Variation in nuclear size and PD-L2 positivity correlate with aggressive chromophobe renal cell carcinoma.
Ann Diagn Pathol
; 34: 31-35, 2018 Jun.
Article
em En
| MEDLINE
| ID: mdl-29661724
ABSTRACT
Chromophobe renal cell carcinoma (CRCC) is not amenable to International Society for Urologic Pathology-endorsed nucleolar grading. Novel grading approaches were proposed, but the rarity of adverse pathology hampers their discriminatory value. We investigate simple linear micrometer measurements and a proposed immunostain in CRCCs. 32 patients' CRCCs were studied 12 adverse cases (stage pT3, recurrence, or metastasis), 15 controls (stage ≤pT2, no recurrence or metastasis after >3â¯years), and 8 metastases (3 were paired with primary adverse cases). The ratio of greatest dimensions of largest and smallest nuclei, in each of 5 "worst" high-power fields, excluding those with degenerative features, was designated variation in nuclear size (VNS). Percent multinucleate cells (PMC) were also counted. Mouse anti PD-L2 monoclonal antibody immunostaining was performed. Mean VNS measured in adverse primary and control primary tumors were 3.7⯱â¯0.5 and 2.4⯱â¯0.4 respectively (Pâ¯<â¯.001), and 3.4⯱â¯0.4 for metastases (Pâ¯<â¯.001). Optimal VNS cut-off was 2.5, with sensitivity and specificity 0.85 and 0.81, respectively. PMCs were 6.0⯱â¯3.0 for adverse group, 5.7⯱â¯2.7 for controls, and 4.1⯱â¯1.6 for metastases (Pâ¯=â¯NS). PD-L2 could not discriminate adverse versus good primary tumors (χ21.6, Pâ¯=â¯.2), but was higher in metastases (χ2 6.9, Pâ¯<â¯.01), or metastases plus adverse primary tumors (χ2 4.8, Pâ¯=â¯.03), compared to good-pathology primary tumors. In conclusion, VNS is an easily obtained measurement that can predict adverse behavior of chromophobe RCC, and may impart value for needle biopsy reporting and the choice of active surveillance. PD-L2 was elevated in metastases but was less useful for primary tumors.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Carcinoma de Células Renais
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Tamanho do Núcleo Celular
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Proteína 2 Ligante de Morte Celular Programada 1
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Neoplasias Renais
Tipo de estudo:
Prognostic_studies
Limite:
Adult
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Aged
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Aged80
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Animals
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Diagn Pathol
Assunto da revista:
PATOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos