Department of Urology, Princess Alexandra Hospital, Woolloongabba, Brisbane, Qld, Australia; Centre for Kidney Disease Research, Faculty of Medicine, University of Queensland, Translational Research Institute, Woolloongabba, Brisbane, Qld, Australia; Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Centre for Kidney Disease Research, Faculty of Medicine, University of Queensland, Translational Research Institute, Woolloongabba, Brisbane, Qld, Australia.
Pathology. 2018 Aug;50(5):504-510. doi: 10.1016/j.pathol.2018.01.007. Epub 2018 Jun 30.
One of the challenges in differentiating chromophobe renal cell carcinoma (chRCC) from benign renal oncocytoma (RO) is overlapping morphology between the two subtypes. The aim of this study was to investigate the usefulness of expression of leptin (Ob) and its receptor (ObR) in discriminating chRCC from RO. Sections from paraffin-embedded, formalin-fixed tumour nephrectomy specimens of 45 patients, made up of 30 chRCC (15 eosinophilic variant and 15 non-eosinophilic variant) and 15 RO, were used in this study. Samples (30) of clear cell RCC (ccRCC), the most common histological subtype, were used to verify staining patterns found by others in our cohort of Australasian patients. Matched morphologically normal non-cancer kidney tissues were included for each specimen. Sections were batch-immunostained using antibodies against Ob and ObR. Stained sections were digitally scanned using Aperio ImageScope, and the expression pattern of Ob and ObR was studied. In this cohort, male to female ratio was 2:1; median age was 64 (45-88 years); and median tumour size was 3.8 cm (range 1.2-18 cm). There were 47 (62.7%) T1, seven T2, 20 T3 and one T4 stage RCC. Two patients with ccRCC presented with metastases. Nuclear expression of Ob was significantly higher in RO compared with chRCC. The increased nuclear expression of Ob in RO compared with chRCC may be a useful aid in the difficult histological differentiation of RO from chRCC, especially eosinophilic variants of chRCC.
从形态学上鉴别嫌色细胞肾细胞癌（chRCC）和良性肾嗜酸细胞瘤（RO）的一个挑战是这两种亚型之间存在重叠。本研究旨在探讨瘦素（Ob）及其受体（ObR）的表达在鉴别 chRCC 和 RO 中的作用。本研究使用了 45 例经福尔马林固定、石蜡包埋的肿瘤肾切除术标本的切片，其中包括 30 例 chRCC（15 例嗜酸细胞变体和 15 例非嗜酸细胞变体）和 15 例 RO。还使用了 30 例透明细胞肾细胞癌（ccRCC）样本，这是最常见的组织学亚型，以验证在我们的澳大利亚患者队列中其他人发现的染色模式。每个标本都包含了形态上正常的非癌性肾组织。使用 Ob 和 ObR 抗体对切片进行批量免疫染色。使用 Aperio ImageScope 对染色切片进行数字化扫描，并研究 Ob 和 ObR 的表达模式。在本队列中，男女比例为 2:1；中位年龄为 64 岁（45-88 岁）；中位肿瘤大小为 3.8 厘米（范围 1.2-18 厘米）。47 例（62.7%）为 T1 期，7 例为 T2 期，20 例为 T3 期，1 例为 T4 期。2 例 ccRCC 患者出现转移。RO 的核 Ob 表达明显高于 chRCC。RO 中 Ob 的核表达增加可能有助于在 RO 与 chRCC 的组织学鉴别中，尤其是 chRCC 的嗜酸细胞变体中，起到辅助作用。
