Large (>3.8 cm) clear cell renal cell carcinomas are morphologically and immunohistochemically heterogeneous.

Heterogeneity is an inherent event to tumour development that is lately receiving much attention in oncologic research. The topic is being addressed primarily at the molecular level, and results are promising. However, translation to practical medicine is still pending. Our intention in this study i...

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Publicado en:Virchows Archiv: European Journal of Pathology Vol. 466; no. 1; pp. 61 - 67
Autores principales: Zaldumbide, Laura, Erramuzpe, Asier, Guarch, Rosa, Cortés, Jesús M, López, José I
Formato: research Journal Article
Publicado: Springer Nature Jan2015
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2015
      vid: 466
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00428-014-1673-8
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        atl: Large (>3.8 cm) clear cell renal cell carcinomas are morphologically and immunohistochemically heterogeneous.
      aug:
        au:
          Zaldumbide, Laura
          Erramuzpe, Asier
          Guarch, Rosa
          Cortés, Jesús M
          López, José I
        affil: Department of Pathology, Cruces University Hospital, University of the Basque Country (UPV/EHU), Barakaldo, Bizkaia, Spain.
      sug:
        subj:
          Carcinoma, Renal Cell Metabolism
          Carcinoma, Renal Cell Pathology
          Oxidoreductases Metabolism
          Tumor Markers, Biological Metabolism
          Kidney Neoplasms Metabolism
          Kidney Neoplasms Pathology
          Body Weights and Measures
          Antigens, Tumor Metabolism
          Carbonic Anhydrases Metabolism
          Carcinoma, Renal Cell Diagnosis
          Cell Physiology
          Female
          Genes
          Human
          Kidney Neoplasms Diagnosis
          Male
          Neoplasm Grading
          Prognosis
          Prospective Studies
          Proteins Metabolism
          Esterases Metabolism
          Female
          Male
      ab: Heterogeneity is an inherent event to tumour development that is lately receiving much attention in oncologic research. The topic is being addressed primarily at the molecular level, and results are promising. However, translation to practical medicine is still pending. Our intention in this study is to approach the problem in a series of clear cell renal cell carcinomas with the tools that pathologists use in routine practice. Three randomly selected areas of 48 clear cell renal cell carcinomas prospectively collected in two different institutions were analysed for intratumour heterogeneity. The evaluated parameters were tumour size, cell type (clear vs. eosinophilic), Fuhrman's grade and immunohistochemical expression of carbonic anhydrase IX, BRCA1-associated protein-1 (BAP-1), cyclooxygenase-2 (COX-2) and Ki67. Intratumour heterogeneity was detected in 26 cases (54 %). Cell type, grade and Ki67 index were the parameters more frequently heterogeneous amounting, respectively, 44, 42 and 38 %. Tumour size was a significantly discriminative factor to predict tumour heterogeneity, with a cut-off of 3.8 cm (p < 0.001). Aside from tumour size, the most relevant parameters related with intratumour heterogeneity were cell type (clear vs. eosinophilic), Fuhrman's grade and Ki67 and COX-2 expression patterns. Carbonic anhydrase 9 and BAP-1 did not show statistical relevance. We conclude that heterogeneity is a common event in clear cell renal cell carcinomas that may be overlooked in cases insufficiently sampled. Tumour size appears as a reliable tool in identifying this situation since clear cell renal cell carcinomas under 3.8 cm in diameter are always homogeneous. This point may help the pathologist to make decisions in tumour sampling.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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