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World Journal of Urology

, Volume 13, Issue 3, pp 149–152 | Cite as

Localized renal-cell carcinoma: detection of abnormal cells in peritumoral tissue

A cytophotometry and immunocytochemistry study
  • P. Anton
  • H. J. Tanke
  • E. P. Allehoff
  • M. A. Kuczyk
  • C. G. Stief
  • U. Jonas
Article

Summary

To spare organ function, partial resection of early diagnosed renal-cell carcinoma (RCC) is applied for well-localized and small-volume RCC with increasing frequency, although recurrence of the tumor in the same kidney is occasionally observed. The aim of the present study was to establish objective prognostic parameters that would allow the selection of tumors suitable for an organ-saving procedure. Of the 160 patients undergoing a radical nephrectomy, 67 were included in this study. In 7/45 patients with lymph-node dissection (15.6%), clinical staging revealed a false-negative lymph-node status. By means of conventional histopathology, multifocality could be demonstrated in 2/67 patients (3%); in 1/67 patients (1.5%), the ipsilateral adrenal gland was unexpectantly tumor-involved. Both tumor tissue and normal peritumoral tissue were examined for the presence of premalignant and tumor cells on the basis of DNA ploidy and of the expression of the tumor-associated G250 antigen, which is specifically expressed at the surface of renal cancer cells. In 40/67 (59.1%) peritumoral tissue specimens, cells with an abnormal DNA content could be observed using automated image analysis. In 12/67 cases (18%), cells obtained from peritumoral tissue also showed an aneuploid DNA histogram; 4/67 (6%) had a tumor-correlated DNA ploidy. Additionally, 38/67 (56.9%) of these tissues, histopathologically classified as normal, contained cells expressing the G250 antigen. These observations were independent of the stage or histological grade of the tumor. These data indicate that classic pathological parameters for tumor staging are insufficient for the detection of multifocality, occurring in more than 15% of cases. Additionally, it was shown that examination of tissue adjacent to the RCC allowed a specific detection of abnormal cells revealing abnormal ploidy or altered expression of tumor-associated antigens as compared with normal renal tissue in nearly 60% of cases investigated. The clinical relevance of this observation remains to be determined.

Keywords

Renal Cancer Cell Abnormal Cell Radical Nephrectomy Pathological Parameter Automate Image Analysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Al I, Ploem JS (1979) Detection of suspicious cells and rejection of artefacts in cervical cytology using LEYTAS. J Histochem Cytochem 1:629–634Google Scholar
  2. 2.
    Fearon ER, Vogelstein B (1990) A genetic model for colorectal tumorigenesis. Cell 61:759–767Google Scholar
  3. 3.
    Holthöfer H, Miettinen A, Paasivuo R, Lehto VP, Linder E, Alfthan O, Virtanen I (1983) A fluorescence microscopic study with kidney specific antibodies, antiintermediate filament antibodies and lectins. Lab Invest 49:317–320Google Scholar
  4. 4.
    Hostetter TH, Olson JL, Rinke HG (1981) Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation. Am J Physiol 241:85–88Google Scholar
  5. 5.
    Klein EA (1990) Die Genetik urologischer Tumoren. Aktuel Urol 21:301–311Google Scholar
  6. 6.
    Lacour M, Ghretien Y, Rougeron G, Goldfarb B, Dufour B (1990) Pathological review of 100 nephrectomies for adenocarcinoma. Special reference to intra-renal metastasis. Eur Urol 18 [Suppl 1]:256Google Scholar
  7. 7.
    Mukamel E, Konichezky M, Engelstein D, Servadio C (1988) Incidental small renal tumors accompanying clinically overt renal cell carcinoma. J Urol 140:22–25Google Scholar
  8. 8.
    Novick AC, Streem S, Montie JE, Pontes JE, Siegel S, Montague DK, Goormastic M (1989) Conservative surgery for RCC: a single-center experience with 100 patients. J Urol 141:835–839Google Scholar
  9. 9.
    Oosterwijk E, Ruiter DJ, Wakka JC, Huiskens van den Meij JW, Jonas U, Fleuren GJ, Zwartendijk J, Hoedemaker P, Warnaar SO (1986) Immunohistochemical analysis of monoclonal antibodies to renal antigens. Am J Pathol 123:301–309Google Scholar
  10. 10.
    Oosterwijk E, Ruiter DJ, Hoedemaker P, Pauwels EKJ, Jonas U, Zwartendijk J, Warnaar SO (1986) Monoclonal antibody G 250 recognizes a determinant present in renal cell carcinoma and absent from normal kidney. Int J Cancer 38:489–494Google Scholar
  11. 11.
    Ritchie AWS, deKernion JB (1987) The natural history and clinical features of renal cell carinoma. Semin Nephrol 7:131–137Google Scholar
  12. 12.
    Skinner DG, Vermillion CD, Colvin RB (1984) The surgical management of renal cell carcinoma. In: Whitehead ED, Letter E (eds) Current operative urology, 2nd edn. Harper and Row, Philadelphia, pp 29–35Google Scholar
  13. 13.
    Steinbach F, Stöckle M, Thüroff JW, Störkel S, Melchior S, Müller SC, Stein R, Hohenfellner R (1991) Parenchyma-saving surgery of renal tumors: experiences in over 120 patients. World J Urol 9:178–183Google Scholar
  14. 14.
    Tanke HJ, Ingen EM van, Ploem JS (1979) Acriflavine-Feulgen-Sits: a procedure for automated cervical cytology with a television based system (Leytas). J Histochem Cytochem 27:84Google Scholar
  15. 15.
    Thoenes W, Störkel S, Rumpelt HJ (1986) Histopathology and classification of renal cell tumors (adenomas, oncocytomas and carcinomas). Pathol Res Pract 181:125–143Google Scholar
  16. 16.
    Thompson IM, Peek M (1988) Improvements in survival of patients with renal cell carcinoma: the role of the serendipitously detected tumor. J Urol 140:487–495Google Scholar
  17. 17.
    Topley M, Novick AC, Montie JE (1984) Long-term results following partial nephrectomy for localized renal adenocarcinoma. J Urol 131:1050–1052Google Scholar
  18. 18.
    Wishnow KI, Lorigan J, Charnsangavej CJ (1989) Results of nephrectomy for peripheral well-circumscribed renal cell carcinoma. Urology 34:171–174Google Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • P. Anton
    • 1
  • H. J. Tanke
    • 2
  • E. P. Allehoff
    • 1
  • M. A. Kuczyk
    • 1
  • C. G. Stief
    • 1
  • U. Jonas
    • 1
  1. 1.Department of UrologyMedizinische Hochschule HannoverHannoverGermany
  2. 2.Department of Cytochemistry and CytometryRijksuniversiteitLeidenThe Netherlands

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