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[非透明细胞肾细胞癌:79例新旧组织学分类的比较分析]

[Non-clear cell renal carcinoma: comparative analysis of the new and old histological classification in 79 cases].

作者信息

Cui Wei, Zhang Yan-hui, Chen Ming, Liu Su-xiang, Liu Yan-xue, Yang Ximing J, Yao Xin

机构信息

Department of Urologic Surgery, Tianjin Medical University Cancer Hospital & Institute, Tianjin 300060, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2010 Oct;32(10):772-6.

Abstract

OBJECTIVE

To compare the old classification and 2004 WHO histological classification of renal cell carcinoma, summarize the differences and possible reasons, and correct the traditional pathological concepts of kidney cancer.

METHODS

Specimens of 79 cases histopathologically diagnosed as non-clear cell renal cell carcinomas after radical nephrectomy during 1998 to 2005 in Tianjin Medical University Cancer Hospital were reclassified according to the 2004 WHO renal cell carcinoma histological classification system.

RESULTS

After reclassification, there were 14 cases of clear cell renal cell carcinoma (CCRCC), 23 cases of papillary renal cell carcinoma (PRCC), 34 cases of chromophobe renal cell carcinoma (ChRCC), one collecting duct renal cell carcinoma, one unclassified renal cell carcinoma, 5 cases of mixed cell renal cell carcinoma (CCRCC + PRCC 2 cases, CCRCC + ChRCC 2 cases, PRCC + ChRCC 1 case), and one oncocytoma diagnosed.

CONCLUSIONS

Some chromophobe renal cell carcinomas and papillary renal cell carcinomas were easier to be diagnosed as granular cell renal cell carcinoma in the past. The eosinophilic cytoplasm similar to that in the granular cells, and some confusion between PRCC and ChRCC are the main reasons. The cellular characteristic features of granular renal cell carcinoma can be found in many types of renal tumors. Granular cell renal cell carcinoma is not an independent entity, therefore, it should be removed from the histological classification of renal cell carcinoma. The diagnosis standard of mixed renal cell carcinoma (MRCC) need to be determined and consummated.

摘要

目的

比较肾细胞癌的旧分类与2004年世界卫生组织(WHO)组织学分类,总结两者差异及可能原因,纠正肾癌传统病理观念。

方法

对1998年至2005年期间在天津医科大学肿瘤医院行根治性肾切除术后经组织病理学诊断为非透明细胞肾细胞癌的79例标本,按照2004年WHO肾细胞癌组织学分类系统进行重新分类。

结果

重新分类后,有透明细胞肾细胞癌(CCRCC)14例,乳头状肾细胞癌(PRCC)23例,嫌色肾细胞癌(ChRCC)34例,集合管肾细胞癌1例,未分类肾细胞癌1例,混合细胞肾细胞癌(CCRCC + PRCC 2例,CCRCC + ChRCC 2例,PRCC + ChRCC 1例)5例,诊断为嗜酸细胞瘤1例。

结论

以往部分嫌色肾细胞癌和乳头状肾细胞癌易被诊断为颗粒细胞肾细胞癌。主要原因是其嗜酸性细胞质与颗粒细胞相似,以及PRCC和ChRCC之间存在一些混淆。颗粒肾细胞癌的细胞特征可见于多种类型的肾肿瘤。颗粒细胞肾细胞癌不是一个独立的实体,因此,应将其从肾细胞癌的组织学分类中去除。混合性肾细胞癌(MRCC)的诊断标准有待确定和完善。

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