Zhou Weimin, Zhong Kuangbiao, Wang Jingrong, Gu Yonghong, Huang Lihua, Jiang Zhiqiang, He Leye
Department of Urology, Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, P.R. China ; Department of Abdominal Surgery, Jiangxi Cancer Hospital, Nanchang, Jiangxi 330029, P.R. China.
Department of Urology, Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, P.R. China.
Oncol Lett. 2014 Dec;8(6):2664-2668. doi: 10.3892/ol.2014.2547. Epub 2014 Sep 18.
Metaplastic changes in the renal pelvis are infrequent and may be malignant transformations to adenocarcinoma. The current study reports a case of intestinal metaplasia in the right renal pelvis, which was associated with staghorn calculi, in a 56-year-old female. The patient underwent a percutaneous nephrolithotomy. Immunohistochemical assessment of the mucosa of the renal pelvis revealed the positive expression of carcinoembryonic antigen, cytokeratin (CK)-7 and CK20, but negative expression for CK5/6 and vimentin. Furthermore, Ki67 expression was diffusely positive, while p53 was negative. Unlike other previously reported cases, the patient opted for active surveillance as opposed to radical nephrectomy, following the removal of the calculi. No evidence of progression was observed after three years of follow-up. Therefore, etiological treatment and close follow-up may be a suitable treatment option for localized intestinal metaplasia.
肾盂化生改变并不常见，可能是向腺癌的恶性转化。本研究报告了一例56岁女性右肾盂肠化生病例，该病例与鹿角形结石有关。患者接受了经皮肾镜取石术。肾盂黏膜的免疫组织化学评估显示癌胚抗原、细胞角蛋白（CK）-7和CK20呈阳性表达，但CK5/6和波形蛋白呈阴性表达。此外，Ki67表达弥漫性阳性，而p53为阴性。与其他先前报道的病例不同，该患者在结石清除后选择了积极监测而非根治性肾切除术。随访三年后未观察到进展迹象。因此，病因治疗和密切随访可能是局限性肠化生的合适治疗选择。
