[Study of satellite tumor lesions and nucleolar organizer regions in renal cell carcinoma--concerning the propriety of nephron sparing surgery].
OBJECTIVE
To study whether nephron sparing surgery is suitable or not for the operation for renal cell carcinoma (RCC) by examining the style of the existence and proliferative potential of satellite tumor lesions (STL).


METHODS
We made whole area histological sections on 58 cases of RCC and investigated histological behavior and proliferative potential of RCC using H & E staining and silver staining for Argyrophilic Nucleolar Organizer Regions (AgNORs) of following lesions: main tumors, STL, adenomas (AD), and dysplastic foci (DF) in which the latter two are supposed to be preneoplastic lesions.


RESULTS
In 58 cases, STL were observed in 27 cases (46.6%) and either AD or DF was noted in 19 cases (32.8%). Thus, either of above lesions including STL, AD and DF was found in 37 cases (63.8%). The frequency of STL had no relationship with main tumor size, but tended to be higher in high grade and/or high stage cases. STL were located more than 2 cm away from the margin of main tumors in 6 (22%) of 27 cases with STL. The numbers of AgNORs in each high power field were 5.09 +/- 1.53 (mean +/- SD) in main tumors, 4.24 +/- 1.36 in STL, and 2.27 +/- 0.07 in AD and DF, respectively.


CONCLUSIONS
These results suggest that STL are composed of cells with accelerated proliferative potential, and that nephron-sparing surgery had the risk of remaining STL. Therefore, further studies are needed to elucidate whether STL have any relation to local recurrence after nephron-sparing surgery.
Department of Urology, Jichi Medical School.
M
M
Kobayashi
D000236:Adenoma / Q000473:pathology; D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery; D000075202:Contraindications; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009697:Nucleolus Organizer Region / Q000473:pathology*; D016622:Silver Staining