Khurana K K, Truong L D, Verani R R
State University of New York, Syracuse 13066, USA.
Mod Pathol. 1998 Apr;11(4):339-46.
Renal cell carcinoma (RCC) arising in acquired cystic kidney disease (ACKD) is considered to be a tumor of low malignant potential, compared with classic RCC. The aim of the present study was to identify any significant differences in the antigenic profiles or tumor cell proliferative activity of ACKD-associated RCC and classic RCC that might be responsible for differences in their biologic behavior. We studied the immunohistochemical profiles and proliferative activity of 12 classic RCCs and 5 ACKD-associated RCCs with markers of proximal tubules (Leu M1, alpha-1 antitrypsin, CAM 5.2), markers of distal tubules (Arachis hypogaea lectin, AE1/AE3, epithelial membrane antigen [EMAJ, CAM 5.2), vimentin, and proliferating cell nuclear antigen (PCNA). We performed proliferation analysis with the CAS 200 image analysis system. For each case, 8 to 20 fields of tumor tissue in the areas of maximal PCNA staining were quantitated, and the percentage of PCNA-positive nuclear area for each individual tumor was calculated. All of the five ACKD-associated RCCs expressed AE1/AE3, EMA, and CAM 5.2 in more than 50% of the tumor cells. Arachis hypogaea lectin was significantly expressed in three of the five ACKD-associated RCCs. Leu M1 and alpha-1 antitrypsin reacted with fewer than 10% of the tumor cells in all of the five ACKD-associated RCCs. In contrast, the 12 classic RCCs showed expression of CAM 5.2 in 11 cases, alpha-1 antitrypsin in 10 cases, Leu M1 in 9, EMA in 8, and AE1/AE3 in 3 cases in more than 50% of the tumor cells and a totally negative reaction with Arachis hypogaea lectin in 8 cases, EMA in 4, AE1/AE3 in 4, and vimentin in 5 cases. Although coexpression of proximal and distal tubule markers was seen in some cases of RCC in either category, there was uniform and strong staining for distal tubule markers in ACKD-associated RCC and for proximal tubule markers in classic RCC. The mean percentage of PCNA-positive nuclear area for the ACKD-associated RCCs (2.41%) was significantly (P < .05) less than that of the classic RCCs (21.42%). The differences in expression of proximal and distal tubule markers and proliferative activity might be responsible for the differences in the biologic behavior of ACKD-associated RCC and classic RCC.
与经典肾细胞癌（RCC）相比，获得性囊性肾病（ACKD）中发生的肾细胞癌被认为是一种低恶性潜能的肿瘤。本研究的目的是确定ACKD相关RCC和经典RCC在抗原谱或肿瘤细胞增殖活性方面是否存在任何显著差异，这些差异可能是它们生物学行为不同的原因。我们用近端小管标志物（Leu M1、α-1抗胰蛋白酶、CAM 5.2）、远端小管标志物（花生凝集素、AE1/AE3、上皮膜抗原[EMA]、CAM 5.2）、波形蛋白和增殖细胞核抗原（PCNA）研究了12例经典RCC和5例ACKD相关RCC的免疫组织化学谱和增殖活性。我们使用CAS 200图像分析系统进行增殖分析。对于每个病例，对肿瘤组织中PCNA染色最强区域的8至20个视野进行定量，并计算每个肿瘤中PCNA阳性核面积的百分比。所有5例ACKD相关RCC中，超过50%的肿瘤细胞表达AE1/AE3、EMA和CAM 5.2。5例ACKD相关RCC中有3例花生凝集素表达显著。在所有5例ACKD相关RCC中，Leu M1和α-1抗胰蛋白酶与不到10%的肿瘤细胞发生反应。相比之下，12例经典RCC中，11例CAM 5.2、10例α-1抗胰蛋白酶、9例Leu M1、8例EMA、3例AE1/AE3在超过50%的肿瘤细胞中表达，8例花生凝集素、4例EMA、4例AE1/AE3和5例波形蛋白完全呈阴性反应。虽然两类RCC的某些病例中均可见近端和远端小管标志物的共表达，但ACKD相关RCC中远端小管标志物呈均匀且强阳性染色，经典RCC中近端小管标志物呈均匀且强阳性染色。ACKD相关RCC的PCNA阳性核面积平均百分比（2.41%）显著低于经典RCC（21.42%）（P <.05）。近端和远端小管标志物表达及增殖活性的差异可能是ACKD相关RCC和经典RCC生物学行为不同的原因。
