I-renal cell carcinoma pathology

I-Renal cell carcinoma pathology ibandakanya uvavanyo lwe-microscopic kunye nohlalutyo lwezicubu zezintso ukufumanisa kunye nokuhlelwa komhlaza wezintso. Linyathelo elibalulekileyo ekumiseleni uhlobo, ibakala, kunye nenqanaba lomhlaza, elazisa ngezigqibo zonyango kunye nokuqikelela kwangaphambili iprognosis. Ukuqonda iimpawu ze-pathological kubalulekile kuzo zombini izigulana kunye neengcali zonyango. Esi sikhokelo sinika inkcazo eneenkcukacha I-renal cell carcinoma pathology, kubandakanywa ii-subtypes eziqhelekileyo, iinkqubo zokulinganisa, isiteji, kunye nendima ye-immunohistochemistry.Ukuqonda i-Renal Cell Carcinoma (RCC)I-Renal cell carcinoma (RCC) lolona hlobo luxhaphakileyo lomhlaza wezintso kubantu abadala, lubalelwa malunga ne-90% yazo zonke izifo ezichaphazela izintso. Ivela kwi-lining ye-proximal convoluted tubule, eziyimibhobho encinci kwizintso ezihluza igazi kwaye zivelise umchamo. Ukuxilongwa ngokuchanekileyo kunye nokuhlelwa kwe-RCC kubaluleke kakhulu ekukhokeleni izicwangciso zonyango olusebenzayo kunye nokuqikelela iziphumo zesigulane.Ii-Subtypes eziqhelekileyo ze-Renal Cell CarcinomaIintlobo ezininzi ze-RCC zikhona, nganye ineempawu ezicacileyo ze-pathological, iimpawu zofuzo, kunye nokuziphatha kweklinikhi. Ezi zincinci ziyakwazi ukwahlula phantsi kovavanyo lwe-microscopic kwaye ziqinisekiswa ngakumbi yi-immunohistochemistry. Ii-subtypes ezinkulu ziquka:I-Clear Cell Renal Cell Carcinoma (ccRCC)I-Clear cell RCC lolona hlobo luxhaphakileyo, lubalelwa malunga ne-70-80% yazo zonke iimeko ze-RCC. Ibonakaliswa ngamaseli ane-cytoplasm ecacileyo okanye ephaphathekileyo ngenxa ye-glycogen ephezulu kunye nomxholo we-lipid. Ezi seli zihlala zenza iindlwane okanye amakhasi, kwaye ithumba lidla ngokuba ne-vascularized.Papillary Renal Cell Carcinoma (pRCC)Papillary RCC lolona hlobo lwesibini luxhaphakileyo, lenza malunga ne-10-15% yamatyala e-RCC. Ibonakaliswa yi-papillary architecture, okuthetha ukuba iiseli zethumba zikhula kwiingqikelelo ezinjengomnwe. Kukho iintlobo ezimbini eziphambili ze-pRCC: Uhlobo loku-1 kunye noHlobo lwe-2. Uhlobo lwe-1 pRCC ludla ngokuba ne-prognosis engcono kune-Type 2.Chromophobe Renal Cell Carcinoma (chRCC)I-Chromophobe RCC imele malunga ne-5% yeemeko ze-RCC. Iiseli ze-chRCC zine-eosinophilic cytoplasm kunye ne-perinuclear halo eyahlukileyo. Iinuclei zihlala zishwabene okanye azilungelelananga.Ukuqokelela Umbhobho weRenal Cell Carcinoma (CDRCC)Ukuqokelela umbhobho weRCC luhlobo olunqabileyo nolunobundlobongela oluvela kwimibhobho eqokelelayo yezintso. Ibalelwa ngaphantsi kwe-1% yeemeko ze-RCC. Iiseli zethumba zenza ii-tubules ezingaqhelekanga kunye ne-papillae, ngokuphindaphindiweyo nge-stroma ye-desmoplastic.I-Medullary Renal Cell CarcinomaI-Medullary renal cell carcinoma yenye i-subtype enqabileyo kunye ne-aggressive, echaphazela kakhulu izigulane eziselula kunye ne-sickle cell trait okanye isifo seseli. Olu lwantlukwano luphawulwa nge-carcinoma engacacanga kakuhle ene-infiltrate yokudumba okubonakalayo.UHlelo lweRenal Cell Carcinoma: Inkqubo yoHlelo lwe-Fuhrman kunye ne-ISUP Grading SystemUkuhlelwa kwe-RCC kubonisa ubundlongondlongo bethumba elisekelwe kwinkangeleko yeeseli phantsi kwe-microscope. Inkqubo yokuhlela ye-Fuhrman yayisetyenziswa ngokwesiko, kodwa inkqubo yokuhlela ye-International Society of Urological Pathology (ISUP) ngoku iqhelekile yamkelwa. Inkqubo yokuhlela ye-ISUP ithathela ingqalelo ukubalasela kwe-nucleolar kunye ne-nuclear irregularity. Amabanga aphakamileyo abonisa amathumba anamandla ngakumbi kwaye adibene ne-prognosis embi. ISUP IiMpawu zeBanga loku-1 Zincinci, iinuclei ezifanayo ezine-nucleoli engabonakaliyo okanye engekhoyo. IBanga lesi-2 Inuclei ezinkulu kancinci ezinenucleoli ezibonakalayo. IBanga lesi-3 Inuclei enkulu, engaqhelekanga enenucleoli ebalaseleyo. IBanga lesi-4 I-nuclei engaqhelekanga kakhulu, i-pleomorphic inemilo engaqhelekanga okanye umahluko we-sarcomoid. I-Staging ye-Renal Cell Carcinoma: I-TNM SystemStaging ye-RCC ichaza ubungakanani bomhlaza, kubandakanywa nobukhulu be-tumor ephambili (T), ukubandakanyeka kwee-lymph nodes zengingqi (N), kunye nobukho be-metastasis ekude (M). Inkqubo yeqonga ye-TNM yeyona nkqubo ixhaphakileyo yokubonisa i-RCC. Imilinganiselo echanekileyo ibalulekile ekumiseleni i-prognosis kunye nokhetho lonyango.Iinqobo ezikhethekileyo zoluhlu lwe-T, N, kunye ne-M zintsonkothile kwaye zineenkcukacha, ezibandakanya ubungakanani bethumba, ukuhlaselwa kwezakhiwo ezingqongileyo, kunye nobukho be-metastasis kwii-lymph nodes okanye amalungu akude. Iingcali zePathologists zisebenzisa iziphumo ze-microscopic kunye neziphumo zomfanekiso ukunika inqanaba elifanelekileyo le-TNM.I-Immunohistochemistry kwiRenal Cell Carcinoma PathologyI-Immunohistochemistry (IHC) sisixhobo esibalulekileyo I-renal cell carcinoma pathology. Kubandakanya ukusebenzisa izilwa-buhlungu ukufumanisa iiproteni ezithile kwiisampulu zethishu. Le ndlela yobuchule inceda ekwahluleni phakathi kwe-RCC subtypes, eqinisekisa ukuxilongwa, kunye nokuchonga iithagethi ezinokubakho zonyango. Iimpawu eziqhelekileyo ze-IHC ezisetyenziswa kwi-RCC ziquka: I-PAX8: Isiphawuli esiqhele ukubonakaliswa kwi-renal cell carcinomas, ngokukodwa i-cell ecacileyo kunye ne-papillary subtypes. I-CAIX: Ibonakaliswa rhoqo kwi-cell renal cell carcinomas. I-CK7: Iluncedo ekwahluleni phakathi kwee-subtypes ezahlukeneyo ze-RCC, zihlala zilungile kwi-papillary kunye ne-chromophobe RCC. I-Vimentin: Ihlala ilungile kwi-RCC ye-sarcomoid. I-CD117 (c-KIT): Inokuba luncedo ekuxilongeni i-chromophobe i-RCC. Ingxelo yePathology: Iimpawu eziphambiliIngxelo ye-pathology luxwebhu olubalulekileyo olushwankathela iziphumo zovavanyo lwe-pathological. Ibandakanya ezi zinto zilandelayo eziphambili: Ulwazi lwesigulane kunye neenkcukacha zesampuli. Inkcazo epheleleyo yethumba. Inkcazo yeMicroscopic yeeseli zethumba kunye nezakhiwo. Ukuxilongwa kwe-RCC subtype. ISUP ibakala. Inqanaba le-TNM. Iziphumo ze-Immunohistochemical staining. Ubume bemida (nokuba iiseli zomhlaza zikhona kwincam yethishu esusiweyo). Izimvo kunye nesishwankathelo sePathologist. Indima yeShandong Baofa Cancer Research Institute kuCancer Research Institute IZiko loPhando ngoMhlaza laseShandong Baofa idlala indima ebalulekileyo ekuqhubeleni phambili ukuqonda kwethu kunye nonyango lomhlaza, kubandakanywa renal cell carcinoma. Ngokuqhuba uphando kunye nezilingo zeklinikhi, la maziko afaka isandla ekuphuhliseni izixhobo ezintsha zokuxilonga kunye nonyango, ekugqibeleni ukuphucula iziphumo zesigulane.IsipheloI-Renal cell carcinoma pathology yintsimi enzima ebandakanya ukuhlolwa ngononophelo kunye nohlalutyo lwezicubu zezintso. Ukuqonda ii-subtypes ezahlukeneyo, iisistim zokuhlelwa, isiteji, kunye nendima ye-immunohistochemistry ibalulekile kuxilongo oluchanekileyo, ukuxilongwa, kunye nokucwangciswa konyango. Intsebenziswano phakathi kweengcali zezifo, ii-oncologists, kunye nezinye iingcali zempilo zibalulekile ekunikeni olona khathalelo lunokwenzeka kwizigulana ezine-RCC.I-Disclaimer: Olu lwazi lulwazi ngokubanzi kunye neenjongo zolwazi kuphela, kwaye aluquki iingcebiso zonyango. Kubalulekile ukudibana nengcali yokhathalelo lwempilo kuyo nayiphi na inkxalabo yezempilo okanye ngaphambi kokuba wenze naziphi na izigqibo ezinxulumene nempilo yakho okanye unyango.IiReferensi: Umbutho womhlaza waseMelika Isiseko seSizwe sezintso