Retrospective analysis of 25 immunohistochemical tissue markers for differentiating multilocular cystic renal neoplasm of low malignant potential and multicystic renal cell carcinoma
Sung Han Kim1, Boram Park2, Jungnam Joo2, Jae Young Joung1, Ho Kyung Seo1, Kang Hyun Lee1, Weon Seo Park3 and Jinsoo Chung1
1Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, 2Biometrics Research Branch, Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center and 3Department of Pathology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Republic of Korea
Offprint requests to: Jinsoo Chung MD, PhD, Department of Urology, Center for Prostate Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. e-mail: cjs5225@ncc.re.kr or Weon Seo Park, MD, PhD, Department of Pathology, Center for Prostate Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea. e-mail: thymus@ncc.re.kr
Summary. Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) and multicystic renal cell carcinoma (MCRCC) are morphologically indistinguishable. MCRNLMP is a tumor composed entirely of numerous cysts, the septa of which contain individual or groups of clear cells without expansile growth. However, unlike MCRCC, neither recurrence nor metastasis has been reported in MCRNLMP. The aim of this study was to identify significant differential pathological characteristics in resected specimens from patients diagnosed with MCRNLMP (n=13) and MCRCC (n=17) using immunohistochemistry of 25 tissue markers. Staining interpretation was performed semi-quantitatively using the H-score (0-300) or intensity score (0-3), and differences between groups were evaluated using the Fisher exact and Wilcoxon rank-sum tests. During a median follow-up of 66.2 months (1-141.9 months), there was only one case of MCRCC recurrence among all 30 patients, including 19 (63.3%) at stage pT1a, 8 (26.7%) at stage pT1b, and 3 (10.0%) patients at stage pT2. Tumor necrosis rate (0% vs. 52.9%) and median tumor size (3.2 cm vs. 4.1 cm) significantly differed between MCRNLMP and MCRCC samples. Among the 25 tissue markers, only HIF1a, PDGFRα, SMA, VEGFR1, VEGFR2, VEGFR3, CD10, CD31, CD34, CK7-tubule, TGAse-2, and Ki-67 showed significantly different expression between the groups. These tissue markers with differential expression between MCRNLMP and MCRCC can provide a clue to understanding their distinct pathophysiology. Histol Histopathol 33, 589-596 (2018)
Key words: Renal cell carcinoma, Comparison, Cyst, Immunohistochemistry
DOI: 10.14670/HH-11-958