Kanamaru H, Mori H, Sasaki M, Fujikawa K, Akino H, Miwa Y, Okada K
Department of Urology, Fukui Medical School, Japan.
Int J Urol. 1997 Sep;4(5):451-5. doi: 10.1111/j.1442-2042.1997.tb00284.x.
This study was conducted to determine if there are any specific histologic features that are associated with lymph node metastasis in renal cell carcinoma (RCC).
TNM classification, histologic grade, mean nuclear volume, cell type, and histologic architecture of the tumors were evaluated in 66 patients who had undergone nephrectomy and lymphadenectomy for RCC. In the 18 patients with positive lymph node metastasis, both primary lesions and metastatic lymph nodes were evaluated.
Lymph node status was correlated with primary tumor stage, venous involvement, and distant metastasis. The tumor grade was higher, and the mean nuclear volume was larger, in both primary and metastatic lesions of RCCs with lymph node metastasis than in tumors with no metastasis. In primary lesions of RCCs with lymph node metastasis, clear cell, alveolar, or cystic patterns were observed less frequently, and granular or spindle/pleomorphic cells and papillary or solid patterns, were observed more frequently, as compared to those lesions without metastasis. Comparison between primary and metastatic lesions in individual patients revealed no significant difference in grade or mean nuclear volume. The development of new cell types or histologic architectures, which was not noted in the primary lesions, was also a rare event in the metastatic lesions.
Several characteristic histologic features, which may reflect the increased metastatic potential of the tumor, were observed in both primary and metastatic lesions in cases of RCC with lymph node metastasis. No substantial difference in histologic features was observed between the primary or metastatic lesions of individual patients.
本研究旨在确定肾细胞癌（RCC）中是否存在与淋巴结转移相关的特定组织学特征。
对66例行肾切除术和淋巴结切除术的RCC患者的肿瘤进行TNM分类、组织学分级、平均核体积、细胞类型和组织学结构评估。对18例淋巴结转移阳性患者的原发灶和转移淋巴结均进行评估。
淋巴结状态与原发肿瘤分期、静脉受累及远处转移相关。有淋巴结转移的RCC原发灶和转移灶的肿瘤分级更高，平均核体积更大。与无转移的肿瘤相比，有淋巴结转移的RCC原发灶中透明细胞、肺泡状或囊性模式较少见，颗粒状或梭形/多形性细胞以及乳头状或实性模式更常见。对个体患者的原发灶和转移灶进行比较，发现分级或平均核体积无显著差异。在原发灶中未发现的新细胞类型或组织学结构在转移灶中也很少见。
在有淋巴结转移的RCC病例中，原发灶和转移灶均观察到一些可能反映肿瘤转移潜能增加的特征性组织学特征。个体患者的原发灶和转移灶在组织学特征上无实质性差异。
