Histological architectures of clear cell carcinoma and their correlation to clinicopathologic features.

Abstract

576 Background: The aim of this study is to clarify the relationship between histological architectures (HA) and clinicopathological features (CF) in clear cell carcinoma (CCC). Methods: Between 1984 and 2014 nephrectomy or partial nephrectomy were performed in 723 renal cell carcinoma cases in our hospital. Among them 603 cases (83.4%) were CCC. We reviewed the pathological reports and found 556 CCC cases had description of HA. The relationship between HA and CF were investigated. Results: HA were as follows: small acinar (SA)/acinar (A) in 453 cases (81.5%), large acinar (LA)/solid (S) in 113 (20.3%), papillary (P) in 54 (9.7%), Cystic (C) in 121 (21.8%) and tubular in 53 (9.5%). By the Spearman rank correlation, significant correlation was observed between HA and tumor grades: SA/A (rho -0.408, p < 0.0001), LA/S (0.567, p < 0.0001), P (0.257, p < 0.0001), C (-0.241, p < 0.0001). Acinar sizes were correlated with tumor grade (0.541, p < 0.0001), tumor size (0.435, p < 0.0001) and local stage (0.414, p < 0.0001). LA/S or P showed low microvessel density evaluated by CD31 immunostaining, which resulted in weaker attenuation in corticomedullary phase of enhancement CT. On the contrary SA had high microvessel density and high attenuation after enhancement. Conclusions: HA is well-correlated with tumor grade, tumor size and local stage, and could be predicted by dynamic CT pattern preoperatively.