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目的探讨透明细胞乳头状肾细胞癌(CCPRCC)的临床病理特征、鉴别诊断与预后。方法复习9例CCPRCC的临床资料,进行组织病理学形态和免疫组化观察。结果 9例中男性7例,女性2例,年龄38~68岁,平均年龄51.9岁。肿瘤直径1.2~7 cm,平均3.5 cm;8例为单发病例。9例均为查体时发现,无终末期肾病及VHL病家族史。镜下肿瘤由数量不等的腺泡状、乳头状、囊状和实性巢状结构组成,细胞核形态温和,远离基膜并朝向管腔、腺泡、乳头表面呈整齐的单层线状排列,间质内可见数量不等的平滑肌组织。免疫组化:CK、vimentin、CAⅨ和CK7均强(+),CD10、P504S和RCC灶性弱(+),CD117和TFE3均(-)。随访6个月~5年,均无复发和远处转移。结论 CCPRCC为一种少见的惰性肾肿瘤,典型的组织学表现结合免疫组化结果通常可以明确诊断。手术切除是首选治疗方法,总体预后良好。
Objective To investigate the clinicopathological features, differential diagnosis and prognosis of clear cell papillary renal cell carcinoma (CCPRCC). Methods The clinical data of 9 cases of CCPRCC were reviewed and their histopathological features and immunohistochemistry were observed. Results In 9 cases, there were 7 males and 2 females, aged from 38 to 68 years with a mean age of 51.9 years. Tumor diameter 1.2 ~ 7 cm, an average of 3.5 cm; 8 cases of solitary cases. 9 cases were found when the examination, no end-stage renal disease and family history of VHL disease. Microscopically, the tumor consisted of alveolar, papillary, cystic and solid nested structures in varying numbers. The nucleus was mild and far away from the basilar membrane and toward the lumen, acinus and nipple. , The amount of visible interstitial smooth muscle tissue. Immunohistochemistry: CK, vimentin, CA and CK7 were both strong (+), CD10, P504S and RCC were weak (+), CD117 and TFE3 were both (-). Follow-up 6 months to 5 years, no recurrence and distant metastasis. Conclusions CCPRCC is a rare form of indolent renal tumor. The typical histological findings combined with immunohistochemistry results usually confirm the diagnosis. Surgery is the preferred treatment, the overall prognosis is good.