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目的:分析6例肾集合管癌患者的临床病理特征,以提高对该类肿瘤的认识。方法:复习行外科手术治疗的6例肾集合管癌患者的临床资料,对肿瘤组织进行病理组织学和免疫组织化学检查,并复习相关文献进行分析。结果:6例肾集合管癌患者中,男4例,女2例;年龄30~69岁,平均51岁;肿瘤直径4.0~13.5 cm。病理检查显示肿瘤以呈管状、乳头状结构为主,部分表现为片状生长,肿瘤细胞表现为靴钉样改变,其中特征性变化为间质纤维增生及多量浆细胞、淋巴细胞浸润和集合管上皮的异型增生;免疫标记显示,肿瘤细胞表达CK19、上皮膜抗原(EMA)、波形蛋白(vimentin)、上皮钙黏蛋白(E-cadherin)、34βE12、CK7、Ksp-cadherin和P504S,而均缺乏CK20、CD10、TFE3、CEA、Villin及CD117表达。结论:肾集合管癌是一种少见的高度恶性肾上皮性肿瘤,患者预后差;其诊断时应与乳头状肾细胞癌、肾髓质癌等鉴别,而免疫组织化学有助于鉴别诊断。
Objective: To analyze the clinicopathological features of 6 patients with renal tubulointerstitial cancer so as to improve the understanding of these tumors. Methods: The clinical data of 6 patients with renal tuberculous carcinoma treated by surgical operation were reviewed. The histopathological and immunohistochemical examinations were performed on the tumor tissues, and the related literatures were reviewed. Results: Among the 6 patients with renal tubules, there were 4 males and 2 females, aged from 30 to 69 years with an average of 51 years old. The diameter of tumors was 4.0 to 13.5 cm. Pathological examination showed that the tumor was mainly tubular and papillary, with some showing flake growth. The tumor cells showed a change in the shape of the boot nail. The characteristic changes were interstitial fibrosis and a large amount of plasma cells, lymphocyte infiltration and collecting tube Epithelial dysplasia; Immunohistochemistry showed that tumor cells expressed CK19, EMA, vimentin, E-cadherin, 34βE12, CK7, Ksp-cadherin and P504S CK20, CD10, TFE3, CEA, Villin and CD117 expression. CONCLUSIONS: Renal tubal carcinoma is a rare and highly malignant nephroepithelial neoplasm with poor prognosis. Its diagnosis should be differentiated from papillary renal cell carcinoma and renal medullary carcinoma. Immunohistochemistry is helpful for the differential diagnosis.