肿瘤预防与治疗2025，Vol.38Issue(6)：510-515,6.DOI:10.3969/j.issn.1674-0904.2025.06.008
2例核极向反转的乳头状肾肿瘤临床病理特征暨文献复习
Clinicopathological Characteristics and Literature Review of Papillary Re-nal Neoplasm with Reverse Polarity:A Report of 2 Cases
摘要
Abstract
Objective:To investigate the clinical and pathological characteristics,diagnosis and differential diagnosis of papillary renal neoplasm with reverse polarity(PRNRP).Methods:We retrospectively analyzed the clinicopathological fea-tures,immunophenotype and genetic analysis results of two cases of PRNRP,and reviewed the related literatures.Results:The two patients which we report were female,aged 46 and 66 years,respectively.Case one had a history of rectal cancer.The tumor was solid and cystic,and its maximum diameter is 2.1 cm and 1.3 cm respectively.Microscopically,the tumor cells were arranged in tubules and papillaes.The tumor was composed predominantly of thin,branching papillary architec-ture covered by a single layer of cuboidal cells with finely granular cytoplasm,and low-grade nuclei(World Health Organization/International Society of Urologic Pathologists grade 1)typically located toward the apical surface away from the basement.Immunohistochemically,tumor cells were diffusely posi-tive for GATA3,CK7,PAX-8 and EMA,partially positive for E-cadherin,P504S and CD10,and negative for CD117 and Vi-mentin.The Ki-67 proliferation index was 1％ and 2％,respectively.KRAS gene mutation was detected in both cases,and the same KRAS mutation was found in rectal cancer tissue of case 1.Both patients underwent partial nephrectomy.There was no recurrence and metastasis after follow-up for 26 months and 32 months.PRNRP is relatively inert,with a higher incidence in males and characteristic KRAS gene mutation.The tumor cells express GATA3 and CK7 diffusely.It's mostly solitary,and some may be combined with other tumors.Conclusion:PRNRP is very rare and has unique clinicopathologic features,im-munophenotypes and molecular genetic changes.It should be differentiated from other renal tumors.The patient has a good prognosis after tumor complete resection.关键词
乳头状/肾细胞癌/极向反转/GATA3/KRASKey words
Papillary/Renal cell carcinoma/Polar reversal/GATA3/KRAS分类
医药卫生引用本文复制引用
戴桂红,王伟霞,朱婷,靖红艳,刘静..2例核极向反转的乳头状肾肿瘤临床病理特征暨文献复习[J].肿瘤预防与治疗,2025,38(6):510-515,6.基金项目
This study was supported by grants from Qingpu Health Commission of Shanghai(No.XD2023-20). 上海市青浦区卫生健康系统第五轮学科建设和人才培养项目(编号:XD2023-20) （No.XD2023-20）
