RENAL CELL CARCINOMA
Pathology(1)
Classification of Renal Cell Carcinoma
Subtype
incidence Genetic Alteration
Clinical Features
Conventional 70-80% Loss of VHL gene
RENAL CELL CARCINOMA
Clinical Presentation 1.An increasing number of renal cell tumors are found as incidental asymptomatic masses on imaging studies obtained for another purpose. 2."Classic triad." Only 11 percent of RCC patients present with hematuria, flank pain, and a palpable mass.
3. Most cases are sporadic but it is also seen in families with von Hippel-Lindau disease (VHL) and less commonly with the tuberous sclerosis complex (TSC).
Garden-variety RCC
Deletion of Chromosome 3 Hypervascular
Papillary 10-15% Activation of MET
Increased incidence
Proto-oncogene
multicentricity
Trisomy chromosomes Often hypovascular
7 and 17
Chromophobic 4-5% Not defined
Not def<1% Not defined
Poor prognosis
Medullary cell <1% Not defined
Poor prognosis
Oncocytoma 3-7% Loss of chromosomes Benign
StageⅠTumor is confined to the kidney; perinephric fat, renal
vein, and regional nodes show no evidence of malignancy.
Stage II Tumor involves the perinephric fat but is confined
TUMORS OF GENITOURINARY TRACT
黄翼然
Deportment of Urology, Renji Hospital, Shanghai Jiao Tong University Medical School
RENAL CELL CARCINOMA
1.Incidence of RCC is increased. 2.The initial diagnosis is most commonly made during an ultrasound or CT scan performed for other reasons. 3.RCC is resistent to chemotherapy and radiotherapy 3.RCC is the model of target treatment.
1 and Y
肾癌的病理亚型
上海交通大学医学院附属仁济医院 泌尿科
RENAL CELL CARCINOMA
ppaatthhoollooggyy((22))
Robson Staging System for Renal Cell Carcinoma
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within's Gerota's fascia; renal vein and regional nodes show no evidence of malignancy.
Stage Ⅲ Tumor involves renal vein or regional nodes, with or
without involvement of the vena cava or perinephric fat.
Stage IV Distant metastases secondary to RCC are evident on
presentation or there is histologic involvement of contiguous
Visceral
Structures
by
tumor.
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遗传性VHL病肾癌
－－一个中国VHL大家系的研究
上海交通大学医学院附属仁济医院 泌尿科
RENAL CELL CARCINOMA
Etiology
smoking , Phencetin-containing painkillers abused or over-used, some heavy metals exposure ( lead and cadmium). Other risk factors include long-term dialysis, overweight, a high fat diet.
RENAL CELL CARCINOMA
Epidemiology 1. Male-to-female ratio is roughly 2:1. 2. The majority of patients present in the fifth to seventh decades of life.