肾癌多中心病灶发生机理的探讨

Study of the genesis of multicentricity in renal cell carcinoma

目的 探讨肾癌多中心病灶的发生机理。 方法 肾癌根治术标本 10 2例 ,间隔 3mm切开检查切面 ,原发灶外可疑处取材证实肾癌者为多中心灶阳性。免疫组化法检查肾癌原发灶及多中心灶p5 3、PCNA、c erbB2 、CD44 v6、bcl 2、nm2 3 H1 蛋白表达情况。 结果 多中心灶发生率为 15 .7%( 16 10 2 ) ,16例多中心性肾癌中 ,原发灶与多中心灶p5 3、PCNA、c erbB2 、CD44 v6、bcl 2、nm2 3 H1 蛋白表达情况均相近 ,统计学处理差异无显著性意义 (P均 >0 .4)。 结论 肾癌多中心灶具有与原发灶相似的生物学特征 ,其发生以原发灶肾内转移可能性大。

ObjectiveTo study the genesis of multicentricity in renal cell carcinoma (RCC).Methods102 kidneys from radical nephrectomy for RCC were step sectioned at 3 mm intervals and examined for the presence of multifocal cancers and vascular invasion and for the condition of the pseudocapsule.Expressions of p53,PCNA,c-erb B 2,CD 44v6,bcl-2 and nm 23-H 1 in the primary and multifocal RCC were assayed by standard SP immunohistochemical procedures.ResultsOf the 102 cases,positive multifocal RCC was found in 16 (15.6%).The expressions of p53,PCNA,c-erb B 2,CD 44v6,bcl-2 and nm 23-H 1 in the primary tumors were very similar to those in the multifocal lesions without significant differences statistically (P>0.4).ConclusionsThese data denote that biological behaviors and malignant features of multifocal tumors are very similar to those of primary ones.In addition,considering the significant relationship of multicentricity with vascular invasion and incompleteness of pseudocapsule of RCC,it is suggested that the secondary tumors might be more likely the result of intrarenal metastasis of the primary tumor rather than the results of multifocal genesis.