López José I
Department of Pathology, Cruces University Hospital, BioCruces Health Research Institute, University of the Basque Country (UPV/EHU), Barakaldo, Spain.
APMIS. 2016 Mar;124(3):153-9. doi: 10.1111/apm.12500. Epub 2016 Jan 14.
Intertumor heterogeneity, defined as the spectrum of morphological differences found in similar tumors in different patients, is a well-known event for pathologists. However, recent molecular studies have pointed to intratumor heterogeneity as one of the most important issues in human neoplasia in the next years. Clear cell renal cell carcinoma is an example of an intrinsically heterogeneous neoplasm, and some of the most salient advances in the knowledge of intratumor heterogeneity have been developed on it. This review intends to analyze this phenomenon in this tumor from the practicing pathologist's point of view. A careful study of the surgical specimen and an exhaustive tumor sampling are mandatory to keep relevant information. Currently accepted protocols designed for renal tumor sampling may be insufficient. As a result, a different approach to tumor sampling is advisable to ascertain that intratumor heterogeneity, if present, will be well represented in the selected material.
肿瘤间异质性是指在不同患者的相似肿瘤中发现的形态学差异谱，这对病理学家来说是一个众所周知的现象。然而，最近的分子研究指出肿瘤内异质性是未来几年人类肿瘤形成中最重要的问题之一。透明细胞肾细胞癌是一种本质上异质性肿瘤的例子，并且在肿瘤内异质性知识方面的一些最显著进展就是基于它而取得的。本综述旨在从执业病理学家的角度分析该肿瘤中的这一现象。仔细研究手术标本并进行详尽的肿瘤取样对于保留相关信息至关重要。目前公认的用于肾肿瘤取样的方案可能并不充分。因此，建议采用不同的肿瘤取样方法，以确保如果存在肿瘤内异质性，其在所选材料中能得到充分体现。
