Zhao Wei, Tian Bo, Wu Chao, Peng Yan, Wang Hui, Gu Wen-Li, Gao Feng-Hou
Department of Pathology, the First People's Hospital of ChangzhouV (the Third Affiliated Hospital of Soochow University), Changzhou 213003, China.
Department of Pathology, the First People's Hospital of ChangzhouV (the Third Affiliated Hospital of Soochow University), Changzhou 213003, China.
Pathol Res Pract. 2015 Apr;211(4):303-7. doi: 10.1016/j.prp.2014.12.014. Epub 2014 Dec 30.
The distinction between chromophobe renal cell carcinoma (ChRCC), clear cell renal cell carcinoma (CRCC) and renal oncocytoma may cause a diagnostic dilemma. The usefulness of DOG1, cyclin D1, CK7, CD117 and vimentin in the differential diagnosis of these renal epithelial tumors was investigated. DOG1 was positive in ChRCC (32 of 32, 100%) and in renal oncocytoma (21 of 21, 100%). In contrast, DOG1 was absent in all CRCC (0 of 30). Cyclin D1 was positive in renal oncocytomas (17 of 21, 81%) but negative in the ChRCC (0/23) and CRCC (0 of 30). CK7 was positive in ChRCC (30 of 32, 94%), but was negative in oncocytoma (only scattered single positive cells), and was only focal positive in two cases of CRCC. CD117 was expressed in 88% of ChRCC (28 of 32), 86% of renal oncocytoma (18 of 21), and was negative in all CRCC (0 of 30). Twenty-six of the 30 cases of CRCC were positive (87%) for vimentin with prominent membrane staining patterns. All 23 chromophobe carcinomas were negative for vimentin and 15 of 21 oncocytomas demonstrated focal vimentin positivity, but less than 10%. The above results demonstrate that: (1) DOG1 was very sensitive and specific marker for distinguish ChRCC from CRCC; (2) Cyclin D1 was a useful marker to discriminate between ChRCC and renal oncocytoma; (3) CK7 and CD117 were useful markers to distinguish ChRCC from renal oncocytoma and CRCC. (4) Vimentin was helpful for distinguishing clear cell RCC from chromophobe and oncocytoma (87% of clear cell RCC positive, negative in chromophobe, only focally positive in oncocytoma). (5) CK8/18, CK19, CD10, β-catenin and E-cadherin could not be used to distinguish ChRCC from renal oncocytoma and CRCC.
嫌色性肾细胞癌（ChRCC）、透明细胞肾细胞癌（CRCC）和肾嗜酸细胞瘤之间的鉴别可能会导致诊断困境。研究了DOG1、细胞周期蛋白D1、细胞角蛋白7（CK7）、CD117和波形蛋白在这些肾上皮肿瘤鉴别诊断中的作用。DOG1在ChRCC中呈阳性（32例中的32例，100%），在肾嗜酸细胞瘤中也呈阳性（21例中的21例，100%）。相比之下，在所有CRCC中DOG1均为阴性（30例中的0例）。细胞周期蛋白D1在肾嗜酸细胞瘤中呈阳性（21例中的17例，81%），但在ChRCC中为阴性（0/23），在CRCC中也为阴性（30例中的0例）。CK7在ChRCC中呈阳性（32例中的30例，94%），但在嗜酸细胞瘤中为阴性（仅散在单个阳性细胞），在2例CRCC中仅局灶性阳性。CD117在88%的ChRCC（32例中的28例）、86%的肾嗜酸细胞瘤（21例中的18例）中表达，在所有CRCC中均为阴性（30例中的0例）。30例CRCC中有26例波形蛋白呈阳性（87%），膜染色模式明显。所有23例嫌色性癌波形蛋白均为阴性，21例嗜酸细胞瘤中有15例波形蛋白呈局灶性阳性，但低于10%。上述结果表明：（1）DOG1是区分ChRCC和CRCC的非常敏感和特异的标志物；（2）细胞周期蛋白D1是鉴别ChRCC和肾嗜酸细胞瘤的有用标志物；（3）CK7和CD117是区分ChRCC与肾嗜酸细胞瘤和CRCC的有用标志物。（4）波形蛋白有助于区分透明细胞肾细胞癌与嫌色性癌和嗜酸细胞瘤（87%的透明细胞肾细胞癌阳性，嫌色性癌阴性，嗜酸细胞瘤仅局灶性阳性）。（5）CK8/18、CK19、CD10、β-连环蛋白和E-钙黏蛋白不能用于区分ChRCC与肾嗜酸细胞瘤和CRCC。
