The Histological And Serological Studies On The Diagnosis And Prognosis Of Renal Cell Carcinoma

Part-IRelationship between infiltration of dendritic cells and prognosis or lymph nodes' metastasis in renal cell carcinomaObjectiveTo study the relationship between dendritic cells (DC) and prognosis or metastasis of the lymph nodes in renal cell carcinoma.MethodsThis study was based on tissues from 69 patients with renal cell carcinomas treated surgically from 1994 to 1999. All patients were followed up for over two years. The tumor tissues were stained by ABC immunohistochemical method with S-100 protein antibody and DC was counted.ResultsThe patients without recurrence in two years had significantly more numbers of S-100+DC than those recurred in two years (61.3+14.7/mm2 to 31.4+11.6/mm2). The number of S-100+DC of the group with lymph nodes metastasis was much lower than that of group without lymph nodes metastasis (28.8 + 10.4/mm2 vs 62.6+ 13.5/mm2).ConclusionThe DC infiltrating density is closely related to metastasis of renal cell carcinoma. The DC infiltrating density is a good indicator in assaying prognosis of RCC patients.Key words renal cell carcinoma(RCC);immunohistochemical(IHC);prognosis;dendritic cells(DC)Part-IIThe studies of tumor markers on renal cell carcinomaObjectiveTo assess the value of serum TPS,TPA,NSE,CA242 in the diagnosis of renal cell carcinoma,in early predicting resurrance of renal cell carcinoma,in monitoring and prognosis.MethodsThe levels of serum TPS,TPA,NSE,CA242 were determined with EL1SA and enzyme immunoassay semi-automaticly.Results(1) The diagnostic sensitivity of TPS to the renal cell carcinoma was 73.5%(61/83) while the diagnostic specificity was 72.0%(36/50).The positive rates of TPS in the group of patients with renal cell carcinoma in stage I and stage II was lower than that of group in stage III and IV (87.2% to 55.5%). And the positive rate of TPS of the patients who recurred in the next year was higher than that of the patients who did not recur (83.3% to 26.5%).(2) The diagnostic sensitivity of TPA to the renal cell carcinoma was 72.3%(60/83) while the diagnostic specificity was 66.0%(33/50).The positive rate of TPA in the group of patients with renal cell carcinoma in stage I and stage II was lower than that of group in stage III and IV (87.2% to 52.8%). And the positive rate of TPA of the patients who recurred in the next year was higher than that of the patients who did not recur (72.7% to 24.5%).(3) The diagnostic sensitivity of NSE to the renal cell carcinoma was 56.6%(47/83) while the diagnostic specificity was 92.0%(46/50).The positive rate of NSE in the group of patients with renal cell carcinoma in stage I and stage II was lower than that of group in stage III and IV (72.3% to 36.5%). And the positive rate of NSE of the patients who recurred in the next year was higher than that of the patients who did not recur (100.0% to 2.6%).(4) The diagnostic sensitivity of TPS+TPA to the renal cell carcinoma was 90.4%(75/83) while the diagnostic specificity was 52.0%(26/50).The positive rate of TPS+TPA in the group of patients with renal cell carcinoma in stage I and stage II was lower than that of group in stage III and IV (100.0% to 77.8%). And the positive rate of TPS+TPA of the patients who recurred in the next year was higher than that of the patients who did not recur (92.9% to 31.4%).(5) The diagnostic sensitivity of CA242 to the renal cell carcinoma was 36.8%(32/83) while the diagnostic specificity was 78.0%(39/50).Conclusion(1) TPS,TPA are good tumor marks to monitor the recurrance of the renal cell carcinoma for their high positive rates in the group of the patients who recurred in one year.And it is valuable to use TPS or TPA for the diagnosis of the renal cell carcinoma.(2) NSE has a high diagnostic specificity to the renal cell carcinoma and a better diagnostic sensitivity to the patients with advanced renal cell carcinoma. And it has a high positive rate in the group of the patients wrho recurred in one year. So it should be a g...