Sarkany Beatrix, Kuthi Levente, Kovacs Gyula
Department of Urology, Medical School, University of Pecs, 7621, Pecs, Hungary.
Department of Pathology, University of Szeged, 6725, Szeged, Hungary.
Hum Pathol. 2023 Aug;138:34-40. doi: 10.1016/j.humpath.2023.05.004. Epub 2023 May 18.
It is acknowledged that nephron develops after bilateral induction of the metanephric mesenchyma and branching ureteric bud (UB), and that nephrogenic rest and Wilms' tumor (nephroblastoma) arises from impaired differentiation of metanephric blastema. The aim of this study was to obtain more information on the involvement of UB derivatives in nephrogenic rest and Wilms' tumor. We applied immunohistochemistry to analyze nephrogenic rests and Wilms' tumors with mixed histology, including regressive and blastemal types. We used antibodies recognizing UB tip cells (ROBO1, SLIT2, RET), principal cells (AQP2), α- and β-intercalated cells (SLC26A4, SLC4A1, ATP6V1B1, ATP6V0D2), and their precursors (CA2). Tubules surrounded by tumorous blastemal cells resembling UB tip were positive for RET, ROBO1, and SLIT2 in Wilms' tumor. Moreover, CA2-positive tubular structures and ATP6V1B1- and ATP6V0D2-positive immature non-α- and non-β-intercalated cells were detected in nephrogenic rest and Wilms' tumor. We suggest that Wilms' tumor is more than nephroblastoma and propose a definition that Wilms tumor is a malignant embryonal neoplasm derived from pluripotential cells of nephrogenic blastema and of ureteric bud tip.
人们认识到肾单位是在双侧诱导后肾间充质和分支输尿管芽（UB）发育而成的，肾源性残留和威尔姆斯瘤（肾母细胞瘤）源于后肾胚基的分化受损。本研究的目的是获取更多关于UB衍生物在肾源性残留和威尔姆斯瘤中的作用的信息。我们应用免疫组织化学分析了具有混合组织学的肾源性残留和威尔姆斯瘤，包括退行性和胚芽型。我们使用了识别UB顶端细胞（ROBO1、SLIT2、RET）、主细胞（AQP2）、α和β闰细胞（SLC26A4、SLC4A1、ATP6V1B1、ATP6V0D2）及其前体（CA2）的抗体。在威尔姆斯瘤中，被类似UB顶端的肿瘤胚芽细胞包围的小管对RET、ROBO1和SLIT2呈阳性。此外，在肾源性残留和威尔姆斯瘤中检测到CA2阳性管状结构以及ATP6V1B1和ATP6V0D2阳性的未成熟非α和非β闰细胞。我们认为威尔姆斯瘤不仅仅是肾母细胞瘤，并提出一个定义，即威尔姆斯瘤是一种源自肾源性胚基和输尿管芽顶端多能细胞的恶性胚胎性肿瘤。
