Walton J M, Lee C L, Mikhail E, Welch J P, Gillis D A
Department of Surgery, Izaak Walton Killam Children's Hospital, Halifax, Nova Scotia, Canada.
J Pediatr Surg. 1992 Oct;27(10):1311-4. doi: 10.1016/0022-3468(92)90283-d.
Genetic studies in Wilms' tumor have most commonly shown a deletion involving band 13 on the p arm of chromosome 11 in association with aniridia. Structural rearrangements of chromosome 3p have been found in carcinoma of renal cell and lung origin but have not been previously reported in Wilms' tumors. We present two phenotypically normal, unrelated patients with Wilms' tumors, one of which was bilateral, in which cytogenetic analysis of the tumors showed an unbalanced translocation of the p arm of chromosome 3. Two biopsies were done in the patient with bilateral Wilms' tumor. The first biopsy specimen showed a translocation between chromosome 3 and 13 with partial trisomy of 3p and loss of material from 13q. The second biopsy three and a half months later again showed trisomy of chromosome 3p. The unilateral Wilms' tumor showed trisomy of 3p with partial loss of 7p. Neither patient showed a constitutional chromosomal abnormality and neither tumor showed any cytogenetic abnormality involving chromosome 11p. Quantitative DNA analysis was performed in the tumors of both patients. The bilateral Wilms' tumor was nearly diploid with a DNA index of 1.284 (mean ploidy, 2.45; SD, 0.854) while the unilateral Wilms' tumor was aneuploid with a DNA index of 1.531 (mean ploidy, 3.35; SD, 0.976). DNA analysis results are discussed in relationship to the chromosome abnormality seen on the karyotype analysis. These cytogenetic findings suggest that genetic oncogenesis in Wilms' tumor is heterogenous.
肾母细胞瘤的遗传学研究最常显示11号染色体短臂13区带缺失,与无虹膜相关。3号染色体短臂的结构重排已在肾细胞癌和肺癌中发现,但此前未在肾母细胞瘤中报道。我们报告了两名表型正常、无亲缘关系的肾母细胞瘤患者,其中一名为双侧发病,对其肿瘤进行的细胞遗传学分析显示3号染色体短臂发生了不平衡易位。对双侧肾母细胞瘤患者进行了两次活检。第一次活检标本显示3号和13号染色体之间发生易位,伴有3号染色体短臂部分三体化和13号染色体长臂物质丢失。三个半月后进行的第二次活检再次显示3号染色体短臂三体化。单侧肾母细胞瘤显示3号染色体短臂三体化,伴有7号染色体短臂部分缺失。两名患者均未显示染色体结构异常,且肿瘤均未显示涉及11号染色体短臂的细胞遗传学异常。对两名患者的肿瘤进行了DNA定量分析。双侧肾母细胞瘤接近二倍体,DNA指数为1.284(平均倍体数,2.45;标准差,0.854),而单侧肾母细胞瘤为非整倍体,DNA指数为1.531(平均倍体数,3.35;标准差,0.976)。结合核型分析中观察到的染色体异常对DNA分析结果进行了讨论。这些细胞遗传学发现提示肾母细胞瘤的遗传致癌机制是异质性的。