АСПЕКТЫ ПАТОМОРФОЛОГИИ СВЕТЛОКЛЕТОЧНОГО ВАРИАНТА ПОЧЕЧНО-КЛЕТОЧНОЙ КАРЦИНОМЫ

Abstract

Renal cell carcinoma (kidney cancer, RCC) has been and remains one of the most important problems of oncourology, which is expressed by a steady increase in the incidence of 6—10 % every year [1]. Pathology occurs with the same frequency in both men (2.4 % in the structure of cancer mortality in the Republic of Belarus) and women (2.1 %) and accounts for 4 % of all adult malignant tumors. Objective. To identify the diagnostically significant pathomorphological aspects of the light-cell variant of renal cell carcinoma by morphometric analysis. Materials and methods. We analyzed the surgical material from 20 patients (10 men and 10 women) aged 29 to 83 years (median 64 ± 3.2 years) with a verified diagnosis of renal cell carcinoma from the State Institution "RNPC OMR named after N. N. Alexandrov". Grading and staging of the tumor was carried out according to the recommendations of the WHO (World Health Organization Classification of Tumours. Pathology & Genetics: Tumours of the Urinary System and Male Genital Organs. Lyon, France: IARC Press, 2004:179—184). The pathomorphological assessment of the material was carried out both at the microscopic and macro levels. Methods used: histological and morphometric. Results. At the macro level, in all cases of SPCR, the growth patterns, cytological and nuclear signs characteristic of it were revealed: the average size of the cells: 5,0*6,7*4,8 cm (p < 0.05), the material is light yellow with areas of hemorrhage. Macroscopically, it can be seen that in most cases the tumor extends into the renal sinus and a smooth contour into the paranephral tissue. CHLS invasion was detected in one case (5 %), invasion into the portal vessels — in two cases (10 %), focal compression of CHLS — in one case (5 %). The parenchyma is not preserved along the entire perimeter in all cases of SPCR, and PPCR (p > 0.1). Conclusion: 1. According to the results of the work carried out, it was found that the light-cell variant of renal cell carcinoma is characterized by a variety of pathomorphological manifestations that occur in other variants of renal cancer. On the other hand, the presence of foci of "thyroidization" was detected only in SPCR. 2. The morphometric parameters of the nuclei of renal cell carcinoma cells may directly depend on the patient's gender. In this case, the superiority of nuclei in size was observed in male patients. 3. The nuclei in the light-cell variant of renal cancer are significantly larger than the nuclei in chromophobic renal cancer and smaller than the cell nuclei in papillary renal cancer. 4. These indicators can be used in the future to improve the definition of significant criteria for the differential diagnosis of various variants of renal cell cancers.