Renal Histologic Parameters Influencing Postoperative Renal Function in Renal Cell
고명주, 임범진, 최규헌, 김연희, 정현주,
소속 상세정보
고명주 ( Koh Myoung-Ju )
Yonsei University College of Medicine Department of Pathology
임범진 ( Lim Beom-Jin )
Yonsei University College of Medicine Department of Pathology
최규헌 ( Choi Kyu-Hun )
Yonsei University College of Medicine Department of Internal Medicine
김연희 ( Kim Yon-Hee )
Yonsei University College of Medicine Department of Pathology
정현주 ( Jeong Hyeon-Joo )
Yonsei University College of Medicine Department of Pathology
KMID : 0357920130470060557
Abstract
Background: Pre-existing non-neoplastic renal diseases or lesions may influence patient renal function after tumor removal. However, its description is often neglected or omitted in pathologic reports. To determine the incidence and clinical significance of non-neoplastic lesions, we retrospectively examined renal tissues obtained during 85 radical nephrectomies for renal cell carcinoma.
Methods: One paraffin-embedded tissue block from each case containing a sufficient amount of non-tumorous renal parenchyma was cut and processed with hematoxylin and eosin and periodic acid-Schiff methods. Non-neoplastic lesions of each histological compartment were semi-quantitatively and quantitatively evaluated.
Results: Among the various histologic lesions found, tubular atrophy, arterial intimal thickening, and glomerulosclerosis were the most common (94.1%, 91.8%, and 88.2%, respectively). Glomerulosclerosis correlated with estimated glomerular filtration rate at the time of surgery, as well as at 1- and 5-years post-surgery (p=.0071), but tubulointerstitial fibrosis or arterial fibrous intimal thickening did not. Post-hoc analysis revealed that glomerulosclerosis of more than 20% predicted post-operative renal function. However, its significance disappeared when gender and age were considered.
Conclusions: In conclusion, non-neoplastic lesions, especially with regard to glomerulosclerosis percentage, should be described in pathology reports to provide additional information on renal function decline.
키워드
Nephrectomy; Carcinoma; renal cell; Glomerular filtration rate; Histology
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