Mishra K, Mathur M, Logani K B, Kakkar N, Krishna A
Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India.
Cancer. 1998 Nov 15;83(10):2228-32.
Studies regarding different ethnic populations of children with Wilms' tumor (WT) in the U. S. have shown differences between age and gender incidence and the type of its precursor lesions (nephrogenic rests). To the authors' knowledge there are few reports in the literature regarding nephrogenic rests in a large number of cases from other parts of the world.
In this study, histopathology sections from 127 WTs were pooled from the archives of 4 institutions in northern India and studied for the incidence of nephrogenic rests. Their incidence also was cross-correlated with patient age gender, and tumor morphology.
Significantly, the complete absence of perilobar nephrogenic rests was observed in all cases. Intralobar rests were associated with 45.3% of WTs and were observed predominantly with a triphasic histologic pattern and a relatively lower incidence of anaplasia compared with reports in the Western literature (1.5% vs. 4.5%). A lower median age of 2.5 years with a peak in the first 2 years of life was consistent with reported studies in Asian children. The male gender preponderance was in contrast to the equal male to female ratio reported in Western cases.
The type of nephrogenic rests present in Indian children was noted to be different from that in children reported in the Western literature. Differences also existed with regard to the age and gender incidence of children with WT and its morphologic pattern, possibly due to the different genetic nature of the tumor. However, this theory requires confirmation by large epidemiologic and genetic studies.
关于美国不同种族儿童肾母细胞瘤（WT）的研究表明，年龄、性别发病率及其前驱病变（肾源性残留）类型存在差异。据作者所知，文献中鲜有关于世界其他地区大量病例肾源性残留的报道。
本研究汇总了印度北部4家机构档案中的127例WT组织病理学切片，研究肾源性残留的发生率。其发生率还与患者年龄、性别及肿瘤形态进行了交叉关联分析。
值得注意的是，所有病例均未观察到叶外周肾源性残留。叶内残留与45.3%的WT相关，主要表现为三相组织学模式，与西方文献报道相比，间变发生率相对较低（1.5%对4.5%）。2.5岁的较低中位年龄及出生后前2年的发病高峰与亚洲儿童的报道研究一致。男性占优势，这与西方病例报道的男女比例相等形成对比。
印度儿童中存在的肾源性残留类型与西方文献报道的儿童不同。WT患儿的年龄、性别发病率及其形态模式也存在差异，这可能是由于肿瘤的不同遗传性质所致。然而，这一理论需要通过大规模的流行病学和遗传学研究来证实。
