I-renal cell carcinoma pathology

I-Renal cell carcinoma pathology kuhlanganisa ukuhlolwa kwe-microscopic kanye nokuhlaziywa kwezicubu zezinso ukuze kuhlonzwe futhi kuhlukaniswe umdlavuza wezinso. Kuyisinyathelo esibalulekile ekunqumeni uhlobo, ibanga, kanye nesigaba somdlavuza, esazisa izinqumo zokwelashwa futhi sibikezele ukubikezelwa. Ukuqonda izici ze-pathological kubalulekile kokubili iziguli kanye nochwepheshe bezokwelapha. Lo mhlahlandlela unikeza ukubuka konke okuningiliziwe I-renal cell carcinoma pathology, okuhlanganisa izinhlobo ezincane ezivamile, izinhlelo zokugreda, isiteji, kanye nendima ye-immunohistochemistry.Understanding Renal Cell Carcinoma (RCC)I-Renal cell carcinoma (RCC) wuhlobo oluvame kakhulu lomdlavuza wezinso kubantu abadala, olubalela cishe amaphesenti angama-90 azo zonke izifo ezithinta izinso. Iphuma olwelweni lwe-proximal convoluted tubule, okungamashubhu amancane ezinso ahlunga igazi futhi akhiqize umchamo. Ukuxilongwa okunembile nokuhlukaniswa kwe-RCC kubaluleke kakhulu ekuqondiseni amasu okwelapha asebenzayo kanye nokubikezela imiphumela yesiguli.Izinhlobo Ezincane Ezivamile Ze-Renal Cell CarcinomaIzinhlobo ezincane ze-RCC ezikhona, ngayinye enezici ezihlukile zokugula, izici zofuzo, nokuziphatha komtholampilo. Lezi zinhlobo ezincane zingahlukaniswa ngaphansi kokuhlolwa kwe-microscopic futhi ziphinde ziqinisekiswe yi-immunohistochemistry. Izinhlobo ezincane ezinkulu zihlanganisa:I-Clear Cell Renal Cell Carcinoma (ccRCC)I-Clear cell RCC iwuhlobo oluncane oluvame kakhulu, olubalelwa cishe ku-70-80% wazo zonke izigameko ze-RCC. Ibonakala ngamaseli ane-cytoplasm ecacile noma ephaphathekile ngenxa yokuqukethwe okuphezulu kwe-glycogen ne-lipid. Lawa maseli avame ukwakha izidleke noma amashidi, futhi isimila ngokuvamile sine-vascularized kakhulu.I-Papillary Renal Cell Carcinoma (pRCC)Papillary RCC iwuhlobo oluncane lwesibili oluvame kakhulu, olwakha cishe u-10-15% wezigameko ze-RCC. Ibonakala ngokwakhiwa kwe-papillary, okusho ukuthi amaseli wesimila akhula ngendlela efana nomunwe. Kunezinhlobo ezimbili eziyinhloko ze-pRCC: Uhlobo 1 kanye Nohlobo 2. Uhlobo loku-1 lwe-pRCC ngokuvamile lunokubikezelwa okungcono kune-Type 2.Chromophobe Renal Cell Carcinoma (chRCC)I-Chromophobe RCC imele cishe u-5% wezigameko ze-RCC. Amaseli e-chRCC ane-eosinophilic cytoplasm ephaphathekile kanye ne-perinuclear halo ehlukile. Ama-nuclei avame ukushwabana noma angavamile.Ukuqoqa i-Duct Renal Cell Carcinoma (CDRCC)Ithunjana lokuqoqa i-RCC iwuhlobo oluncane oluyivelakancane olungavamile futhi olunolaka oluvela emiseleni eqoqayo yezinso. Ibala ngaphansi kuka-1% wamacala e-RCC. Amaseli wesimila enza amashubhu angavamile kanye nama-papillae, ngokuvamile ane-stroma ye-desmoplastic.I-Medullary Renal Cell CarcinomaI-Medullary renal cell carcinoma ingenye i-subtype engavamile futhi enolaka, ethinta ngokuyinhloko iziguli ezisencane ezinesici se-sickle cell noma isifo se-sickle cell. Lokhu okuhlukile kubonakala nge-carcinoma engahlukani kahle ene-infiltrate yokuvuvukala okuvelele.Ukugredwa Kwe-Renal Cell Carcinoma: I-Fuhrman Grading System kanye ne-ISUP Grading SystemUkuhlelwa kwe-RCC kubonisa ulaka lwesimila ngokusekelwe ekubukekeni kwamaseli ngaphansi kwesibonakhulu. Uhlelo lokugreda lwe-Fuhrman lwalusetshenziswa ngokwesiko, kodwa uhlelo lokugreda lwe-International Society of Urological Pathology (ISUP) manje seluvame ukwamukelwa. Isistimu yokugreda ye-ISUP ibheka ukugqama kwe-nucleolar nokungahambi kahle kwe-nuclear. Amabanga aphezulu akhombisa izimila ezinolaka futhi ahlotshaniswa ne-prognosis empofu. ISUP Grade Characteristics Grade 1 Small, nuclei iyunifomu enenucleoli engabonakali noma engekho. Ibanga lesi-2 Ama-nuclei amakhudlwana anenucleoli ebonakalayo. Ibanga lesi-3 Ama-nuclei amakhulu, angajwayelekile ane-nucleoli evelele. IBanga lesi-4 I-nuclei engavamile kakhulu, e-pleomorphic enobunjwa obuyinqaba noma umehluko we-sarcomatoid. Ukuma Kwe-Renal Cell Carcinoma: I-TNM SystemStaging ye-RCC ichaza izinga lomdlavuza, okuhlanganisa nosayizi wesimila esiyinhloko (T), ukubandakanyeka kwama-lymph nodes esifunda (N), kanye nokuba khona kwe-distasis metastasis (M). Uhlelo lwesiteji lwe-TNM luwuhlelo olusetshenziswa kakhulu ukwenza i-RCC. Izigaba ezinembile zibalulekile ekunqumeni ukubikezela kanye nezinketho zokwelapha.Imibandela eqondile yezigaba T, N, kanye ne-M iyinkimbinkimbi futhi inemininingwane eminingi, ehlanganisa usayizi wesimila, ukuhlasela kwezakhiwo ezizungezile, nokuba khona kwe-metastasis kuma-lymph node noma izitho ezikude. Izazi zezifo zisebenzisa okutholwe nge-microscopic kanye nemiphumela yokucabanga ukunikeza isigaba esifanele se-TNM.I-Immunohistochemistry ku-Renal Cell Carcinoma PathologyI-Immunohistochemistry (IHC) iyithuluzi elibalulekile I-renal cell carcinoma pathology. Kubandakanya ukusebenzisa amasosha omzimba ukuthola amaprotheni athile kumasampula ezicubu. Le nqubo isiza ekuhlukaniseni phakathi kwe-RCC subtypes, iqinisekise ukuxilongwa, kanye nokuhlonza okungase kube khona okuhloswe kokwelapha. Omaka be-IHC abavamile abasetshenziswa ku-RCC bahlanganisa: I-PAX8: Umaka ovame ukuvezwa ku-renal cell carcinomas, ikakhulukazi iseli ecacile ne-papillary subtypes. I-CAIX: Ivezwa kaningi kuma-cell renal cell carcinomas. I-CK7: Iwusizo ekuhlukaniseni phakathi kwezinhlobo ezincane ze-RCC ezihlukene, ngokuvamile ezinhle ku-papillary kanye ne-chromophobe RCC. I-Vimentin: Ivamise ukuba ne-sarcomatoid RCC. I-CD117 (c-KIT): Ingasiza ekuxilongeni i-chromophobe i-RCC.Umbiko We-Pathology: Izingxenye EzibalulekileUmbiko we-pathology uwumbhalo obalulekile ofingqa okutholwe ekuhlolweni kokugula. Kuhlanganisa izici ezibalulekile ezilandelayo: Ulwazi lwesiguli kanye nemininingwane yesifanekiso. Incazelo eyingqikithi yesimila. Incazelo ye-Microscopic yamaseli wesimila kanye nezakhiwo. Ukuxilongwa kwe-RCC subtype. Ibanga le-ISUP. Isiteji se-TNM. Imiphumela ye-Immunohistochemical staining. Isimo se-margins (ukuthi amangqamuzana omdlavuza akhona yini emaphethelweni ezicubu ezisusiwe). Amazwana nesifinyezo se-pathologist.Iqhaza le-Shandong Baofa Cancer Research Institute ocwaningweni lomdlavuzaIzinhlangano ezifana I-Shandong Baofa Cancer Research Institute idlala indima ebalulekile ekuthuthukiseni ukuqonda kwethu kanye nokwelapha umdlavuza, okuhlanganisa I-renal cell carcinoma. Ngokwenza ucwaningo nezivivinyo zemitholampilo, lezi zikhungo zifaka isandla ekwakhiweni kwamathuluzi amasha okuxilonga kanye nezindlela zokwelapha, ekugcineni zithuthukise imiphumela yesiguli.IsiphethoI-Renal cell carcinoma pathology iwumkhakha oyinkimbinkimbi ohilela ukuhlolwa ngokucophelela nokuhlaziywa kwezicubu zezinso. Ukuqonda ama-subtypes ahlukene, amasistimu wokugreda, isiteji, kanye nendima ye-immunohistochemistry kubalulekile ekuxilongweni okunembile, ukubikezela, nokuhlela ukwelashwa. Ukusebenzisana phakathi kodokotela bezifo, odokotela be-oncologists, nabanye ochwepheshe bezempilo kubalulekile ekuhlinzekeni ukunakekelwa okungcono kakhulu kweziguli ezine-RCC.Umshwana wokuzihlangula: Lolu lwazi ololwazi olujwayelekile kanye nezinjongo zolwazi kuphela, futhi aluhlanganisi iseluleko sezokwelapha. Kubalulekile ukubonisana nochwepheshe bezempilo abaqeqeshiwe nganoma yikuphi ukukhathazeka ngezempilo noma ngaphambi kokwenza noma yiziphi izinqumo ezihlobene nempilo noma ukwelashwa kwakho.Izithenjwa: I-American Cancer Society I-National Kidney Foundation