乳头状肾细胞癌的病理及免疫组织化学研究

The Pathological and Immunohistochemical Study of Papillary Renal Cell Carcinoma

目的观察乳头状肾细胞癌(PRCC)的病理特点及免疫组织学研究。方法分析PRCC标本共45例,按组织细胞特点嗜碱亚型14例,嗜酸亚型31例。免疫组化染色,检测2种亚型上皮膜抗原(EMA)、细胞角蛋白7(CK7)、CD10、波形蛋白(Vim)及2种亚型Fuhrman分级比较与患者预后分析。结果嗜碱型与嗜酸型在EMA、CK7、CD10、Vim表达方面具有统计学意义(P<0.01,P<0.005)。嗜碱型与嗜酸型在Fuhrman分级比较,嗜酸型显著高于嗜碱型,两组分级比较具有统计学意义(P<0.005)。本组45例患者,随访期间病死率为15.6%(7/45),其中嗜碱型2例,嗜酸型5例。其余患者随访期间未出现复发或转移。结论乳头状肾细胞癌临床多发恶性肿瘤,其嗜碱亚型和嗜酸亚型的免疫组织学特点和Fuhrman分级以及临床预后均不同。

Objective To observe the pathological and immunohistochemical study of papillary renal cell carcinoma（PRCC）.Methods We analysis 45 cases who had PRCC,all cases were divide into basophilic subtype in 14 cases,acidophilic subtype in 31 cases,according to the organization cell characteristics.Immunohistochemical staining,detection two isoforms epithelial membrane antigen（EMA） and cytokeratin 7（CK7）,CD10,waveform protein（Vim）,and two subtypes of Fuhrman classification comparison with the prognosis of patients.Results There had statistical significance of basophilic type and acidophilic type in the EMA,CK7,CD10,Vim expression（P0.01,P0.005）.Basophilic type and acidophilic type in Fuhrman classification comparison,acidophilic type significantly higher than basophilic type（P0.005）.The 45 patients,follow-up period mortality were 15.6%（7/45）,of which type basophil in 2 cases,acidophilic type 5 cases.The rest of the patients were followed up for does not appear during the recurrence or metastases.Conclusion PRCC frequent malignant tumor,its basophilic subtype and acidophilic subtype immune histological characteristics and Fuhrman classification and clinical outcomes are different.