[The significance of morphologic characteristics of the tumor for the prognosis of 5-year survival of patients with kidney cancer]. / Znachenie morfologicheskikh osobennostei opukholi dlia prognozirovaniia piatiletnei vyzhivaemosti bol'nykh rakom pochki.

The study of 130 surgical and autopsy cases of renal carcinoma allowed us to identify morphological features of the highest importance for the prognosis of the 5-year survival: the stage of tumour according to pTNM classification, the degree of malignancy as determined by quantitative criteria, the pattern of growth, the tumour node size the growth into the renal vein and its branches, relative volume of the necrotic foci. These criteria help to bring about the individual prognosis and individual treatment.

[Morphology and differential diagnosis of oncocytic kidney tumors]. / Morfologiia i differentsial'naia diagnostika onkotsitarnykh opukholei pochek.

5 oncocytomas and 3 oncocytic carcinomas were studied morphologically, morphometrically, cytophotometrically, histochemically and ultrastructurally. Oncocytic carcinoma is characterized by the presence of necrotic foci, pronounced cell and nuclear polymorphism, invasive growth. Significantly higher degree of the nucleus size variability is found in the oncocytic carcinoma (as compared to oncocytoma). Anomalies of DNA content in the form of aneuploidy and polyploidy are found cytophotometrically in all oncocytic carcinomas but in 2 out of 5 cases oncocytomas only.

[Renal clear cell tumors: morphology, histochemistry, ultrastructure, differential diagnosis]. / Svetlokletochnye opukkholi pochek: morfologiia, gistokhimiia, ul'trastruktura, differentsial'naia diagnostika.

To define criteria for differential diagnosis of renal clear cell adenoma and grade I clear cell carcinoma, morphological, morphometric, histochemical, and ultrastructural studies were undertaken to examine 30 renal clear cell tumors (18 carcinomas and 12 adenomas). No morphological, morphometric, histochemical, and ultrastructural differences were found between the tumors, but the average tumor size was smaller in the adenoma than in the carcinoma. Clinically and morphologically, clear cell adenoma should be classified as grade I clear cell carcinoma of stage I, which has a relatively favourable prognosis by virtue of its small node sizes.

[Comparative characteristics of the stroma of renal adenomas and cancer]. / Sravnitel'naia kharakteristika stromy adenomy i raka pochek.

In a comparative study of 120 renal carcinomas and 10 adenomas it was found that in the adenomas the stroma as well as vessels were uniform with respect to distribution and degree of maturity and showed only scanty lymphoid infiltration, but that in the carcinomas, on the contrary, the distribution was irregular and lymphoid infiltration was much more abundant, particularly in areas of invasive growth. A close correlation was observed between stromal morphology and proliferative activity of the tumor. It is concluded that morphologic differences between these two kinds of tumor may be of use in diagnostic differentiation.

[The degree of malignancy and histologic variants of kidney cancer: their importance in diagnosis and prognosis]. / Stepen' zlokachestvennosti i gistologicheskis varianty raka pochek: znachenie dlia diagnoza i prognoza.

Basing on quantitative morphological and histochemical findings, 170 cases of renal carcinoma were divided into 3 (I, II, III) grades of malignancy. This grading system is of a high prognostic significance. Histological variant, i.e. the predominance of clear or granular cells in the tumor specimens, is not prognostically significant. The clear cells differ from the granular ones by high lipid and glycogen content and by low proliferation rate. In tumors of a high malignancy grade the lipid and glycogen levels are low. The authors offer to divide all cases of renal carcinoma not into clear- and granular-cell tumors, but on lipid-rich and lipid-poor ones because the lipid content is in good correlation with the grade of malignancy and therefore prognostically valuable.

[Quantitative morphological criteria of the degree of malignancy of kidney cancer]. / Kolichestvennye morfologicheskie kriterii stepeni zrelosti raka pochek.

Eighty cases of renal carcinoma were studied by morphological and morphometrical methods. According to the current classification all the cases were divided into three groups: clear-cell, granular-cell, and anaplastic carcinoma. Clear-cell and granular-cell carcinomas may be of three degrees of malignancy: low, moderate, and high. In tumors of low degree of malignancy, the mitotic index, the rate of pathological mitotic figures, and the nucleus-cytoplasm ratio are higher than in tumors of high degree of malignancy. In the former, cytophotometry revealed increasing heterogeneity in DNA distribution. According to the results of the quantitative studies, tumors of moderate degree of malignancy can be divided into two groups: one with the parameters of low, the other of high degree of malignancy. The results of the study will be useful for improving the microscopic diagnosis of renal carcinoma.

[Ultrastructural characteristics of renal cancer cells]. / Ul'trastrukturnye osobennosti kletok raka pochki.

The ultrastructural study of the renal carcinoma revealed some differences in the fine structure of the two main cell types: clear and dark cells. The cytoplasm of clear cells is rich in fat and glycogen. Fat is found in lipid vacuoles and glycogen in diffuse granularity in the cell cytoplasm. Dark cells contain small amounts of fat and glycogen but have well developed mitochondria and other organelles. Comparison of these cell types shows some features of their similarity such as microvilli on the cell surface, desmosomes and interdigitations in the region of cell contacts and channels between tumour cells. These features suggest that clear and dark cells have a common origin from the epithelium of the proximal tubules.

[Prognostic value of the histological grading of cancer of the kidney]. / Prognosticheskoe znachenie gistologicheskoi gradatsii raka pochki.

The data of morphologic examination of 83 cases of renal carcinoma were used for grading tumor malignancy (grades I--III). The classification is based on such quantitative parameters as nucleus-cytoplasm and nucleolus-nucleus ratios, percentage of nucleolus-containing nuclei, and size and DNA content of the nucleus. The grading system proved to be of prognostic value and easy to reproduce.

[Use of quantitative histochemistry in the prognosis of renal cell cancer]. / Primenenie kolichestvennoi gistokhimii v prognoze pri pochechno-kletochnom rake.

The study was concerned with evaluating the quantitative histochemical and histoenzymatic peculiarities of renal cell carcinoma of various grade of malignancy. It involved measuring levels of lipids, glycogen, protein, nucleic acids and sugar as well as the activities of dehydrogenases, phosphatases, non-specific esterase and lipase in tumor cells. Grade I neoplasms were found to be associated with low proliferative activity matched by relatively high energy production thus causing excessive synthesis of lipids and glycogen to occur. Higher cell proliferative activity in grade II and III tumors accounts for a significantly lower level of lipids and glycogen. Those metabolic peculiarities appeared to correlate with prognosis.

[Significance of morphologic signs of primary tumor for the prognosis of metastases of renal cell carcinoma]. / Znachenie morfologicheskikh priznakov pervichnoi opukholi dlia prognozirovaniia metastazov pochechnokletochnogo raka.

The purpose of the study was to determine the value of macro- and microscopic signs of primary tumor that had the highest chance to contribute to metastatic growth in renal cancer patients within 3 years after nephrectomy. The study covered 92 cases of renal cancer, including 42 cases with, and 50 cases, without metastases by the time of surgery, autopsy or within 3 years after nephrectomy. Diagnostic coefficients were calculated for each sign by means of the consecutive Walde's analysis, and their respective values were estimated by Coulbaque's formula. The degree of malignancy was assessed on the basis of a combination of quantitative parameters of proliferative activity and cataplasia of the tumor. The degree of malignancy, tumor stage by the PTNM classification, size and growth pattern, renal vein involvement and the volume of necrotic foci were the most valuable predictors of metastatic growth.

[Errors and difficulties in the clinical diagnosis of kidney cancer]. / Oshibki i trudnosti klinicheskoi diagnostiki raka pochki.

Differences in the clinical and pathoanatomical diagnosis of renal cancers were evaluated in 52 autopsy cases of patients who died of renal cancer. The diagnoses differed in 14 cases (26.9%) Most errors are related to prevalence in the clinical pictures of symptoms caused by metastases. The second frequent error was domination in the clinical picture of paraneoplastic syndromes--fever, amyloidosis, etc.

[Retrospective evaluation of the efficacy of regional endolymphatic polychemotherapy in kidney cancer depending on the histologic structure of the tumor]. / Retrospektivnaia otsenka éffektivnosti regionarnoi éndolimfaticheskoi polikhimioterapii pri rake pochki v zavisimosti ot gistologicheskogo stroeniia opukholi.

An attempt was made to differentiate the prognosis for patients with various histological patterns of renal cell carcinoma subjected to adjuvant regional endolymphatic polychemotherapy from those patients who were not. A total of 90 patients were allocated to 3 groups: the first group consisted of those persons for whom a 4-component endolymphatic therapy with 5-fluorouracil, cyclophosphamide, methotrexate, thiotepa was employed; the second group (25 patients) was administered the same preparations intravenously; the third-group patients (25 subjects) were those who after surgery were not given drugs at all. Tumor biopsy specimens were studied in detail histologically and 3 carcinoma patterns were distinguished: clear cell, granular cell and anaplastic carcinoma. The number of mitotic figures per 1,000 tumor cells was defined as well. The life-span of all anaplastic carcinoma patients was less than 5 yrs. Three-year survival was the most common in first group patients with clear cell or granular cell carcinomas. Five-year survival in patients with granular cell carcinoma was 50 per cent in the first and 11.1 per cent in the second group, while in those with clear cell carcinoma it was relatively equal in all groups. The total five-year survival rate was 40 per cent in group I, 20 per cent in group II and 16 per cent in group III. The results obtained were indicative of a higher effect of adjuvant endolymphatic polychemotherapy versus intravenous treatment. As better results were in those with granular cell carcinoma than in patients with clear cell carcinoma, tumor histological pattern be considered before the adjustment of cytostatic dosages and disease prognostication.