CAJ | 학술논문

目的比较2004年世界卫生组织(WHO)肾细胞癌组织学分类标准与旧分类标准的异同,总结容易出现的诊断差异及可能原因,纠正对肾细胞癌传统病理分类的观念.方法天津医科大学肿瘤医院1998年2月至2005年12月间,根治性肾切除术后病理诊断为非透明性细胞癌79例,按2004年WHO肾癌组织学分类标准进行重新分类,并收集相关临床资料进行分析.结果重新分类后,透明性肾细胞癌14例,乳头状肾细胞癌23例,嫌色性肾细胞癌34例,肾集合管癌1例,未分类的肾细胞癌1例,混合型肾细胞癌5例(透明及乳头状肾细胞癌混合型2例,透明及嫌色性肾细胞癌混合型2例,乳头状及嫌色性肾细胞癌混合型1例),肾嗜酸细胞瘤1例.结论以往,部分嫌色性肾细胞癌与乳头状肾细胞癌易被诊断为颗粒细胞癌,主要原因相似的嗜酸性颗粒样胞浆特点以及对嫌色性肾细胞癌及乳头状肾细胞癌的组织学特点认识不清.旧有诊断中颗粒细胞癌的结构特点可见于多种肾细胞癌,但不是一种独立的肾癌类型,应从分类中去除.对于混合两种或以上不同类型肾细胞癌的诊断标准有待定义与完善.
목적 비교2004년세계위생조직(WHO)신세포암조직학분류표준여구분류표준적이동,총결용역출현적진단차이급가능원인,규정대신세포암전통병리분류적관념.방법 천진의과대학종류의원1998년2월지2005년12월간,근치성신절제술후병리진단위비투명성세포암79례,안2004년WHO신암조직학분류표준진행중신분류,병수집상관림상자료진행분석.결과 중신분류후,투명성신세포암14례,유두상신세포암23례,혐색성신세포암34례,신집합관암1례,미분류적신세포암1례,혼합형신세포암5례(투명급유두상신세포암혼합형2례,투명급혐색성신세포암혼합형2례,유두상급혐색성신세포암혼합형1례),신기산세포류1례.결론 이왕,부분혐색성신세포암여유두상신세포암역피진단위과립세포암,주요원인상사적기산성과립양포장특점이급대혐색성신세포암급유두상신세포암적조직학특점인식불청.구유진단중과립세포암적결구특점가견우다충신세포암,단불시일충독립적신암류형,응종분류중거제.대우혼합량충혹이상불동류형신세포암적진단표준유대정의여완선.
Objective To compare the old classification and 2004 WHO histological classification of renal cell carcinoma, summarize the differences and possible reasons, and correct the traditional pathological concepts of kidney cancer. Methods Specimens of 79 cases histopathologically diagnosed as non-clear cell renal cell carcinomas after radical nephrectomy during 1998 to 2005 in Tianjin Medical University Cancer Hospital were reclassified according to the 2004 WHO renal cell carcinoma histological classification system. Results After reclassification, threr were 14 cases of clear cell renal cell carcinoma (CCRCC), 23 cases of papillary renal cell carcinoma (PRCC), 34 cases of chromophobe renal cell carcinoma (ChRCC), one collecting duct renal cell carcinoma, one unclassified renal cell carcinoma,5 cases of mixed cell renal cell carcinoma ( CCRCC + PRCC 2 cases, CCRCC + ChRCC 2 cases, PRCC +ChRCC 1 case), and one oncocytoma diagnosed. Conclusions Some chromophobe renal cell carcinomas and papillary renal cell carcinomas were easier to be diagnosed as granular cell renal cell carcinoma in the past. The eosinophilic cytoplasm similar to that in the granular cells, and some confusion between PRCC and ChRCC are the main reasons. The cellular characteristic features of granular renal cell carcinoma can be found in many types of renal tumors. Granular cell renal cell carcinoma is not an independent entity,therefore, it should be removed from the histological classification of renal cell carcinoma. The diagnosis standard of mixed renal cell carcinoma (MRCC) need to be determined and consummated.