Prognostic value of histological examination of renal cell carcinoma
Article published in Urologia Polska 2008/61/1.

authors

Iwona Wypychowska, Anna Bąkiewicz, Stanisław Sporny: Zakład Patomorfologii Wojewódzkiego Szpitala Zespolonego w Kaliszu
Zakładu Patomorfologii Stomatologicznej Uniwersytetu Medycznego w Łodzi

keywords

kidney, renal cell carcinoma, bcl-2, PCNA, prognosis, immunohistochemistry

summary

Introduction. Renal cell carcinoma is the tumor deriving from the renal tubular epithelium (WHO) in which, apart from traditional prognostic factors, such as: stage, grade and histological type, investigations of others indicators of biological malignancy are carried out.

Material and methods. Histological and clinical analyses were performed on nephrectomy material from Voivodeship Hospital in

Kalisz – 77 cases of patients with well known follow-up were selected (44 men and 33 women, mean age 61,1 ±10,9). After the

gross examination, histological slides (H+E) and immunohistochemical staining (ABC technique with use of commercial PCNA and

bcl-2 DAKO antibodies) were prepared.Statistical analysis of following parameters was performed: age, sex, survival, smoking, alcohol consumption, tumor size, histological type of carcinoma, hemorrhages into the tumor, tumor necrosis, infiltration of perirenal fat tissue, infiltration of renal vein and PCNA and bcl-2 indexes.

Results. Five histological types of renal cell carcinoma were distinguished: clear cell carcinoma (53), granular cell carcinoma (5), papillary carcinoma (10), chromophobe carcinoma (7), cystic carcinoma (2).

Statistically significant dependences were revealed: 1. Significantly poorer prognosis is observed in alcohol consuming patients. 2. The

presence of necrosis and infiltration of perirenal fat tissue and renal vein makes the prognosis worse. 3. The worst prognosis is associated

with granular cell carcinoma. 4.There is high index of immunoreactivity of bcl-2 in deeply invasive neoplasms.

Conclusion. The PCNA and bcl-2 staining may be useful, in addition to the classic microscopic examination result, in distinguishing

worse prognosing cases.

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