stain and numerous intracytoplasmic membrane-bound microvesicles under EM. After operation, all the patients were followed for a perod of 3 to 126 months (average, 70 months), and they were all alive, had no recurrence and metastasis. Conclusions Chromophobe cell carcinoma is a morphologically distinchve neoplasm with a compe atively favorable prognosis. This tumor can be adifferentiated from other renal epithelial tumors on the basis of histologic changes and adjunct assays, that is of great clinical significance.