Licht M R, Novick A C, Tubbs R R, Klein E A, Levin H S, Streem S B
Department of Urology, Cleveland Clinic Foundation, Ohio 44195.
J Urol. 1993 Nov;150(5 Pt 1):1380-3. doi: 10.1016/s0022-5347(17)35784-1.
We treated 31 patients with renal oncocytoma. Renal cell carcinoma was found existing separately within the same or contralateral kidney in 10 patients (32%). Followup of 29 patients revealed 24 alive with no evidence of disease and 1 alive with recurrent oncocytoma, while 1 with coexistent tumors died of progressive renal cell carcinoma and 3 tumor-free patients died of unrelated diseases. Quantitative deoxyribonucleic acid analysis was performed on cell suspensions of fresh tumor by flow cytometry or by image cytometry on touch preparations from frozen tissue in 16 patients with renal oncocytoma. Ploidy analysis revealed all oncocytomas to be diploid. Frozen tissue immunohistology was performed using murine monoclonal antibody against human HLA-A, B and C (class I) antigens with the avidin-biotin peroxidase technique in 11 patients with renal oncocytoma. Ten oncocytomas did not express these self-recognition antigens and 1 was only weakly positive for antigen expression. In contrast, renal cell carcinomas strongly expressed HLA class I antigens. The high incidence of coexistence of renal oncocytoma and renal cell carcinoma has important clinical implications. Loss of HLA class I antigen expression by renal oncocytomas may provide an additional method for differentiating this lesion from renal cell carcinoma.
我们对31例肾嗜酸细胞瘤患者进行了治疗。在10例患者（32%）的同一侧或对侧肾脏中发现了单独存在的肾细胞癌。对29例患者的随访显示，24例存活且无疾病证据，1例存活但有复发性嗜酸细胞瘤，1例合并肿瘤患者死于进行性肾细胞癌，3例无肿瘤患者死于无关疾病。对16例肾嗜酸细胞瘤患者的新鲜肿瘤细胞悬液进行了流式细胞术定量脱氧核糖核酸分析，或对冷冻组织的触片进行了图像细胞术分析。倍体分析显示所有嗜酸细胞瘤均为二倍体。对11例肾嗜酸细胞瘤患者使用抗人HLA - A、B和C（I类）抗原的鼠单克隆抗体，采用抗生物素蛋白 - 生物素过氧化物酶技术进行冷冻组织免疫组织化学检测。10例嗜酸细胞瘤未表达这些自身识别抗原，1例仅为抗原表达弱阳性。相比之下，肾细胞癌强烈表达HLA I类抗原。肾嗜酸细胞瘤与肾细胞癌共存的高发生率具有重要的临床意义。肾嗜酸细胞瘤HLA I类抗原表达缺失可能为将该病变与肾细胞癌区分开来提供一种额外的方法。
