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This paper presents 216 cases of ma- lignant renal tumor treated in this hospital during 1957~1984.The patients of over 31 years of age accounted for 86.8% and 6 patients were more than 20 years of age, the youngest being 7 years old.It is of great singnificance.of these 216 patients, 120 were renal cell carcinoma(55.6%), (the most common tumor in kidneys) of which 80 had pathological examination after operation.In this series,75 cases of clear cell carcinoma(91.5%),2 cases of granulose cell carcinoms and 5... This paper presents 216 cases of ma- lignant renal tumor treated in this hospital during 1957~1984.The patients of over 31 years of age accounted for 86.8% and 6 patients were more than 20 years of age, the youngest being 7 years old.It is of great singnificance.of these 216 patients, 120 were renal cell carcinoma(55.6%), (the most common tumor in kidneys) of which 80 had pathological examination after operation.In this series,75 cases of clear cell carcinoma(91.5%),2 cases of granulose cell carcinoms and 5 cases of undiffirentiated renal cell carcinoms were found.In this series.75 cases had ne- phrotectomy.Follow-up studies that the three-yeat survival rate was 47.1% and the five-year survival rate was 32.9% The survival rate for 23 cases was more than 5 years,of which 17 cases were proved to be stage 1 and 6 stage 11,sug- gesting that in order to improve the survi- val rate,to early diagnosis and proper treatment must be paid special attentioe. 本文报告了我院1957~1984年共收治的肾脏恶性肿瘤216例其中肾细胞癌120例(55.6%),占肾脏肿瘤的第一位。有82例通过手术及活组织检查得到病理结果,透明细胞癌76例(占91.5%),颗粒细胞癌2例,未分化癌5例。在患者中31岁以上者占86.7%,而20岁以下者6例,其中年龄最小者为7岁(1例),值得注意。本组中75例做了肾切除术。术后随访,三年存活率为47.1%,五年存活率为32.9%,有23例存活五年以上。其中Ⅰ期17例,Ⅱ期6例。因此在今后应尽早诊断、治疗肾肿瘤,以提高长期存活率。 Although it is now generally accepted that renal cell carcinoma (RCC) arises from proximal convoluted tubules (PCT), there are some features of RCC difficult to interpret by the hypothesis. We employed four monoclonal antibodies (mAbs) against different tubules to determine the antigenic expression of adult kidney and RCC with the avidin-biotin peroxidase complex (ABC) technique.The results in 38 adult kidney showed: the mAb Uro-2 stained intensively the epithelial cell of PCT and weakly glomeruli; the mAb against... Although it is now generally accepted that renal cell carcinoma (RCC) arises from proximal convoluted tubules (PCT), there are some features of RCC difficult to interpret by the hypothesis. We employed four monoclonal antibodies (mAbs) against different tubules to determine the antigenic expression of adult kidney and RCC with the avidin-biotin peroxidase complex (ABC) technique.The results in 38 adult kidney showed: the mAb Uro-2 stained intensively the epithelial cell of PCT and weakly glomeruli; the mAb against Tamm-Horsfall glycoprotein reacted with the cellular membranes of ascending thick limb of Henle's loop and distal tubules (DCT); the mAb Uro-5 bound to the epithelial cells of DCT, collecting ducts (CD); the mAb Uro-10 outlined the PCT. On the basis of immunoanatomic study of normal kidney we used these mAbs to detect the antigens of 32 cases of RCC. 13 cases (40.6%) only expressed the antigns of PCT and indicated the origin of this site. Five cases (15.6%) presented exclusively the antigen of DCT and were considered arising from the cells of them. Two cases 'had the antigen of CD and suggested deriving from this segment of nephron.Analysing the data in the literature and our results we have come to a preliminary conclusion that (1) not all RCC originate from the PCT, besides this portion of the nephron RCC also derive from the other segments of renal tubules, including DCT and CD; (2) the staining patterns of the mAbs are typical and consistent, and useful in immuno-microanatomy of kidney. 近年公认肾细胞癌起源于近曲小管,作者应用4种肾小管抗原的单克隆抗体(mAb)对38例成人肾及32例肾细胞癌进行免疫组化研究;发现这些mAb在肾脏有稳定的染色类型,肾细胞癌多数表达近曲小管抗原,少数表达远曲小管、集合管抗原。经肿瘤细胞类型分析,透明细胞癌主要起源于近曲小管,颗粒细胞癌可能起源于远曲小管。 30 cases ot RCC, including 16 clear, 1 spindle and 6 mixed (clear and granular), were carefully compared in their ultrastructural characteristics. The clear, granular and spindle cell type of RCC were not different in nature but rather in the quantity of lipid, glycogen and mitochondria present. So, ultrastructually, RCC may be classified into 3 types: that rich in lipid and/or glycogen (clear), that rich in mitochondria (granular) and that poor in lipid and mitochondria (spindle). It was also found that the... 30 cases ot RCC, including 16 clear, 1 spindle and 6 mixed (clear and granular), were carefully compared in their ultrastructural characteristics. The clear, granular and spindle cell type of RCC were not different in nature but rather in the quantity of lipid, glycogen and mitochondria present. So, ultrastructually, RCC may be classified into 3 types: that rich in lipid and/or glycogen (clear), that rich in mitochondria (granular) and that poor in lipid and mitochondria (spindle). It was also found that the degree in ultrastructural differention can be of value in prognosing the RCC. 本文对30例肾细胞癌(包括16例透明细胞型,7例颗粒细胞型,1例梭形细胞型和6例透明细胞与颗粒细胞混合型)的超微特征进行了仔细的比较。在电镜下,透明细胞、颗粒细胞和梭形细胞之间除了脂滴、糖原和线粒体的数量有所不同之外,并无本质上的差异。因此,本文建议将肾细胞癌分为三个超微结构类型:富于脂滴和/或糖原型(透明细胞型),富于线粒体型(颗粒细胞型)和脂滴和线粒体贫乏型(梭形细胞型)。超微结构的分化程度可能具有预后价值。
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