Mazal Peter R, Schaufler Roland, Altenhuber-Müller Romana, Haitel Andrea, Watschinger Bruno, Kratzik Christian, Krupitza Georg, Regele Heinz, Meisl Franz T, Zechner Othmar, Kerjaschki Dontscho, Susani Martin
Department of Clinical Pathology and Center of Excellence in Clinical and Experimental Oncology, University of Vienna General Hospital, Austria.
N Engl J Med. 2002 Aug 29;347(9):653-9. doi: 10.1056/NEJMoa013413.
Nephrogenic adenomas are benign, tumor-like lesions within the urothelial mucosa of the urinary tract that are not uncommon in renal-transplant recipients. We investigated the origin of nephrogenic adenomas in renal-transplant recipients.
Tissue sections were analyzed by fluorescence in situ hybridization with the use of probes for the X and Y chromosomes, by immunohistochemical methods with the use of antibodies to renal tubular antigens, and by lectin histochemical methods. Forty-six nephrogenic adenomas from 29 patients were analyzed.
All nephrogenic adenomas in 14 female recipients of transplants from male donors and 10 male recipients of transplants from female donors showed the same sex-chromosome status as the donor kidney, but not the same sex-chromosome status as the recipient's surrounding bladder tissue. The nephrogenic adenomas from all 6 female recipients of transplants from female donors showed female chromosomes, and those from the 16 male recipients of transplants from male donors showed male chromosomes. The presence of aquaporin 1, PAX2, and lectin-binding capacity for peanut agglutinin, Lotus tetragonolobus agglutinin, and Sophora japonica agglutinin in nephrogenic adenomas indicated an origin from renal tubular cells.
Nephrogenic adenomas in renal-transplant recipients are derived from tubular cells of the renal transplants and are not metaplastic proliferations of the recipient's bladder urothelium.
肾源性腺瘤是泌尿道尿路上皮黏膜内的良性肿瘤样病变，在肾移植受者中并不少见。我们研究了肾移植受者中肾源性腺瘤的起源。
采用X和Y染色体探针通过荧光原位杂交、使用肾小管抗原抗体通过免疫组织化学方法以及通过凝集素组织化学方法对组织切片进行分析。对来自29例患者的46个肾源性腺瘤进行了分析。
14名接受男性供体移植的女性受者和10名接受女性供体移植的男性受者的所有肾源性腺瘤均显示出与供体肾脏相同的性染色体状态，但与受者周围膀胱组织的性染色体状态不同。6名接受女性供体移植的女性受者的肾源性腺瘤均显示女性染色体，16名接受男性供体移植的男性受者的肾源性腺瘤显示男性染色体。肾源性腺瘤中存在水通道蛋白1、PAX2以及对花生凝集素、四角豆凝集素和槐凝集素的凝集素结合能力表明其起源于肾小管细胞。
肾移植受者中的肾源性腺瘤源自肾移植的肾小管细胞，而非受者膀胱尿路上皮的化生增殖。
