肾母细胞瘤与胚胎肾发育及肾源性剩余的关系

Relationship of nephroblastoma to development of fetal kidney and to nephrogenic rest

目的 探讨肾母细胞瘤发生与胚胎肾分化发育及肾源性剩余的关系。 方法 在光学显微镜下比较３０ 例肾母细胞瘤和１６ 例不同胎龄肾组织的形态特点；观察比较２２ 例肾母细胞瘤瘤旁肾组织和３０ 例非肿瘤成熟肾组织中肾源性剩余的阳性率。 结果 肾母细胞瘤与早期胚胎肾在组织形态上有相似之处；２２ 例肾母细胞瘤瘤旁肾组织中６ 例见肾源性剩余存在，３０ 例非肿瘤成熟肾组织中仅１ 例见肾源性剩余存在。 结论 肾母细胞瘤的发生与胚胎肾分化停滞有关，肾源性剩余可能是肾母细胞瘤的前期病变。

Objective To study the relationship of nephroblastoma to the differentiation and development of fetal kidney and to the existence of nephrogenic rest(NR). Methods 30 cases of nephroblastoma and 16 fetal kidneys were observed under microscope to compare their histomorphologic characters. 22 cases of renal tissues adjacent to nephroblastoma and 30 cases of non neoplastic mature renal tissues were observed to compare the positive rate of NR. Results Histomorphology of nephroblastoma mimiced that of the immature structures in fetal kidney.NR was the locus immature structure existing in the mature kidney, similar to those in fetal kidney. NR was found in 6 of 22 cases of renal tissues adjacent to nephroblastoma whereas it was found in only 1 of the 30 cases of non neoplastic mature renal tissues. The difference between these 2 groups was statistically significant. Conclusions The results suggested that the genesis of nephroblastoma is relevant to the retarded differentiation of fetal kidney. NR is the precursor lesion of nephroblastoma.