Mazal Peter R, Exner Markus, Haitel Andrea, Krieger Sigurd, Thomson R Brent, Aronson Peter S, Susani Martin
Department of Clinical Pathology, Medical University of Vienna, Austria.
Hum Pathol. 2005 Jan;36(1):22-8. doi: 10.1016/j.humpath.2004.09.011.
Distinguishing renal oncocytoma from chromophobe and other renal carcinomas is essential, considering their differing biological potentials. Although renal oncocytoma is considered a benign tumor, chromophobe renal cell carcinoma has potentially malignant biological behavior. The numerous reported studies on distinguishing these 2 entities have been based on morphological, histochemical, immunohistochemical, ultrastructural, and cytogenetic features. But none of these features has proven to be reliably specific, especially in tumors with overlapping phenotypes. We report a novel immunohistochemical approach based on the expression of a recently described kidney-specific cadherin (Ksp-cadherin) for the differential diagnosis of these 2 tumors. We compared Ksp-cadherin expression in 212 renal tumors, including 102 clear cell renal carcinomas, 46 papillary renal cell carcinomas, 30 chromophobe carcinomas, 3 collecting duct carcinomas, and 31 oncocytomas. In addition, we examined the expression of epithelial membrane antigen, vimentin, CK7, and Hale's colloidal iron staining. We found that chromophobe renal cell carcinomas consistently (96.7% of cases) demonstrated a distinctive membrane pattern of Ksp-cadherin expression, whereas renal oncocytomas (3.2%), clear cell renal cell carcinomas (0%), papillary renal cell carcinomas (2.2%), and collecting duct carcinomas (0%) usually did not express Ksp-cadherin. CK7 expression was found in 90.0%, 6.5%, 7.8%, 76.1%, and 33.3% of these tumor cases, respectively. Whereas CK7 was detected in different types of renal cell carcinomas, Ksp-cadherin was expressed almost exclusively in chromophobe renal cell carcinomas. Immunohistochemical analysis of Ksp-cadherin offers a fast, reliable approach for the distinguishing between renal oncocytoma and chromophobe renal cell carcinoma that is applicable for routine pathology laboratory studies without the need for time-consuming and costly ancillary studies.
鉴于肾嗜酸细胞瘤与嫌色性肾癌及其他肾癌具有不同的生物学潜能，区分它们至关重要。尽管肾嗜酸细胞瘤被认为是良性肿瘤，但嫌色性肾细胞癌具有潜在的恶性生物学行为。众多关于区分这两种实体的报道研究均基于形态学、组织化学、免疫组织化学、超微结构和细胞遗传学特征。但这些特征均未被证明具有可靠的特异性，尤其是在具有重叠表型的肿瘤中。我们报告了一种基于最近描述的肾特异性钙黏蛋白（Ksp-钙黏蛋白）表达的新型免疫组织化学方法，用于这两种肿瘤的鉴别诊断。我们比较了212例肾肿瘤中Ksp-钙黏蛋白的表达情况，其中包括102例透明细胞肾癌、46例乳头状肾细胞癌、30例嫌色性癌、3例集合管癌和31例嗜酸细胞瘤。此外，我们还检测了上皮膜抗原、波形蛋白、CK7的表达以及黑尔胶体铁染色。我们发现，嫌色性肾细胞癌始终（96.7%的病例）表现出独特的Ksp-钙黏蛋白表达膜模式，而肾嗜酸细胞瘤（3.2%）、透明细胞肾细胞癌（0%）、乳头状肾细胞癌（2.2%）和集合管癌（0%）通常不表达Ksp-钙黏蛋白。在这些肿瘤病例中，CK7的表达分别为90.0%、6.5%、7.8%、76.1%和33.3%。虽然CK7在不同类型的肾细胞癌中均有检测到，但Ksp-钙黏蛋白几乎仅在嫌色性肾细胞癌中表达。Ksp-钙黏蛋白的免疫组织化学分析为区分肾嗜酸细胞瘤和嫌色性肾细胞癌提供了一种快速、可靠的方法，适用于常规病理实验室研究，无需耗时且昂贵的辅助研究。
