Preliminary Study On The Clinical Diagnosis And Prognosis Of Renal Mucinous Tubular And Spindle Cell Carcipoma

Objective:This study explores diagnosis,clinical manifestation and prognosis of mucinous tubular and spindle cell carcinoma(MTSCC)in the anticipation to improve recognition of this disease.Method:Fourteen patients who were diagnosed with kidney MTSCC through postoperative pathology were divided into A and B group in line wit degree of tumor invasion.General materials,imaging representation,features of microscopic appearance,inmmunohistochemistry(expression of E-cadherin and Vimentin)and prognosis in two groups were compared and analyzed in conjunction with TNM clinical stages and latest standards for classifications in the 2016 version WHO renal cell carcinoma.Chi square test and t test were selected for statistical analysis.Difference of P<0.05 was of statistical significance.Results:Among the 14 kidney MTSCC patients,there were eight females and six males.11 patients were occasionally discovered by physical checkup,two visited hospital due to soreness of waist and discomfort and one due to continuous fever.Imaging examinations all indicated that 14 kidney MTSCC were hypovascular tumor without obvious difference.Plain CT scan value of kidney MTSCC was 16～38 HU,being 30.7±6.4 HU in average.CT value of normal renal cortex was 26～33 HU,being 30.2±5.6 HU in average.Comparison difference of the two was of no statistical significance(P>0.05).Lesions during cortical phase was slightly intensified and the enhanced CT value was 2～19 HU,being 9.4±5.5 HU in average.Lesions in corticomedullary phase and lag phase was represented by continued gradual enhancement and the improved CT value was 8.4～46.6 HU and 9～52.8 HU respectively,being 26.2±11.8 HU and 33.5±12.6 HU in average.In line with invasion degree,the fourteen patients were divided into A and B group.General materials of patients in the two groups were of no statistical significance(P>0.05).Microscopy in group A showed that the tumor cells were mild in morphology without obvious nucleolus and rare or seldom mitotic figures.Microscopy in group B indicated obvious atypia of tumor cells and visible nucleolus and mitotic figure.For immunollistochemistry(EnVision method),① for E-cadherin in group A,ten were positively expressed and one was negatively expressed.In group B,none was positively expressed and three were negatively expressed.② for Vimentin,nine were positively expressed and 2 negatively expressed in group A.Three were positively expressed and none negatively expressed in group B.The results showed that expression results of E-cadherin in two groups were of statistical difference(P<0.05)while that of Vimentin was of no statistical difference(P>0.05)Conclusion:1.The majority of MTSCC are low potential malignant but there are also ones of high potential malignancy,which required distinction.2.Negative expression of E-cadherin is closely related to WHO/ISUP classification of kidney MTSCC.patients which is certain of clinical application value to patients’ prognosis Up-regulated expression of Vimentin has no correlation to TNM stages and WHO/ISUP classification of kidney MTSCC patients.