Das Ram Narayan, Chatterjee Uttara, Sinha Swapan K, Ray Ashoke K, Saha Koushik, Banerjee Sugato
Department of Pathology, I.P.G.M.E and R, Kolkata, West Bengal, India.
Indian J Med Paediatr Oncol. 2012 Apr;33(2):102-6. doi: 10.4103/0971-5851.99744.
The spectrum of pediatric renal tumors is different from adult renal tumors, and Wilms' tumor (WT) forms the majority. The histological type and clinicopathological staging are the two important prognostic parameters. The role of newer prognostic factors is not clear.
This study was performed to analyze the histopathological spectrum of pediatric renal tumors and to study the expression of proliferation markers (Ki-67 and p53) in WT and correlate its expression in epithelial and blastema components in different stages.
Twenty-seven cases of pediatric renal tumors were collected over 2 years. Hematoxylin-eosin staining was used for diagnosis. Immunostaining was performed for Ki-67 and p53. Ki-67 proliferation index (PI) and p53 expression were determined in each case and for the epithelial and blastema components separately.
We had 20 cases of WT (74.1%), three cases of mesoblastic nephroma (11.1%), three cases of clear cell sarcoma (11.1%) and one case of rhabdoid tumor (3.7%). It was observed that the PI of the epithelial component (57.2%) was significantly higher than that of blastema (39.53%) in all stages. The PI in Stage II is significantly higher than that in Stage I. Statistical analysis could not be performed in Stages III and IV due to the small number of cases. p53 expression did not show any significant difference in the epithelial and blastema components. There was also no significant difference between the stages.
In this study, we found the differences between PI of different tissue components of WT, with the epithelial component having a higher PI, which correlated with the stage of advancement of the disease.
小儿肾肿瘤的谱系与成人肾肿瘤不同，其中肾母细胞瘤（WT）占大多数。组织学类型和临床病理分期是两个重要的预后参数。新的预后因素的作用尚不清楚。
本研究旨在分析小儿肾肿瘤的组织病理学谱系，并研究增殖标志物（Ki-67和p53）在WT中的表达，并将其在不同阶段的上皮和胚芽成分中的表达进行关联。
在2年时间内收集了27例小儿肾肿瘤病例。采用苏木精-伊红染色进行诊断。对Ki-67和p53进行免疫染色。分别测定每例以及上皮和胚芽成分的Ki-67增殖指数（PI）和p53表达。
我们有20例WT（74.1%），3例中胚层肾瘤（11.1%），3例透明细胞肉瘤（11.1%）和1例横纹肌样瘤（3.7%）。观察到在所有阶段上皮成分的PI（57.2%）显著高于胚芽成分（39.53%）。II期的PI显著高于I期。由于病例数少，无法对III期和IV期进行统计分析。p53表达在上皮和胚芽成分中未显示任何显著差异。各阶段之间也无显著差异。
在本研究中，我们发现WT不同组织成分的PI之间存在差异，上皮成分的PI较高，这与疾病的进展阶段相关。
