肾嫌色细胞癌13例临床病理分析并文献复习

Pathology Analysis and Literature Review of 13 Patients with Chromophobe Renal Cell Carcinoma

目的探讨肾嫌色细胞癌（chromophoberenalcellcarcinoma，CRCC）的临床病理特点、免疫学表型及预后。方法回顾性分析13例CRCC临床及病理资料，结合文献进行复习讨论。结果13例均行患侧肾根治性切除术。光镜所见：肿瘤细胞由嫌色细胞和嗜酸细胞组成，呈梁状和腺状分布。嫌色细胞呈多角形，胞膜清晰，胞浆呈半透明的网状结构，细胞核皱缩，有核沟及核异型存在，无明显核仁；而嗜酸细胞胞质嗜酸性，多呈圆形，可见明显的核周空晕。免疫组化CD117（＋），EMA（＋），Vimentin（-）。7例获随访，随访时间8～65个月，均未发现肿瘤复发及转移。结论CRCC是一种低度恶性的肾细胞癌，明确诊断需要依据典型的病理学特征。治疗仍以手术切除为主，长期随访发现预后良好。

Objective To explore the clinicopathological features, immunological phenotype and prognosis of ehromophobe renal cell carcinoma （CRCC）. Methods The clinical and pathological data of 13 patients with CRCC was retrospectively analyzed, and discussed in terms of literature review. Results All the 13 patients underwent renal affect- ed side radical resections. The light microscope showed that tumor cells were composed of chromophobe cells and eosino- philic cells with trabeeular and adeniform histological distribution. Chromophobe cells were polygon, clear cell mem- brane, the translucent and reticulated endoehylema, and crimp, grooved and abnormal nuclei were found in chromophobe cell renal carcinoma without obvious nueleoli; eosinophilic cells had eosinophilic cytoplasm with round and obvious peri- nuclearhalo. Immunohistochemistry showed the positive CDl17 and EMA, and negative Vimentin. There was no tumor- ous recurrence or metastasis in 7 patients during the follow-up for 8 -65 months. Conclusion CRCC is a low potential malignancy of CRCC, and the definite diagnosis depends on typical pathological features. The major treatment method is surgical ablation, and longterm follow-up shows good prognosis.