Morphologic typing of papillary renal cell carcinoma

Comparison of growth kinetics and patient survival in 66 cases

Brett Delahunt, John Eble, Margaret R E McCredie, Peter B. Bethwaite, John H. Stewart, A. Michael Bilous

Research output: Contribution to journalArticle

234 Citations (Scopus)

Abstract

Whereas papillary renal cell carcinoma is now established as a subtype of renal cell neoplasia, division of these tumors into 2 distinctive morphotypes has been proposed. Type 1 tumors have cells with scanty pale cytoplasm arranged in a single layer on the basement membrane of papillary cores. In these tumors, psammoma bodies and foamy macrophages are frequently seen, and the tumors frequently express cytokeratin 7. Type 2 tumor cells have pseudostratified nuclei and usually have voluminous eosinophilic cytoplasm. Recent studies have supported this subclassification of papillary renal cell carcinoma by demonstrating differing genotypes for type 1 and 2 tumors. To further study the subclassification of papillary renal carcinoma, we compared clinical features, nuclear grade, stage, tumor growth kinetics, and survival in a series of 50 type 1 and 16 type 2 papillary renal cell carcinomas. Comparison of patient age at presentation, sex, and primary tumor size shows no significant difference between the 2 tumor types. Type 1 tumors were of significantly lower Fuhrman grade (P = .0001) and higher Robson stage (P = .009) than type 2 tumors. There was no significant difference when tumors were staged according to the TNM classification. Assessment of tumor growth kinetics showed significantly different mean silver-staining nucleolar organizer region (AgNOR) scores and Ki-67 indices (AgNOR type 1, 3.83, type 2, 7.24, P = .0001; Ki-67 type 1, 3.17%, type 2, 6.01%, P = .0002). Multivariate analysis showed tumor type (P = .03), presence of metastases (P = .04), AgNOR score (P = .001), and Ki-67 index (P = .03) to be independently associated with survival. These results provide evidence of the clinical utility of dividing papillary renal cell carcinomas into 2 types according to histologic characteristics.

Original languageEnglish
Pages (from-to)590-595
Number of pages6
JournalHuman Pathology
Volume32
Issue number6
DOIs
StatePublished - 2001

Fingerprint

Renal Cell Carcinoma
Survival
Growth
Neoplasms
Cytoplasm
Keratin-7
Kidney
Nucleolus Organizer Region
Silver Staining
Neoplasm Staging
Papillary Carcinoma
Basement Membrane
Cell Division
Multivariate Analysis
Macrophages
Genotype

Keywords

  • AgNOR
  • Grade
  • Growth kinetics
  • Ki-67
  • Papillary renal cell carcinoma
  • Stage
  • Survival

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Morphologic typing of papillary renal cell carcinoma : Comparison of growth kinetics and patient survival in 66 cases. / Delahunt, Brett; Eble, John; McCredie, Margaret R E; Bethwaite, Peter B.; Stewart, John H.; Bilous, A. Michael.

In: Human Pathology, Vol. 32, No. 6, 2001, p. 590-595.

Research output: Contribution to journalArticle

Delahunt, Brett ; Eble, John ; McCredie, Margaret R E ; Bethwaite, Peter B. ; Stewart, John H. ; Bilous, A. Michael. / Morphologic typing of papillary renal cell carcinoma : Comparison of growth kinetics and patient survival in 66 cases. In: Human Pathology. 2001 ; Vol. 32, No. 6. pp. 590-595.
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